For many nursing students, clinical training represents a stressful experience. The levels of stress and anxiety may vary during students’ educational training, depending on their ability to adopt behavioral strategies for coping with stress, and other factors. This study aimed to investigate the relationship between anxiety, perceived stress, and the coping strategies used by nursing students during their clinical training. A cross-sectional correlational descriptive study. The sample consisted of 190 nursing students enrolled in the Nursing Faculty of Ciudad Real University in Spain. Participants provided data on background characteristics and completed the following instruments: the Perceived Stress Scale; the State-Trait Anxiety Inventory and the Coping Behavior Inventory. Relationships between scores were examined using Spearman’s rho. The mean age of participants was 20.71 ± 3.89 years (range 18–46 years). Approximately half of the students (47.92%) indicated a moderate level of stress with a mean Perceived Stress Scale score of 22.78 (±8.54). Senior nursing students perceived higher levels of stress than novice students. The results showed a significant correlation for perceived stress and state anxiety (r = 0.463, p < .000) and also for trait anxiety (r = 0.718, p < .000). There was also a significant relationship between the total amount of perceived stress and the following domains of the coping behavior inventory: problem solving (r = −.452, p < .01), self-criticism (r = .408 p < .01), wishful thinking (r = .459, p < .01), social support(r = −.220, p < .01), cognitive restructuring (r = −.375, p < .01), and social withdrawal (r = .388, p < .01). In the current study, the coping strategy most frequently used by students was problem-solving, followed by social support and cognitive restructuring. Nursing students in our study presented a moderate level of stress, in addition there was a significant correlation with anxiety. Nursing teachers and clinical preceptors/mentors should be encouraged to develop programs to help prepare nursing students to cope with the challenges they are about to face during their clinical placements.

/pdf/anxiety-perceived-stress-and-coping-strategies-in-nursing-4yqbd76jrm.pdf

Anxiety, perceived stress and coping strategies in nursing students: a cross-sectional, correlational, descriptive study

Stressors and coping of nursing students in clinical placement: A qualitative study contextualizing their resilience and burnout

Background The COVID-19 pandemic has forced universities all over the world to transition to distance learning. The aim of this study was to examine the stress levels, stressors, and associated sociodemographic variables among undergraduate nursing students as a result of the transition to distance learning amid COVID-19. Method This study used a mixed-methods embedded design. A total of 355 nursing students were recruited. The Higher Education Stress Inventory was used to assess stress levels, and an open-ended question was used to examine the sources of stress. Descriptive statistics and one-way ANOVA tests were used for data analysis. Results Statistically significant differences in stress levels were found based on some of the sociodemographic characteristics of the students. Four themes representing the stressors related to distance learning emerged from the qualitative data. Conclusion Distance learning-related stress and stressors among nursing students were found to vary based on students' sociodemographic characteristics. [J Nurs Educ. 2020;59(12):666-674.].

Distance Learning-Related Stress Among Undergraduate Nursing Students During the COVID-19 Pandemic.

In clinical environments, nursing students experience a range of stressors that can affect their health, learning, and quality of patient care. This study aimed to develop a Nursing Students’ Perceptions of Clinical Stressors Scale (NSPCSS) and to evaluate its psychometric properties. This exploratory, sequential mixed-method study was conducted in 2 phases. In the qualitative (item generation) phase, NSPCSS items were generated using the data collected from semi-structured interviews and a literature review. In the quantitative (psychometric evaluation) phase, face, content, construct, convergent, and discriminant validity and reliability of the scale were tested. To evaluate construct validity, exploratory and confirmatory factor analyses were performed on the data collected from 430 nursing students. Reliability was also assessed through internal consistency and composite reliability. In this study, 6 factors were extracted from 30 itemes through exploratory factor analysis: (1) instructor’s limited competence in clinical environments, (2) inappropriate clinical environment, (3) inadequate knowledge and skills, (4) inefficient education in clinical planning, (5) instructor’s inappropriate conduct, and (6) concerns about the characteristics of nursing career. These factors accounted for 58.8% of the total variance. The results of the confirmatory factor analysis suggested the goodness-of-fit indices was acceptable. Furthermore, the internal consistency and composite reliability indices of all factors were greater than 0.7. The NSPCSS is a valid and reliable instrument for assessing clinical stressors among nursing students.

/pdf/development-and-psychometric-testing-of-nursing-students-a1pmux8bxx.pdf

Development and psychometric testing of nursing students’ perceptions of clinical stressors scale: an instrument design study

Purpose – This paper aims to provide systemic understanding with regard to the adoption of computer mediated communication (CMC) technology and its impact on technostress levels.Design/methodology/approach – Based on the theoretical lens rooted in the psychology literature and emerging problems observed through engagement with organizations in their field research, the authors propose a conceptual model that articulates technology characteristics in telemedicine communication. The model defines both the antecedents and outcomes of technostress, emphasizing investigation of the underlying mechanisms of the overall process in regard to fit between users and adopted technologies.Findings – In order to understand the impact of technostress on telemedicine users, it is necessary to investigate the “black box” of how technology influences stressors. According to the theoretical lens of person‐environment (P‐E) theory, stress occurs when there is a misfit between individuals’ characteristics and environmental se...

A conceptual model of technology features and technostress in telemedicine communication

Nursing students' stress and satisfaction in clinical practice along different stages: A cross-sectional study

The aim of this study was to develop and implement a tool for measuring the role stress of charge nurses. Tools are lacking regarding measurement of nursing role stressors, particularly for charge nurses. Based on focus groups and in-depth interviews with charge nurses within a large tertiary hospital, a charge nurse stress questionnaire was developed which measures six factors of stress: authority-responsibility conflict, patient-nurse interaction, deficient resources, managerial decision making, role conflict, and overload. The prominent stressors on charge nurses were specific to the role. Mean levels of stress were significantly higher for nurses who attended post-graduate clinical courses than for those who did not. The mean level of stress was higher for department nurse managers than for nurses without a managerial position. This tool was designed to measure charge nurse stress demonstrates reliability, and highlights the specific stressors demanded by the role. Preparation and ongoing support for fulfilling this position are recommended.

Stress among charge nurses: tool development and stress measurement.

yagil d., luria g., admi h., moshe-eilon y. & linn s. (2010) Parents, spouses, and children of hospitalized patients: evaluation of nursing care. Journal of Advanced Nursing 66(8), 1793–1801.

Abstract
Title. Parents, spouses, and children of hospitalized patients: evaluation of nursing care.

Aim.  This paper is a report of a study of the effect of kinship type and gender on family members’ evaluation of nursing care for patients and their families in hospital units.

Background.  With increasing competition in the healthcare system, hospitals attribute great importance to client satisfaction, which is strongly related to the quality of nursing care. However, to date there has been little research into family members’ evaluation of nursing care.

Methods.  Questionnaires were administered to spouses, parents and children (n = 441) of hospitalized patients in three Israeli hospitals during 2007–2008.

Results.  Kinship type interacted with gender in affecting family members’ evaluation of the quality of nursing care. Among men, husbands were the most satisfied with nursing behaviour, treatment of the patients, and the information they receive. Fathers were the least satisfied. Overall family evaluation of the service was predicted by their evaluation of caring, treatment, and the patient’s environment; departmental reputation was predicted by evaluation of treatment.

Conclusion.  Nurses should be trained to develop sensitivity to the diverse expectations and needs of relatives, as well as awareness of how their own preconceptions affect their behaviour toward patients’ families. Nurses should develop self-awareness of possible stereotypes and prejudices that may bias their behaviour towards family members. Reactions of family members should also be included in surveys of client satisfaction with nursing care.

Parents, spouses, and children of hospitalized patients: evaluation of nursing care

Negative attitudes of health care workers (HCW) toward people living with HIV (PLWH) impact patients' care, quality-of-life, therapy adherence, and retention in care. Few publications address stigma and discrimination among HCWs in high income countries. This study aims to provide a better understanding of HCW knowledge and attitudes toward caring for PLWH, how this relates to discriminatory tendencies and professional contacts, and proposes effective strategies to reduce negative attitudes and stigmas among health care providers in a tertiary hospital in Israel. Of 321 health care personnel who responded to an electronic questionnaire, HCWs had a good level of general knowledge regarding HIV. A lack of knowledge was noted regarding antiretroviral therapy influences, HIV transmission from mother to child, and HIV risks and transmission. Cultural diversity was also noted. This study supports the need to implement a training program for HCWs on HIV-related stigma-reduction.

Medical personnel knowledge and stigmatic attitude toward HIV patients in a high-income country

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Nursing students' stress and satisfaction in clinical practice along different stages: A cross-sectional study

Stress among charge nurses: tool development and stress measurement.

Parents, spouses, and children of hospitalized patients: evaluation of nursing care

Medical personnel knowledge and stigmatic attitude toward HIV patients in a high-income country