STRESS IN STUDENTS: A CASE STUDY OF THE UNDERGRADUATE NURSING STUDENTS OF THE UNIVERSITY OF BUEA

Abstract

Background: students face different types of stress during their studies. Stress refers to a reaction to any challenging event that requires an individual to react or adapt through physical, emotional, mental, and psychological responses.

Stress is a psychological factor that influences the academic performance and welfare of nursing students. There has been increased attention in the literature about stress among nursing students. It has been evident that they experience a lot of stress during their training.

Objective: the aim of this study was to assess the level of stress, the common sources of stress and the coping strategies used by undergraduate nursing students in their academics.

Methodology: a quantitative descriptive study was used on a sample of 142 undergraduate nursing students selected purposively in the Faculty of Health Sciences of the University of Buea in the respective classes. Data was collected using a structured questionnaire and analysed using SPSS version 20.0. The significance level was set at p<0.05 for all statistical test

Results: a sample size of 142 nursing students was obtained (121), 85.2% females and (21) 14.8% males. They perceive moderate stress and the three main stressors identified include (105), 73.9% of the students were worried about bad grades, (95), 66.9% reported the fear of making a mistake in the care of a patient and (100), 70.0% had inadequate finances. (48), 33.8% reported sleep and rest as the most frequently used coping strategy whereas (10),7.0 reported isolation as a coping strategy which is considered to be maladaptive.

Conclusion: As a result of this study, it was determined that the level of stress among undergraduate nursing students of the University of Buea is moderate.

The most common sources of stress identified among these students were worried about bad grades, fear of making a mistake in caring for a patient, and inadequate finances. The coping strategies they used were sleep and rest, prayers, and talking to someone.

CHAPTER ONE

INTRODUCTION

1.1 Background

The term stress was first used back in the 17th century as to describe the “sorrow, suppression, discomfort and adversity”. In the 19th century, the term was reformed and among others, had the meaning of a strong influence exerted on a physical object or on a person.

Stress can also be defined either as a reaction or as a stimulus. As a reaction, the meaning of stress is consubstantial with specific changes that a human biological system is experiencing.

As stimulus, the definition of stress is related to environmental events that causes those changes [1]. Each person’s definition and thinking about the term stress is uniquely personal. The earlier researchers defined stress as follows:

Selye defined stress as “any external event or any internal drive which threatens to upset the organism’s equilibrium”. Stress is a condition or feeling experienced when a person perceives that demands exceed the personal and social resources the individual is able to mobilize.

According to Lazarus and Folkman, stress is a mental or physical phenomenon formed through one’s cognitive appraisal of the stimulation and is a result of one’s interaction with the environment [2].

Levi in his research concluded that, “ stress is caused by a multitude of demands (stressors) such as inadequate fit between what we need and what we are capable of, and what our environment offers and what it demands of us”[3].

Stress maybe either external with environmental source, or caused by internal perceptions of the individual.

The latter form, in turn can produce anxiety, and/ or other negative emotions and feelings such as pain, sadness, worry and depression and results in serious psychological disorders such as post-traumatic stress disorder [4].Stress also has both beneficial and harmful impacts on individuals. As a beneficial impact, stress is able to force us towards achievement. This impact is called “eustress” which means positive stress.

As a harmful impact, literature reveals that stress has negative effects that might be classified into three groups: physical manifestations, such as headache and infections; psychological manifestations such as anger, low self-respect and anxiety; and behavioural manifestations, such as weight loss, smoking and drinking.

The concept of stress is significant because it provides a way of understanding the person as a whole in various aspects of life [1].

There are many sources of stress among students, which can be related to worry about success, availability of time, academic workload, many assignments and exposure to new settings. The rate and level of stress is an alarm among students in different academic fields [5].

The capability of the individuals to adapt and the availability of helpful resources are important to overcome stressful situations [6]. Coping has been described as any cognitive and or behavioural efforts to manage, minimize or tolerate events that individuals perceive as potentially threatening to their well-being.

It does not imply success in dealing with situations, the responses to stressors can also be maladaptive. The two forms of coping are problem focused and emotion focused coping strategies.

Problem focused coping strategies are problem solving tactics which encompasses efforts to define the problem, generate alternative solutions, weigh the cost and benefits of various actions, take actions to change what is modifiable and if necessary learn new skills.

Emotional focused coping strategies are directed towards decreasing emotional distress. These tactics include efforts like distancing, avoiding, selective attention, blaming, and seeking social support. Emotion-focused coping is the most common form of coping used when events are not changeable [1].

Students stress in their academic and clinical practice can be altered and influenced by the  coping strategies they choose to employ. Effective coping strategies help students to perform markedly better in their studies.

Coping strategies also aid in relieving students’ stress. It was observed that the best and most useful coping strategies are problem solving, transference and unrelenting optimism [7].

Some students can’t cope with their stressors because they don’t have the suitable study plan. In general, students cannot eradicate the stress but they can reduce it, so coping is an element that helps in preserving their psycho-social lives. Many studies found that nursing students have high level of stress compared to other students [6].

Stress in nursing education is acknowledged as one of the most important issues in the modern world. During nursing education and training, nursing students are frequently exposed to various stressors which may directly or indirectly impede their learning and performance [8].

1.2. Problem Statement

Psychological distress among nursing students is a global concern which involves both mental health and emotional well-being. Nursing students are frequently exposed to various stressors, which may affect their learning performance [9].

Nursing students find themselves constantly shuffling their schedule due to clinical practice rotations, night shifts and heavy workload during their studies which exposes them to great levels of prolonged stress making them vulnerable to depression. There is an acute shortage of nurses in Cameroon with nurses’ density of 0.67 per 1000.

With such a workload awaiting nursing students who are highly exhausted, it is necessary for early identification of the sources of stress which will minimize burnout among these students as it is known to reduce optimal health care delivery. Identifying and reinforcing adaptive coping strategies will also go a long way to improve on practice after completing the course [10].

1.3. Research Questions

1. What is the level of stress among nursing students?
2. What are the sources of stress among nursing students?
3. What are the coping strategies undergraduate nursing students use to adapt to stress?
4. 4. Research Aim

The aim of the study is to identify the prevalence of stress, common sources of stress and coping responses to stress among undergraduate nursing students of the University of Buea.

1.5. Research Objectives

1. To determine the level of stress in nursing students.
2. To identify the sources of stress in nursing students.
3. To assess the coping strategies used by nursing students to overcome stress.