Query: Stress and health in nursing students

title: Stress and Health in Nursing Students: The Nurse Engagement and Wellness Study.
abstract: Evidence suggests that behavioral, social, and environmental factors may modify the effects of life stress on health and performance of new nurses as they transition to hospitals.  The aim of this study was to describe the methods of a project designed to investigate the role of social, behavioral, and environmental factors in modifying the adverse effects of stress on new nurses and to discuss demographic, health, and life stress characteristics of the cohort at baseline.  A prospective cohort design was used to conduct a comprehensive assessment of health endpoints, life stress, behaviors, personal traits, social factors, indicators of engagement and performance, and environmental exposures in nursing students. Adjusted odds ratios and analyses of covariance were used to examine associations between these factors at baseline.  Health indicators in the cohort were comparable or better than in the broader United States population, and lifetime stress exposure was lower than among students from other majors. Exposure to more lifetime stressors was associated with greater risk for various health conditions, including hypertension, diabetes, and depression. Conversely, better social, environmental, behavioral, and personal profiles were associated with protective effects for the same health conditions.  These data comprehensively summarize the lives of predominately Hispanic nursing students and highlight risk and resilience factors associated with their health and well being. The findings are timely, as the nursing field diversifies in preparation to care for a diverse and aging population. Comprehensively assessing stress health relationships among student nurses ought to inform the policies, practices, and curricula of nursing schools to better prepare nurses to thrive in the often strenuous healthcare environment.

title: Stress and Health in Nursing Students: The Nurse Engagement and Wellness Study.
abstract: Evidence suggests that behavioral, social, and environmental factors may modify the effects of life stress on health and performance of new nurses as they transition to hospitals.  To describe the methods of a study designed to investigate the role of social, behavioral, and environmental factors in modifying the adverse effects of stress on new nurses and discuss demographic, health, and life stress characteristics of the cohort at baseline.  A prospective cohort design was used to conduct a comprehensive assessment of health endpoints, life stress, behaviors, personal traits, social factors, indicators of engagement and performance, and environmental exposures in nursing students. Adjusted odds ratios and analyses of covariance were used to examine associations between these factors at baseline.  Health indicators in the cohort were comparable or better than in the U.S. and lifetime stress exposure was lower than among students from other majors. Exposure to more lifetime stressors was associated with greater risk for various health conditions, including hypertension, diabetes, and depression. Conversely, better social, environmental, behavioral, and personal profiles were associated with protective effects for the same health conditions.  These data comprehensively summarize the lives of predominately Hispanic nursing students and highlight risk and resilience factors associated with their health and wellbeing. The findings are timely, as the nursing field diversifies in preparation to care for a diverse and aging population. Comprehensively assessing stress health relationships among student nurses ought to inform the policies, practices, and curricula of nursing schools to better prepare nurses to thrive in the often strenuous healthcare environment.

title: The Relations among the Emotional Intelligence Levels, the Ways of Coping with Stress and the Informational Literacy of the Health College Nursing Students
abstract: Study was conducted with the aim of detecting the correlation between the emotional intelligence levels, styles of coping with stress and information literacy of nursing students.  The data in this study were collected via a"Personal Information Form" prepared by the reserachers themselves, a Emotional Intelligence Evaluation Form (EIEF) Scale of Stress Coping Styles (SSCS) and a Information Literacy Scale. The population of the study consists of all the students of 3rd and 4th grades in nursing department of a Faculty Of Health Sciences (N=419) and the sample included voluntary students present at school at the time of data collection (n=212) It was found out that emotional intelligence levels of the students were of normal level as total scale score averages; were they used self confident approach and helplessness approach most in coping with stress; their information literacy levels were found below average as total score average was. There was a statistically significant, positive but a poor level of correlation between the average total score of EIEF and average scores from the subscale of "self confident approach" in SSCS.  It was determined that as the level of emotional intelligence increased, the students got a higher level of self confidence and better skills of identifying the need for information.

title: Stress and health in novice and experienced nursing students.
abstract: This paper is a report of a study conducted to identify the differences in novice and experienced nursing students' reports of stress and health.  Stress from clinical practice and its impact are international yet culturally mediated phenomena. Nursing students are under considerable stress during clinical practice periods, putting their education and health at risk. However, there is little or no empirical evidence about the stress suffered by nursing students and its impact on their health throughout clinical practice.  We performed cross sectional research using standard information gathering tools. This study was carried out with 357 students from all 3 years of a nursing diploma programme at a Spanish nursing college (71% response rate) The data were collected over an 8 month period in 2004 2005.  We identified three types of stressors (clinical, academic and external) and two categories of symptoms (physiological and psychological) linked to clinical practice. Factor analysis identified six major sources of stress and six important symptoms. Students perceived clinical stressors more intensely than academic and external stressors, and showed psychological symptoms more frequently than physiological symptoms. Nursing students from all 3 years perceived moderate stress at similar levels. Experienced students perceived more academic stressors than novices. Although the students were healthy, second year students were the most vulnerable to somatic and psychic anxiety, and common symptoms.  We suggest informing students about possible stressors associated with their profession, and introducing interventions to support development of professionalism, social skills and coping capacity for clinical practice.

title: The relationship between educational stress, stress coping, self esteem, social support, and health status among nursing students in Turkey: A structural equation modeling approach.
abstract: Nursing education can be a stressful experience. To fully benefit from this experience and develop a positive professional identity, it is essential for nursing students to effectively cope with education related stress.  The aim of the study was to investigate the relationships between nursing students' education related stress and stress coping, self esteem, social support, and health status.  This study utilized a cross sectional, descriptive, and correlational design. The sample consisted 517 nursing students from a bachelor program in Turkey during the 2014 2015 academic year. Participants provided data on sociodemographic characteristics as well as completing the following instruments: Nursing Education Stress Scale, Coping Behavior Inventory for Nursing Students, Multidimensional Scale of Perceived Social Support, Rosenberg Self Esteem Scale, and General Health Questionnaire. Relationships were examined using multivariate structural equation modeling.  Results indicated that nursing students' stress coping levels were affected by self esteem and social support. Additionally, this interaction appears to affect general health status. Although the direct effect of stress on coping was non significant, its overall effect was significant within the model.  It is necessary to conduct further intervention studies examining the role of self esteem and social support in facilitating nursing students' stress related coping during their education.

title: Relationship of Academic Stress, Ego resilience and Health Promoting Behaviors in Nursing Students
abstract: This study was conducted to investigate the levels of academic stress, ego resilience, and health promoting behaviors of nursing students, and to examine the relationship between these variables. The participants were 208 nursing students(freshman/sophomore) Data were collected from April 3 to April 21, 2017 by self administered questionnaires. Data were analyzed using the SPSS WIN 19.0 program(SPSS Inc. Chicago, IL, USA) The results of this study were as follows: the mean academic stress score was 3.17+ 0.55, ego resilience was 2.70+ 0.38, and health promoting behaviors was 2.47+ 0.32. There were significant differences in health promoting behaviors based on residence status, satisfaction with major, satisfaction with school life and health status. There was a negative correlation between health promoting behaviors and academic stress(r= 0.36, p=0.000) while there was a positive correlation between health promoting behaviors and ego resilience(r=0.60, p=0.000) Variables such as ego resilience, academic stress, satisfaction with school life, residence status, health status and satisfaction with major explained 43.3% of the variance in health promoting behaviors. Based on these results, it is necessaryto develop interventions and programs to reduce academic stress and increase ego resilience to improve health promotion in nursing students.

title: A multi method approach to researching stress and mental health in two groups of healthcare students: nursing students and trainee clinical psychologists
abstract: This dissertation investigates stress and mental health in two groups of healthcare trainees using quantitative and qualitative research. Specifically, the thesis focuses on nursing students and trainee clinical psychologists. The quantitative studies adopt a particular methodological approach that is used at the Centre for Occupational Health Psychology at Cardiff University. The method is multi dimensional in nature, and attempts to "tap in" to the multiple levels of the stress process without overburdening the participants or the service they provide. This approach is described in great detail throughout the thesis, and therefore this work can also act as a template for future studies that may adopt this method to investigate other populations. It is suggested that taking a multi dimensional approach to assessing stress might be a good way to inform regulatory standards, curriculum design, and student support. To complement the quantitative studies, qualitative studies were run to investigate stressors and coping strategies in mental health nursing students and trainee clinical psychologists. Many of the reported stressors were common across the two groups whereas others were specific to the individual population. For example, similarities between the groups included conflict with members of staff, problems in their home life, and 'being a student/trainee' whereas differences included the level of support received. That is, trainee clinical psychologists generally reported feeling well supported, whereas mental health nursing students reported inadequate support. Furthermore, there were additional barriers to accessing support for mental health nursing students, such as gaining access to counselling services during busy periods.

title: Correlations between Life Stress, Sleep Quality, and Mental Health in Nursing College Students

title: Distraction focused interventions on examination stress in nursing students: Effects on psychological stress and biomarker levels. A randomized controlled trial.
abstract: Nursing students all over the world experience high levels of stress with negative impacts on their health, emotional state and performance.  This study aimed to investigate the effects of distraction focused interventions on examination stress and anxiety in nursing students.  A randomized controlled, parallel trial design was conducted from January to June 2016. After baseline measurement, 72 participants were randomized to one of the following groups (n 18 each) (i) animal assisted therapy; (ii) music therapy; (iii) mandala painting; (iv) control group. Outcomes of all groups in terms of stress reduction were compared by measuring self reported perceived stress (STAI State and visual analogue stress scale) and salivary biomarker levels (Cortisol and Immunoglobulin A)  Fifty seven complete data sets (n 12 16 for each group) were analysed. All distraction focused interventions showed stress and anxiety reduction in everyday school situations. By contrast, on days with examinations, stress reductions did not reach statistical significance in regard to self reported psychological stress. At the same time, interventions resulted in significantly decreased levels of stress biomarkers (P .001)  Our preliminary findings suggest positive but situation dependent effects of distraction focused interventions in academic settings. Further research should investigate the complex relationship between physiological and psychological stress parameters.

title: A Study on the Stress, Self Esteem, and Mental Health in Nursing Students
abstract: This study is intended to identify relationship between stress, self esteem and mental health in nursing students. The data were collected from 448 nursing students using self report questionnaire. The data were analyzed by frequencies, t test, ANOVA, Pearson's correlation coefficients and Stepwise multiple regression using the SPSS 19.0 program. The result are as followed; First, the average of stress, self esteem, and mental health was 1.25+ 0.55, 3.33+ 0.42, and 2.79+ 1.20 point. Second, mental health was correlated with stress positively and self esteem negatively. Third, the influencing factor in mental health of the participant were interpersonal relationship and clinical based stress, R2=.561. Thus, development of guidance program to improve mental health of nursing students is recommended.