The research purpose is to identify why nursing students have experienced higher level of stress and more physical and psychological symptoms. According to Jimenez, Navio-Osorio, & Diaz, (2010) it stated that most research on student nurses stress takes place within the United Kingdom and North America. More research needs to be conducted in other countries. This is why the researchers are conducting the study on the Spanish academia. It shows that there is little empirical evidence about the stress experienced on the nursing students during clinical practice.
The researchers are trying to establish the logic behind stressful events in clinical practice for nursing students. What types of stressful events and degrees of stress have been perceived by students during periods of clinical practice? What are the common biopsychosocial responses during period of clinical practice? What are the difference in reports of stress and health between novice and experienced groups of nursing students? The researchers suggest that if stress from clinical practice is an international phenomenon, it would then be useful to help identify the stressors.
Given that the readers have an understanding that student nurses have high stress levels in the UK and North America, the readers can now sense the importance of research in the Spanish academia to help identify the stressors. Study Variables The independent variable in this study is the experience level (novice-experienced) throughout the nursing program (year) and the dependent variables are the student’s scores measuring stress and health. (Jimenez, Navio-Osorio, & Diaz, 2010). With these set of variables, the researchers can determine if the stressors are equal in different stages of nursing experience.
Theoretical Framework This research used theoretical framework model. The researchers are identifying stress appraisal and adaptational outcomes (biopsyschosocial) by using Pollock’s Adaptation Nursing Model (1984). The theoretical framework model will help the researchers determine how nursing students deal with perceived stress and indentify clinical stressors, academic stressors and external stressors. Also, this model looks to find out how the students deal and adapt to stress. Review Literature Researchers’ main focus is how stress from clinical practice and whether it is an international culture phenomena.
It stated that nursing students are under significant stress during clinical practice periods, putting their education and health at risk. (Jimenez, Navio-Osorio, & Diaz, 2010). According to the literature reviewed, Stress and health in novice and experienced nursing students (2010) stated that the 3 major sources of stress are academic stressors (assignments and workload, exams, grades), clinical stressors (patient suffering or death, lack of professional knowledge and skills), external stressors (interference with daily life and financial).
Having identified these stressors in previous research, this study looks to answer other questions that remain. Obviously, this area in research has been highly studied but the data seems to be inconclusive. Study Design A descriptive quantitative and cross-sectional design was used. Cross-sectional was used because the data was collected over an 8-month period in 2004-2005. The researchers did not explain why they decided to do the year of 2004-2005 and between what month it was collected. In this study, the experience level was an independent variable therefore the cross-sectional design was needed.
Two threats to the internal validity were history and mortality. Since nursing programs change, the data can become inconclusive when trying to determine nursing students stress levels. Also, students who report to have high stress levels in beginning years of nursing, can be the same students who drop out of program therefore the data during latter years of nursing can become inconclusive because of the different samples of students. That is why mortality is a threat. Two threats to the external validity are selection threat and also history.
The study is specifically in the Spanish academia therefore there was no way to have a random sample based on geographical location. History was also a threat to the external validity because although there have been many studies in nursing students stress before, there have never been one in the Spanish academia. There would be no previous data to compare making it hard to generalize. Sampling and Setting The study was done in Andalusia (Spain) in a full-time 3 year nursing programme. All 503 nursing students (target population).
There were 388 questionnaires returned and 357 were valid for analysis, representing 71% of the entire nursing students population at the university. (Jimenez, Navio-Osorio, & Diaz, 2010). Extraneous Variables The variables that were described in the study were the demographic data sheet which consisted of socio-demographics characteristics, academic characteristics and characteristics of clinical practice. The tools that measure the variables were the Perceived Stress Scale, PSS. This tool was used to analyze the 30 items, which compile information about the experience of nursing students during clinical practice. Jimenez, Navio-Osorio, & Diaz, 2010). Each items were assessed using 5-point Likert scale, ranging from ‘0’ (Not stressful at all) to ‘4’ (Very stressful) The scores range form 0-120 indicating the degree of stress. Another tool that was used is the Biopsyschosocial Response Scale, BPSRS. This tool was used to identify 22 items which refer to symptoms relating to the student’s physical, psychological and social health.
A 5-point Likert scale were also used to assessed each items. Ranging from 0 (Never) to 4 (Always). The total scores range from 0 to 88 in the presence of symptoms in biopsyschosocial status. Jimenez, Navio-Osorio, & Diaz, 2010). Data Analysis The study used statistics software package SPSS-11. 0 for Window (SPSS) to analyze the data. The data included sex and age, socio-familial aspects and academic aspects. Basic statistics were calculated for items factors and totals of PPS and of PPSRS. Kendal’s W-test was used to analyze the degree of consensus among the groups of students with respect to the item and factor evaluation of two measured variables. (Jimenez, Navio-Osorio, & Diaz, 2010). A paired-samples t-test was used to determine what kinds of stressors (clinical, academic, and external) nursing students perceived.
Non-parametric test (Wilcoxon Signed Ranks test) was used to identify the difference between the physiological and psychological symptoms. To identify the difference in novice and experienced nursing students reports of stress a post hoc Tukey test were performed. Also for the researchers to detect the distinctions between novice and experienced nursing student’s reports of health a (Kruskal-Wallis H-test) and a post hoc Mann-Whitney U-test were used. Another tool that the researchers used was an ANOVA . This procedure Strengths/Limitations The limitation in this study conducted is that it was done cross-sectional.
It stated that it would be essential if longitudinal was performed to follow students in their subsequent years to explore the pattern of changes in stress perception and adaptational responses. The objective in this study is to examine difference in perceived stress in novice and experienced nursing students. The result concluded that there is no difference between years of study or experience groups regarding overall measures of stress. (Jimenez, Navio-Osorio, & Diaz, 2010). However, pervious study was established and a present study shows that stress suffered by nursing students during clinical practice comes mainly from linical stressors. Implications This study has implication for practice and or policy because it stated that teachers need to pay attention to students’ academic performance as well as their biopsychosocial status, especially for those students who express greater stress and show poor health. It also suggested that nursing educators must carefully examine curriculum demands, especially the potential for academic overload of students in each year. The researchers also imply to encourage teachers to design strategies for effective clinical teaching and to develop self-awareness for students.