Student nurses need strategies to cope with stress

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Student nurses should be equipped with tools to deal with stress as a routine part of their training, according to the results of a new study. The research authors made the recommendation after discovering the pressure associated with nursing studies was an “important risk factor” in the mental health of students.

Their study, called “Relationship between mental health of nursing students and coping, self-esteem and social support”, involved 516 nursing students from an undergraduate program in Turkey. Mental health problems among nursing students in the country were “borderline to high”, compared to other university students and the general population, said the article, which was published in the journal Nurse Education Today.

“Nursing students cope with the same problems as other young university students in addition to the difficulties of being in the field of healthcare,” noted the study authors. “Nursing students also experience traumatic events such as death and are witness to dying patients from the first moments of their educational training,” they added. 

The students were split into two groups according to how they scored in a psychological assessment. The low-score group were considered to have “normal” mental health, while those with a high-score were classified as a “risk group for mental problems”.

The study, carried out by academics from Duzce University, found that those in the high-score group were “significantly” more likely to be stressed about their clinical and academic education. Those who had experienced a negative event in the last year were also more likely to be mentally unwell. Significantly, the study found that the lower a student’s self-esteem, the more likely they were to be at risk of mental ill health.

“The stress experienced by nurses during their education generates negative self-perception,” the researchers said. “Negative self-perception causes students to develop the belief that they cannot cope with their problems, and they subsequently experience psychological problems. Students must realise their self-worth, exhibit their skills, knowledge and capabilities and establish a positive professional identity.”

The study also found that students who were more engaged in choosing nursing as a career had better mental health than those who did not.

“A ‘profession’ is defined as a tool that enables individuals to use their skills and to realize their existence,” the researchers said in their report. “Individuals choose their professions voluntarily when they become psychologically and intellectually ready for professional life. Therefore, it can be implied that career choice should be considered as an important factor in the mental health of an individual,” they said.

Other factors that were found to affect the mental health of students were their satisfaction with school life, their academic success and their general physical health. 

The research highlighted the importance of students being given healthy tools to cope with stress. The study found that the high-score group were more likely to take an “avoidance” strategy to dealing with problems, whereas the low-score group would try to “remain optimistic” and tackle the issue head on.

In addition, students who valued “social support” and had people to lean on were at lower risk of mental ill health than those who did not. “High self-esteem and the presence of social support are protective factors for the maintenance of mental health,” the researchers concluded.

They put forward the case for educators doing more to monitor the mental wellbeing of their nursing students and to equip them with tools to cope with stress. Teachers should also develop mechanisms to help student nurses to feel good about themselves, they suggested. 

“The stress levels of nursing students should be monitored in order to facilitate their ability to cope with stressful situations during their training, and components for coping with stress should be included in the curricula of nursing departments,” the authors noted. “Furthermore, programs that enhance the self-esteem of the students and increase their social support should be established.”

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