The impact of a sense of self-efficacy on the level of stress and the ways of coping with difficult situations in Polish nursing students
Introduction
Practical classes are an important part of the nursing educational program. Its purpose is to prepare students to competently fulfil their role and professional functions. The first practical classes are held within the subject called basics of nursing, at the first year of studies. They are the basis for all subsequent practical classes. These activities are carried out in clinical wards, where students put in practice and improve their nursing skills acquired in lab/skill workshops (Zarzycka et al., 2003, Szyszkowska et al., 2005). During these classes a student of nursing is required to contact patients, those who suffer, those in need of help, emotional commitment and a sense of responsibility for the health and lives of others. Such a huge amount of expectations may cause difficulties because the student is still in the process of acquiring personality competence.
Scientific literature often considers difficult or stressful situations as new situations. The first practical training in a hospital abounds in such circumstances (Gugała, 2004, Głowacka and Nowakowska, 2006). Difficult situations, which a student may encounter during practical classes include, among others: situations of tiredness, emergencies, difficulties, conflicts, deprivation. Difficult situations cause a set of reactions that result in the psycho-physiological arousal, frustration, psychological stress; they may be physiological or psychological (Dudek, 2005, Huber, 2010, Dudzińska et al., 2007, Święcicka and Starun, 2005). The psychological effects of stress can lead to behavioural, emotional and cognitive changes. The effects of stressful situations can also have the positive character (Więcikowska, 2008, Mesjasz, 2005). Mild levels of stress can have a positive effect on students by increasing motivation (Ross et al., 2005).
Stress is especially pervasive in the lives of nursing students. They experience higher level of stress than other college students (Golf, 2011, Wolf et al., 2015). Students must deal with interpersonal interactions with clinical instructors and nursing staff, but they also are stressed by their lack of knowledge, insecurity with clinical skills or fear of failure (Gibbons, 2010, Jimenez et al., 2010).
Among the factors responsible for the severity of the nursing stress list: the amount of content to be learned, not knowing how to prepare for examinations and the requirement to successfully pass a nursing course. Other examples were frequent examinations, role conflict with physicians, perceived lack of clinical knowledge, clinical experiences, trying to remain impersonal with patients or discussing sensitive issues with patients (Dutta et al., 2005). Wolf et al. (2015) identified stressors such as clinical incompetence, problematic relationships and time management issues. Predictors of stress included history of depression, year in the program, emotional support, and self-esteem. In an attempt to control and reduce stress levels students use different coping strategies (Yamashita et al., 2012, Klainnin-Yobas et al., 2014, Tomczak, 2009). Studies also revealed that use of positive coping strategies lessens students stress (Hegge and Larson, 2008).
The mechanisms of coping with difficult situations, which are activated in difficult situations, are very important (Dudzińska et al., 2007, Mesjasz, 2005). Coping with stress is usually reported in the literature as a strategy or style. A strategy is understood as a specific way of coping and can be positive or negative. The style in turn is a relatively fixed tendency of a person to use specific ways of coping. The type of style and strategy stems from person's personality traits, the psychophysical condition, gender, education, age and a sense of self-efficacy (Walas et al., 2006). Following Juczyński and Ogińska-Bulik (2012) the authors of the study adopted coping strategies such as Active coping, Planning, Positive revaluation, Seeking Emotional Support, Seeking Instrumental Support, Taking psychoactive substances, Cessation of actions, Blaming oneself, Dealing with something else, Denial, Release, Turn to religion, Acceptance and Sense of humour.
Luo and Wang (2008) found that by improving students' coping skills, problem solving ability improved. Development of adaptive coping mechanisms by nursing students results in students who are less likely to use maladaptive strategies (Reeve et al., 2013). Research conducted by Fornés-Vives et al. (2015) showed that coping and personality changes experienced by nursing students throughout their degree program changed positively and seem to mirror the professional competences needed by future licensed nurses. Wolf et al. (2015) found that main coping strategies used by nursing students included positive thinking and social support.
Identifying students' dispositional tendency to handle stress and determine its potential relationship with personality traits as sense of self-efficacy can guide educators to design specific course to improve curricula.
The aim of this study was to evaluate the effect of a sense of self-efficacy on the level of stress and the ways of coping by Polish nursing students during their first practical classes at a clinical ward.
Section snippets
Material and Methods
The research was carried out using the diagnostic questionnaire method, estimation, and surveying technique. The research tools included: an original questionnaire, Stress scale by S. Cohen, T. Kamarck, R. Mermelstein adapted by Z. Juczyński and N. Ogińska-Bulik, Inventory to measure coping with stress by S. Charles Carver adapted by Juczyński, N. Ogińska-Bulik and Generalized Self-efficacy Scale by R. Schwarzer, M. Jerusalem and Z. Juczyński (Juczyński and Ogińska-Bulik, 2012, Juczyński, 2012).
Results
The mean age of respondents was 20.25 years (SD = 1.22). Men constituted only 3% of the study population. 22.8% of the students declared their preparation to the first practical classes as very good, 63.5% as good, and 12.7% as average. During the first practical classes nursing students usually found difficult discrepancy between theory and practice (N = 208; 52.8%). The difficult situations they also pointed out were as follows: serious health condition of the patient (N = 137; 34.8%); meeting
Discussion
The results of our study showed that Polish nursing students experienced various difficult situations during their first practical classes. These included, among others: discrepancy between theory and practice, the lack of adequate equipment, an insufficient quantity of nursing procedures performed, the serious health condition of the patient, an inability to provide an effective relief, maintaining personal hygiene of intimate parts of the body, communicating with patients, the lack of patient
Conclusions and Recommendations
Nursing students experience high levels of stress due to the emotional demands placed on them, huge amount of expectations when they begin to take the responsibility for patient care. That stress impacts may cause difficulties because the students are in the process of acquiring personality competence.
Communication with patients and discrepancies between theory and practice turned out to be difficult situations that have a significant impact on the stress intensity in nursing students. Besides,
References (39)
- et al.
Strategies for nursing faculty to promote a healthy work environment for nursing students
Teach. Learn. Nurs.
(2012) - et al.
Pre-registration diploma student nurse stress and coping measures
Nurse Educ. Today
(2004) - et al.
Coping, stress, and personality in Spanish nursing students: a longitudinal study
Nurse Educ. Today
(2016) Stress, coping and burn-out in nursing students
Int. J. Nurs. Stud.
(2010)- et al.
Perceived stress and social support in undergraduate nursing students` educational experiences
Nurse Educ. Today
(2013) - et al.
Predictor of stress and coping strategies of US accelerated vs. generic baccalaureate nursing students: an embedded mixed methods study
Nurse Educ. Today
(2015) - et al.
Assessment of nursing students' stress levels and coping strategies in operating room practice
Nurse Educ. Pract.
(2015) - et al.
Correlates of stress and coping among Jordanian nursing students during clinical practice in psychiatric/mental health course
Stress. Health
(2014) - et al.
Determination of nursing students' expectations for faculty members and the perceived stressors during their education
Contemp. Nurse
(2015) Czynniki psychospołeczne a zdrowie pracowników
Med. Pract.
(2005)
Reception of stress and the mechanisms of coping with stress among students of selected universities in Lublin
Zdrow. Publiczne
Stress in health professions: myth or reality? A review of the existing literature
J. Natl. Black Nurses Assoc.
Are students' symptoms and health complaints associated with perceived stress at university? Perspectives from the United Kingdom and Egypt
Int J Environ. Res and Pub Health.
Assessment of stress in the inclusion of nursing students in hospital practice
Investig y Educ. en Enfermeria.
Wypalenie zawodowe pielęgniarek – niebezpieczeństwa, koszty i sposoby zapobiegania
Mag Piel. Poł.
Stressors, academic performance, and learned resourcefulness in baccalaureate nursing students
Int. J. Nurs. Educ. Sholarsh.
Sytuacje trudne w środowisku pracy pielęgniarek a umiejętności radzenia sobie z nimi
Zdrow. Publiczne
Stressors and coping strategies of students in accelerated baccalaureate nursing programs
Nurse Educ. Today
Style adaptacyjne do sytuacji stresowych w różnych grupach wiekowych, a choroby cywilizacyjne XXI wieku
Probl. Hig. Epidemiol.
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