NURSING STUDENTS’ EXPERIENCE OF STRESS DURING THEIR EDUCATION: A STUDY IN THE CENTRAL REGION, GHANA

ABSTRACT
Nursing students suffer high levels of stress during their education experiences. Nursing research supports the argument that practicum experience of course work yields more stress than class experience. The purpose of this study was to investigate the perceived level of stress and sources of stress in undergraduate and diploma nursing students. In this study, a sample of 170 students, 104 undergraduate level 400 and 66 level 300 diploma nursing students completed a modified form of the Hassles Assessment Scale to evaluate the students’ sources of stress. Findings revealed that the diploma nursing students had higher stress levels but these stress levels were closer to the mean of the average stress levels of the undergraduate nursing students indicating both research groups experienced high level of stress. Another significant finding was that, females were found to feel more stress than males. The findings of high stress levels in both nursing groups supports the assumption that stress management needs to be addressed. Further examination of this topic could offer more information.

CHAPTER ONE
INTRODUCTION
This chapter provides the background information of the study, the problem statement with the purpose of the study and research questions that have been formulated. The chapter ends with the description of the significance, limitations, delimitations of the study and operational definition of terms.

Background to the Study
Academic performance is of great importance to parents, teachers and students themselves. Even the larger society is aware of the long term effects of positive or negative academic performance since graduates from educational institutions are expected to shape the destiny of society (Salami, 2001). Unfortunately, academic achievement of students has become a matter of grave concern to many educationists (Aremu, 2001). Students have many obstacles to overcome in order to achieve their optimal academic performance (Womble, 2003). Stress is a common problem to students in schools. The way it is managed may reflect in their academic performance (Salami, 2001). The effects of stress can be positive or negative. Positively used, stress can be a motivator for an improved quality of life. Stress can also be negative when it becomes destructive based on how an individual perceived it and reacted to it (Mallinckrodt and Wei, 2005).

College students have many obstacles to overcome in order to achieve their optimal academic performance. It takes a lot more than just studying to achieve a successful college career. Different stressors such as time management, financial problems, sleep deprivation, social activities, and for some students even having children, all pose their own threats to a student’s academic performance. The way that academic performance is measured is through the ordinal scale of grade point average (GPA). A student’s grade point average determines many things such as class rank and entrance to graduate school. Much research has been done looking at the correlation of stress factors that college students’ experience and the effects of stress factors as academic situational related problems. The study of Niemi and Vainiomaki (1999) took into account a variety of factors that can diminish a student’s academic performance; factors such as fraternity and sorority activities, job responsibilities, or having a boyfriend or girlfriend. One extraneous variable that was taken into account was that, at most universities, students involved in activities such as fraternities or sororities, and also athletics, must maintain an acceptable grade point average to participate. This factor by itself could attribute to these students’ grade point average being higher than the average college student.

The process of encountering increasing and changing amounts of stress over a period of time helps one to develop methods of stress management in adulthood. Methods that improve adaptation to stress include exercise, time for friends, relaxation, and participation in endeavors that improve self-concept (Wong, Perry and Hockenberry, 2002).

Daily stressors in life cannot be avoided, nor can major life changes. Stressful events that change one’s life for an extended period can lead to health related problems. Events that may cause unhealthy stress include death, divorce, moving away from home, serious illness, and financial struggles (Wong, et al., 2002). Those who dwell on life events suffer higher stress (Sarafino and Ewing,

1999). Stress related health problems are rampant in society. An estimated 75-90 percent of all primary care health providers see patients with stress related problems (Peckham, 2001). Sustained psychological stress has been associated with numerous health consequences, especially for those who interpret daily hassles of life as being stressful. Research supports that students in higher education have higher stress levels than the general public. Beck, Hackett, Srivastava, Mckim, and Rockwell (1997) stated that nursing students suffer higher levels of stress during their college years than college students in other disciplines.

Learning and memory can be affected by stress. Although an optimal level of stress can enhance learning ability (Kaplan and Sadock, 2000), too much stress can cause physical and mental health problems (Niemi and Vainiomaki, 1999; Laio, Lu and Yi, 2007), reduce self-esteem (Bressler and Bressler, 2007; Linn and Zeppa, 1984; Silver and Glicken, 1990), and may affect the academic achievement of students (Choi, Abbott, Arthur and Hill, 2007; Elliot, Shell, Henry and Maeir, 2005; Hofer, 2007; Robbin, Allen, Casillas, Peterson and Le, 2006; Trautmein, Ludtke, March, Koller and Baumert, 2006).

University students might experience high stress due to academic commitments, financial pressures or lack of time management skills. When stress is perceived negatively or becomes excessive, it can affect both health and academic performance (Campbell and Svenson, 1992) and can have an adverse effect on students (Amirkhan, 1998; Covington, 1997). Moreover, if the pressure is prolonged and perceived as unmanageable, these experiences have been shown to elicit helplessness, depression and stress (Carver and Scheier, 1994), thereby placing the academic futures of some students in jeopardy (Marcos and Tillema, 2006).

Statement of the Problem
Nurses and students have been identified as a population with an elevated stress level. Stressors for student nurses, identified by Beck and Srivastava (1991), included adjusting to a rigorous program of theory, long hours of study and pressures of student clinical practice requiring emotional and personal maturity. According to Beck and Srivastava (1991), the practicum portion of nursing education was identified by nursing students as more stressful than didactic courses. For nursing students these real life situations are stressful due to the fact that patients can be affected negatively or positively. The idea of causing harm, even death to a patient, is a fear for nursing students and nurses (Admi, 1997).

In Ghana, the age requirement for applying into Nursing and Midwifery Training College is between 18 and 35 years. This age boundary comes with its challenges. Some of the nursing students are already parents with the responsibilities of home keeping and childcare while in school. Apart from the few nursing students who are parents, majority have just finished the senior high school. They were not employed and financially depending on their parents.

Nursing students with varying economic background and challenges pursue their professional training amidst the presence of curricular and extracurricular activities that emanates as a result of the decision to become a professional nurse (Shields, 2001). The student nurse who is economically and academically stressed can only achieve goals of becoming a professional nurse if the institution of training has a facility for counseling at the disposal of the students (Colin, 1996).

In various educational settings it is not unusual for a number of students not to be able to pay their fees, hence not be able to write examinations (Hofer, 2007). These students have peculiar problems and challenges such as caring for self, depending on parent or guardian who could not meet their financial needs, and some may have families that they take care of while in school. Some student nurses drop out while some unceremoniously look for other professions (Admi, 1997).

In Ghana, since 2009, there had been a nationwide decline in the pass rate of the nursing licensing examination nationwide. Ministry of Health Investigative Report (April, 2013) identified students’ poor preparation prior to the licensing examination as one factor. These observations can be linked to a variety of stressors the student nurses experience ranging from socio-economic to choice of vocation that tend to affect their academic performance (Hofer, 2007).The poor pass rate of the nursing students in the licensing examination is causing conflict among students, nurse educators, and the Nursing and Midwifery Council in Ghana. The various institutions in charge of nursing education keep blaming one another for the poor pass rate at the licensing examination. The issue is, these bodies have been in existence and have worked and produced better Nursing Licensing Examination results in the past. What then is the matter that nobody could fathom? The very nurse educators who have produced better Nursing Licensing Examination results over the years are still working while the Nursing and Midwifery Council structures and mandate have not changed. However, curricula have been reviewed and examination structures have moved from more of recall to critical thinking. What are the sources of stress which are inimical to students’ academic performance?

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Item Type: Ghanaian Postgraduate Material  |  Attribute: 123 pages  |  Chapters: 1-5
Format: MS Word  |  Price: GH110 ($20)  |  Delivery: Within 30Mins.
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