Nursing students' stress and satisfaction in clinical practice along different stages: A cross-sectional study.

BACKGROUND: Research in the field of nursing students' stress shifted internationally in recent decades from Western to Eastern countries with an emphasis on Middle East and Far East countries. The clinical experience has always been at the heart of nursing education cross-culturally and is a major source of stress and attrition. OBJECTIVES: To investigate the perceptions of stress and satisfaction of undergraduate nursing students during three stages of clinical learning experiences: preclinical, clinical and advanced clinical. DESIGN: A cross-sectional study. SETTINGS: Three Bachelor's in Nursing programs in three higher educational institutions in Israel. PARTICIPANTS: Nursing undergraduate students in their second, third and fourth year of study (n = 892). METHODS: The Nursing Students Stress Scale and the Nursing Students Professional Satisfaction questionnaires were used for data collection. Descriptive statistics used to analyze the data included: Pearson correlation, Cronbach's alpha, one way ANOVA, t-test, Kruskal Wallis and Mann Whitney U tests. RESULTS: Overall mean level of stress was mild-moderate (2.67) and overall satisfaction moderate-high (3.57). Year of study and gender were the most significant predictors of nursing students' stress. The level of stress and satisfaction of second year students in the preclinical stage was significantly higher compared to peers in their third and fourth year. Female students experienced significantly higher levels of stress and satisfaction. The top most stressful situations for second year students were related to inadequate preparation to cope with knowledge and skill demands, whereas for third and fourth year students they were conflicts between professional beliefs and the reality in hospital practice. CONCLUSIONS: Nurse Educators are challenged to tailor stress reduction interventions according to the students' perceptions of stress. It is not only critical for their wellbeing and attrition, but also important in developing nursing professionals who will provide better care and caring for patients.

Self-esteem in a broad-spectrum approach for mental health promotion.

Self-evaluation is crucial to mental and social well-being. It influences aspirations, personal goals and interaction with others. This paper stresses the importance of self-esteem as a protective factor and a non-specific risk factor in physical and mental health. Evidence is presented illustrating that self-esteem can lead to better health and social behavior, and that poor self-esteem is associated with a broad range of mental disorders and social problems, both internalizing problems (e.g. depression, suicidal tendencies, eating disorders and anxiety) and externalizing problems (e.g. violence and substance abuse). We discuss the dynamics of self-esteem in these relations. It is argued that an understanding of the development of self-esteem, its outcomes, and its active protection and promotion are critical to the improvement of both mental and physical health. The consequences for theory development, program development and health education research are addressed. Focusing on self-esteem is considered a core element of mental health promotion and a fruitful basis for a broad-spectrum approach.