Stress in the Clinical Learning Environment: Perceptions of First-Year Finnish Nursing Students.

AIM: The aim of the study was to examine how first-year Finnish nursing students perceive stress and the coping strategies they use in the clinical learning environment. BACKGROUND: Stress from the clinical learning environment is a recurrent problem in nursing education. This topic has not been explored in the Finnish context. METHOD: This is a cross-sectional study using data from 189 first-year nursing students. Students completed the Perceived Stress Scale and Coping Behavior Inventory; t-tests and Pearson correlation analyses were performed. RESULTS: Our sample rarely experienced stress, with a mean stress score of 1.07 (SD = 0.49). A commonly reported stressor was lack of professional knowledge and skills (M = 1.49, SD = 0.82). Transference was the most common coping strategy. CONCLUSION: Our findings may help nursing teachers understand stressors in the clinical learning environment and support their students to use effective coping strategies, such as problem-solving and optimistic attitudes.

The Psychometric Properties of the Perceived Stress Scale When Used to Measure Stress Levels of Finnish Nursing Undergraduate Students.

BACKGROUND AND PURPOSE: Stress is an important issue in clinical nursing education because it may obstruct learning in clinical environments. This study aimed to translate, adapt, and investigate the psychometric properties of the Perceived Stress Scale (PSS), an instrument for measuring stress. METHODS: Nursing students (N = 189) from five different universities of applied sciences participated in this study in 2018. The modified English version of the 29-item six-factor PSS was cross-culturally adapted into Finnish. Exploratory factor analysis was conducted to assess the scale's factor structure. Confirmatory factor analysis was performed to validate the "best fit" model. RESULTS: The proposed 16-item four-factor model showed excellent internal consistency, with a Cronbach's alpha value of 0.90. CONCLUSIONS: The results support the use of the 16-item four-factor stress scale to investigate stress among Finnish nursing students.

Changes in stress levels and coping strategies among Finnish nursing students.

Nursing students may face significant stress in their clinical learning environment and may use coping strategies to alleviate such stresses. However, little empirical evidence exists about the evolution of such stresses and coping strategies across study years. The aim of this study was to explore changes in stress levels and coping strategies among nursing students in clinical learning environment. Nursing students (N = 131) were followed during their first and second study year. Descriptive statistics and paired sample t-tests were used to measure changes in the variables within the same cohort. Nurse students perceived more stress in their second clinical practice compared to first one, with mean scores of 1.03 and 1.66, respectively. Stress from lack of professional knowledge and skills remained the main stress factor while transference was the main coping strategy across the two study years. Nursing educators should support nursing students to develop effective coping strategies from clinical stressors, especially from stressors such as lack of professional knowledge and skills and prepare their students mentally for clinical placement.

Stress and Coping Among Nursing Students During Clinical Training: An Integrative Review.

BACKGROUND: Nursing students perceive stress during clinical trainings and use various coping strategies to manage it. This integrative review critically appraises previous literature on stress and coping strategies among undergraduate nursing students during clinical training. METHOD: An integrative review procedure was followed. Five electronic databases were searched with various search terms. A total of 1,170 publications were screened, 13 of which were included in the review. RESULTS: Most studies applied a cross-sectional, descriptive approach. Students perceived moderate to high levels of stress during their clinical trainings, with problem solving and transference the most common coping techniques. Teachers and nursing staff were a strong stressor because students felt they were constantly being observed and evaluated. CONCLUSION: The findings may provide guidance for how nursing staff can mentor students during clinical practice and establish a more supportive clinical environment. [J Nurs Educ. 2019;58(5):266-272.].