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Chapter 1IntroductionGlobally, nurses had a normal experience of
being overwhelmed from time to time. It is virtually impossible to
eliminate times when events conspire and the bodys stress response
is triggered, but there are ways that we can quickly reverse our
bodys reaction to stress, like buffering the damage to our health
and keeping our thinking clear so we can deal more effectively with
whats going on in the moment (Carrasco, 2009).In the Philippines, a
student may face many challenges and stressors. However, nursing
students are likely to experience even more stress than their
friends and colleagues enrolled in other programs. To support this
statement, a study comparing the stress levels of various
professional students by Bautista found that nursing students
experience higher levels of stress than medical, social work and
pharmacy students (Salazar, 2002).Stress has been defined as a
barrier to concentration, problem solving, decision making, and
other necessary abilities for students learning.Stress among
nursing students becomes a hindrance in managing their time and
study and may lead to distress. Complying with a longer academic
program and having to contend with clinical duties, makes it
impossible for these students to make it out of a stressful
environment. Some of the most common stressors are time pressures,
workload, making decisions, continuous changes and economic
mistakes at work (M.Pulido-Martos phD, Augusto-Landa phD and
E.Lopez-Zafra phD). Nursing students have limited time in doing
other activities, neglecting their social life and basically having
a good time now and then, because they have to deal with their
academic standings and sometimes become tired from clinical duties
and long hours at school. Although pressure can help in motivating
student nurses in doing their tasks, yet too much pressure will
give them a breakdown. Despite of dealing with the academic
standing, attaining high grades, long hours of studying, another
stressor among student nurses is how to survive their clinical
requirements. According to Sharif and Masoumi, 2005, clinical
practice has been identified as one of the most anxiety producing
components in nursing programs.Lack of experience, fear of making
mistakes, difficult patients, discomfort at being evaluated by
faculty members, worrying about giving patients the wrong
information or medication and concern about possibly harming a
patient are just a few of the stressors for the beginning student
nurse. Managing stress is important for nursing students since
their practice involves taking care of sick patients, functioning
properly to save lives and studying hard to become future
registered nurses. Student nurses should be able to identify the
stressors that cause them to become stressed. If they let stressors
take over them, their practice will be highly affected and will
cause disruption to their mind and body. These are a few key things
that nurses can do to help decrease stress in their lives: Take
time for themselves, think positive self-thoughts, identify
stressors they encounter, collaborate with administration to
resolve workplace issues, make the effort to balance their lives
and pursue supportive relationships with people outside the job,
supporting fellow nurses and acknowledging success also helps
reduce workplace stress, eating a well-balanced diet, exercising,
meditating, doing yoga therapy and other relaxation techniques
(Kirkland, 2003). At Saint Gabriel College, stress among students
is prevalent nowadays. Students are striving to get atleast grades
above 75%-80%, cramming and procrastinating on assignments,
requirements, altered sleep patterns due to clinical duties,
limited time in studying, and continuous quizzes everyday are some
of the stressors experienced by Saint Gabriel College Nursing
students. What these students do to relieve stress is finding time
to relax by going out with friends and taking the time for leisure
activities.Based on the above premise, this study was conducted to
determine how levels of stress and stress management techniques are
utilized by student nurses of Saint Gabriel College of Nursing.
Statement of the ProblemThis study was conducted to determine the
levels of stress and stress management techniques utilized by
student nurses of Saint Gabriel College of Nursing. Specifically it
will have the following objectives:1. To find out the demographic
profile of student nurses such as age, gender, year level, marital
status, residence , allowance per week and number of subjects2. To
assess the level of stress among student nurses of Saint Gabriel
College of Nursing. 3. To identify the stress management techniques
utilized by student nurses of Saint Gabriel College of Nursing. 4.
To determine the relationship between the profile, the levels of
stress to stress management techniques utilized by student nurses
of Saint Gabriel College of Nursing.
Theoretical Framework:This study was based on Sister Callista
Roys adaptation model and concept of stress. Sister Callista Roys
Adaptation model has some characteristics of stress and interaction
theories. Roy borrowed and expanded on theories from other,
including Seyle (1936), Helson (1964) and Maslow (1970). RAM
focuses on the individual (person) as a biopsychosocial adaptive
system and describes nursing as a humanistic discipline that places
emphasis on the persons own coping abilities to achieve health (Roy
1984). Roy defined stress as a constantly changing point, made up
of focal, contextual and residual stimuli which represent the
persons own standard of the range of stimuli to which can respond
with ordinary adaptive response. Stress for Roy represents the
parity of the person in terms of survival, growth, reproduction and
mastery. A persons adaption level is determined by combined effect
of the three classes of stimuli (input). Health results when
adaptation reaches the optimal level of the individuals potential
to meet his or her psychosocial and self actualization needs. The
individuals use both innate and acquired biological, psychological
or social adaptive mechanisms of all three. In this study, stress
refers to the physiological and psychological response of the
nursing students to the stressors in the academic field and stress
management techniques are ways people maintain equilibrium despite
the stressors present in the environment. The Bachelor of Science
of Nursing requirements has been identified as one of the most
stress producing component in the nursing field such as lack of
experience, fear of making mistakes, being evaluated by the
clinical instructor, major exams and paper works like case studies,
thesis reports, concept maps and nursing care plan. It is essential
that they learn to utilize successfully the stress management
techniques to cope with the stressors to maintain their wellness
and to model a healthy behavior. In relation, the regular Bachelor
of Science in Nursing Students experiences different levels of
stress, the greater the stressors, the greater the stress level,
the greater the need for stress management techniques to be
utilized.
Conceptual Pardigm:The conceptual framework shows the
relationship between the independent and dependent variables. In
this study, the independent variables are the levels of stress of
the respondents which is classified into high, moderate, and low.
while the dependent variable are the stress management techniques.
The intervening variable are the personal characteristics of the
respondents which identifies the age, gender, year level, marital
status, residence, allowance per week, and number of subjects.
LEVELS OF STRESSHighModerate LowIndependent Variable Dependent
Variable
STRESS MANAGEMENT TECHNIQUES
PERSONAL CHARACTERISTICSE.g. AgeGenderYear levelMarital status
Residence Allowance per week Number of subjectsHours of
SleepModerator Variable
Figure 1: Figure 1: The Schematic Diagram showing the
relationship between the independent, dependent and intervening
variables.
Null Hypothesis:There is no significant difference between
stress and stress management techniques utilized by student nurses
of Saint Gabriel College.Assumption:All nursing students experience
stress. Scope and Limitations The study was focused on describing
the relationship between the levels of stress and stress management
techniques utilized by regular Bachelor of Science in Nursing
Students, enrolled in the Saint Gabriel College. Data which will be
utilized in this study was gathered from the nursing students
through a modified questionnaire which is originally taken from the
study of Dangan (2006) and Nacilla (2006) and modified by the
researchers. The study was conducted during the 2nd semester of
school year 2012-2013.Limitations of the study includes gathering
20 respondents who are willing to answer the given questionnaires,
which was comprised of student nurses from different year levels at
Saint Gabriel College, Old Buswang, Kalibo, Aklan.
Significance of the Study:The study will benefit to the
following:Nursing StudentsThis study will benefit those nursing
students who have been experiencing stress under their
academic/clinical program. The result of this study will help them
identify the causes of stress, levels of stress and find means in
managing the symptoms of stress which settles as a threat for their
normal functioning and sense of well-being.
Clinical InstructorsThis study will set as a guide for
instructors in planning activities and strategies that would help
students in controlling and avoiding stress when involved in the
academic or clinical field. School AdministratorsThe study will
serve as a basis to encourage them to support and approve school
activities which will benefit the students well-being.
Guidance Counsel This study will serve as a basis for guidance
counselors to develop activities or programs for those students to
release their tension on stress and help them relieve the symptoms
of it. Future Researchers For future researchers, this study will
benefit as a source or reference for your future outputs and will
provide information about the levels of stress and stress
management techniques utilized by nursing students in the academic
and clinical field.
Definition of Terms:The following terms are defined for
clarity:Level of stress refers to the severity of the manifested
physical or mental tension resulting from factors that alter an
existing equilibrium (Mosby, 2009).In this study, this refers to
the state or condition of restrictions, demand, or constraints of
nursing students. This will be measured by a 30 items questionnaire
by Dangan (2006) which is modified by the researchers about
manifestations of stress and scores will be categorized as 0 for
(never) did not experience; 1 for (rarely) experience at least once
a month; 2 for sometimes; 3 for often; and 4 for always
experiencing.
Stress - is the bodys reaction to a change that requires a
physical, mental, or emotional adjustment or response (Morrow,
2009). In this study stress refers to the feeling that is
experienced by Bachelor of Science in nursing students. Acute
stress refers to stress that occurs suddenly, and lasting for a
short period of time (minutes). It has a stress level score of 1 to
40.Moderate stress refers to stress lasting for hours and more
often. It has a stress level score of 41to 80.Chronic stress refers
to an existing stress that lasts for days or longer. It has a
stress level score of 81 to 120.Stressor a stimulus that
causesstress (Meriam-Webster, 2013) In this study, stressor refers
to the causes of stress in Bachelor of Science nursing students.
Stress Management - A set of techniques and programs intended to
help people deal more effectively with stress in their lives by
analyzing the specific stressors and taking positive actions to
minimize their effects. (Gale, 2008)In this study, stress
management techniques refers to the ways employed by nursing
students to avoid stress and stressors such as time management,
music therapy, exercise, and allotting adequate hours of sleep.This
will be measured by a 30 items questionnaire about stress
management techniques by Nacilla (2006) which is modified by the
researchers and the scores will be categorized as 0 for not
practicing; 1 for rarely practicing ; 2 for sometimes practicing; 3
for often practicing; and 4 for always practicing.
CHAPTER IIREVIEW OF RELATED LITERATUREThis chapter presents the
literatures reviewed, which may be utilized in defining the
methodology and/or interpretation of data. Literature reviewed
includes local and foreign books, local and foreign researches,
articles, and internet materials.
Local Literature:Coping with Stress For licesned Apruebo, Roxel,
A. The Science of Psychology, 1st Edition. Philippines: Educational
Publishing House Inc. 2009. Process of Stress Stressful events may
occur as sudden, unexpected, potentially life-threatening
experiences or traumas qualify as catastrophic events, such as
physical or sexual assault, military combat, natural disasters,
explosions, plane crashes and accidents fall into this category.
Life changes and strains include marital separation, illness in the
family, difficulties at work, moving to a new place, and other
circumstances that create demand with which people must adjust.
Chronic stressors continue over a long period of time like living
due to adverse economic conditions, residing in a high-crime
neighborhood, being the victim of discrimination, and even enduring
years of job pressures. Daily hassles involve irritations, heavy
traffics, pressures, and annoyances that may not be major stressors
by themselves but such effects aggravate to become significant.
This frustration of daily commuting in heavy traffic can become so
intense for some drivers display a pattern of aggression. People
reactions to stressful events or stressors, such as catastrophic
events, life changes and strains, chronic stressors, and daily
hassles are contributing components of stress. The use of coping
skills reduces inappropriate stress response and improves
strategies in response to stress. How Filipino Nursing Students
Deal with
Stress(http://royfranciscordero.wordpress.com/sample-thesis/): The
scenes of smiling and laughing Filipinos, singing and dancing (and
drinking) away can be deceptive. Quite often, Filipinos especially
the young ones and the students deal with stress by trying to be
happy. I put that in quotes because the Filipino term ismasaya,
which is really more of an externalized merriment.Masayais social
camaraderie, its making cheer and quite often we do it precisely
because there have been unhappy events, stressful events. The best
example is that of a death our wakes are notorious for its
merry-making, but that, precisely, is part of our stress-coping
mechanism.We have folk psychology, maybe even folk psychiatry, at
work here, Filipinos aware of how dangerous it is to allow stress
to consume us. We warn people about excesses as a cause of illness,
and that includes the excessive emotions generated by stress.But
for all the talk about our communitarian orientation, of helping
friends to overcome stress, social pressures in the Philippines can
also be counterproductive with the way we sometimes force people to
repress the stress. Enjoy! we urge them, not realizing there are
limits to resilience.There are power dimensions to all this, such
as those found in gender. Contrary to stereotypes about women
student being more expressive, Filipinas are actually more prone to
dealing with stressful situations throughtiis(endurance)
andkimkim(repression). Check out the local scenes of merriment: its
usually men students having a good time, bringing out the beer and
toasting their problems away, while their women look for ways to
make ends meet.Men, students too, are expected to keep their
feelings in check, but more out of masculine values of strength and
stoicism. Men are generally not allowed to cry, much less to go
into hysterics; and this probably helps to explain why more men
suffer from cardiovascular disease.According to Dr. Lourdes Ignacio
many students will express their stress by complaining about
recurring headaches, or abdominal pains, accompanied by dizziness,
nausea, fatigue. Doctors used to dismiss these as being all in the
mind, but it has become clear the physical pain and distress may be
quite real, that the pent-up stress is expressed through the
body.The macho imperatives around stress are inevitably tied to
alcohol and drugs. Younger male Filipinos especially nursing are
particularly vulnerable, given their struggles with identity,
masculinity and self-esteem, unable to express their frustrations
and resentment. Drugs are one way of dealing with the stress, with
all its attendant problems. Its significant though that the most
abused drugs are metaphetamines, which are uppers or stimulants.
Again, the Filipino response to stress is to look for more
stimulation. The nerve cells fire away until, frayed and exhausted,
the user develops paranoia (borrowed into Filipino aspraning) and
then psychosis.Ignacio said Filipinos have their own natural coping
mechanism compared to other nationalities.She said Filipinos strong
faith in God, sense of humor and concern for others, are among the
mechanisms that help them cope with depression. We are very much
crisis-oriented and we have natural ways of coping with it, she
said. Ignacio said they consider these as forms of coping with
mental disorders even without scientific basis.Reyes said some
mental patients could function normally again after being treated.
Of course, for example, a bank manager suffered from schizophrenia,
he or she cannot go back as a bank manager, but as a clerk. There
is some form of regression but in terms of symptoms, they are free
from symptoms, but their functioning has already regressed in some
form, he said.On the other hand, Ignacio revealed that the
Philippines is facing an acute shortage of psychiatrists due to the
unabated migration of mental health doctors who seek greener
pastures abroad.Stress plays a great part not only on students but
on every individuals daily living. Quoting from Arnold Burnout,
defined as exhaustion of physical and emotional strength is a term
used to describe the end result of prolonged stress. He further
states that sustained, intense stress decreases productivity and
narrows the individuals perceptions. Too much stress blocks
learning and decreases problem-solving ability, (1989:325). Drs.
Sally and Rena Lawrence have done extensive study in the area of
stress and burnout in nursing. A recent article by these authors
reads as follows: Common stressors for nurses are environmental
conditions, emotional problems of patients and families, demands of
patients and supervisors, working conditions, interpersonal and
collegial relationships, and contemporary ethical and moral
dilemmas. The list of stressors is endless because of the nature of
the nursing profession. Unrealistic self-expectations are perhaps
the most critical sources of stress, Sally concurs with the
Lawrence statement; he writes, Expecting too much of oneself can
lead to burnout faster than any other single stressor,(1980:912).
Smyth in her book,Surviving Nursingelaborates on the burnout
phenomena: the three major causes . . . are (1) a mismatch between
efforts and results leading to disappointment and frustration, (2)
a mismatch between nurse and environment leading to role ambiguity
and conflict, and (3) a mismatch, between people leading to
interpersonal conflict. Storlie adds a final dimension,
Disillusionment and burnout follow confrontation with reality in
which the human spirit is pitted against circumstances intractable
to change.Stress ManagementCuevas, Frances Prescilla L. Public
Helath Nursing in the Phiippines, 10th Edition. Philippines:
National League of Philippine Government Nurses Inc. 2007. 9 stress
management techniques This related literature aids in identifying
some of the different stress management techniques that can be used
to mange stress. These are: 1. Meditation is a way of reaching
beyond the senses. It is very effective method of relaxation. The
idea of meditation is to focus ones thoughts on one relaxing thing
for a sustained period of time. It gives the body time to relax and
recuperate and clear away toxins that may have build up through
stress and mental or physical activity. Meditation may have the
following effects: a) lowers blood pressure; b) slow breathing; c)
gives the body time to eliminate lactic acid and other waste
products; d) eliminates stressful thoughts; e) helps with clear
thinking; f) helps with focus and concentration; g) reduces stress
headache; 2. Self awareness means knowing ones self, getting in
touch with ones feelings, or being pen to experiences. It increases
sensitivity to the inner self and relationship with the world
around. Self awareness is important in evaluating ones abilities
realistically, identifying the areas which needs to be improved,
recognizing and building strengths, developing more effective
interpersonal relationship, understanding the kind of motivations
that are influencing such behavior, developing empathy and
understanding to recognize both personal needs and the needs of
other people. Scheduling: time management time is a source. A
source is something that lies ready for use, or something that can
be drawn upon for aid. Time is a tool that can be drawn upon to
help accomplish results, an aid that can take care of a need,
assistance in solving problems. Managing time really refers to
managing ones self in such as a way as to optimize the time
available in order to achieve gratifying results. 4. Siesta mans
taking a nap, short rest, a break or recharging of battery in order
to improve productivity. It helps relax the mind and body muscles.
It had been proven thru a study that siesta invigorates ones body.
Performance of an individual scored high when siesta is observed
with a 15-30 minutes nap. It relieves stress tension and one wakes
up invigorated and set for the next activity. 5. Stretching are
simple movements performed rhythmical and slow pace executed at the
start of a demanding activity to loosen muscle, lubricate joints,
and increase bodys oxygen supply. It requires no special equipment,
no special clothes, and no special skills and it can be done
anywhere and anytime. Frequent exercise is probably one of the best
physical stress-reduction techniques available. Exercise not only
improves health, it also relaxes tense muscles and induces sleep.
6. Sensation techniques the sense of touch is highly a powerful and
sensitive form of communication. It is a natural reaction to reach
out and touch whether to feel the shape or texture of something or
to response to another person, perhaps by comforting them. Massage
helps to soothe away stress, unknotting tensed and aching muscles,
relieving headaches and helping sleep problems. But massage is also
invigorating; it improves the functioning of many of the bodys
system, promotes healing and tones muscles, leaving with a feeling
of renewed energy. 7. Sports engaging in sports and physical
activities like these have been known to relieve stress. It also
gives the body exercise it badly needs. 8. Socials a man is a
social being who exist in a relationship with his physical
environment and in relationship with people and society.
Socialization plays a very important role in the development of
interpersonal relationships. Through socialization life begins to
be meaningful, happy and worthy. On the contrary without
socialization life would be boring and unhappy. 9. Sounds and songs
music play is an important part in the everyday life of a person.
It provides medium of expression for thoughts and emotions. It is
also a way to relieve tension. Music adds to the quality of life of
a person. Pegues, Deborah Smith. 30 days in Taming your Stress.
Philippines: OMF Literature Inc. 2007. Sleep is more important to
our survival than water or food. Getting sufficient sleep to
restore our bodies is a key factor in coping with day-to-day
stress. Further, failure to get enough sleep also increases stress
and can make us less able to handle stressful situations. Most
adults, regardless of age, need the recommended eight hour us
restful sleep a night. But sometimes stress can keep us awake,
making matters worse as we find ourselves in a vicious cycle of
stressful situation keeping us up and then a lack of sleep causing
more stress. Sleeplessness then can be one of many signs that our
body is under stress. What about your sleeping habits? Do you have
a sleep routine in which you go to bed and get up about the same
time, or do you allow events, people, deadlines or other
circumstances dictate your sleep schedule? For those of you whose
bedtime routine is rather extensive, do you start to wind down in
plenty of time to allow yourself to complete it, or does the
routine itself become stressor? Ever thought about completing it
hours before your bedtime? Most of us think of sleep as some
passive process in which we drift off into oblivion and wake up
several hours later well rested. The truth of the matter is that
sleep is an active state. Many metabolic and other restorative
processes occur during the various stages of sleep. If we do not
sleep long enough for our system to be rejuvenated, we will most
likely find ourselves irritated by the smallest things and battling
a whale of an appetite. The excess hunger is just our bodys cry for
the energy that was supposed to be supplied by a good nights sleep.
Nourish your body You will be able to manage your stress much more
effectively if you know how the foods you consume affect your bodys
ability to cope with daily pressures. Despite the many books on the
market today that adequately explain how to properly fuel our
bodies, nutritional ignorance seems to be the norm as the rate of
obesity continues to rise. When the pressure is on, many find
refuge and comfort in food. Nourishing our bodies properly is a
lifelong endeavor and we would do well to become as
nutrition-conscious as possible. If you have the physical stress
symptoms of poor concentration, fatigue or a ferocious appetite,
you may be tempted to get a quick fix by eating junk food. The
items of choice usually contain caffeine, sugar or something salty
with a crunch. Do your find it interesting that when spelled
backwards, s-t-r-e-s-s-e-d is d-e-s-s-e-r-t-s? Have you noticed
that you never tend to crave foods like carrots, apples, or lean
meats, even though they may be better for you in the long run? But
therein is the answer: the long run. It takes a healthy food choice
longer to raise our blood sugar to the point where we feel
satisfied, whereas the junk food delivers an immediate result
because its refined ingredients are quickly assimilated. Further,
they cause your brain to release serotonin, a hormone that helps
you to relax for a brief time. The time is so brief that youll need
another hit of carbohydrates to recover from the precipitous drop
in your blood sugar. This time youll probably have to consume even
more carbohydrates because your blood sugar drops even lower than
it was originally after the first carbohydrate, so your body is
going to have to work harder to get your sugar level back to
normal. Is this beginning to sound like a drug addiction scenario?
Through all of this activity, there is a good chance that you are
not really hungry but rather feeding whatever the emotion the
stress generated. A 10 to 15 minute nap may be the best solution.
Of course, if you were diligent to make sure that you eat the right
foods frequently throughout the day, then your blood sugar would
stay at a level that would eliminate those cravings. Nutritional
and homeopathic supplements also play a vital role in helping us to
cope with stress, tension or anxiety. However, before you begin a
herbal program, you should at least make a call to your medical
doctor to make sure that certain herbs do not interfere with your
current medications. It is a known fact that during time of stress,
more vitamin C is depleted from the body. Therefore, an extra dose
to replenish it may be needed. Prolonged stress can cause our
internal systems to breakdown. We need to keep our insides strong
by selecting foods that nourish us rather than work against us. Get
Physical activity is an excellent stress-buster and is critical to
normalizing your body after a stressful event. When your brain
senses a threat or danger, it quickly releases hormones carrying an
urgent message via the bloodstream to the adrenal glands (which sit
atop the kidneys). The message says, Lets prepare to resist or run
now! The adrenal glands produce excess stress chemicals, cortisol
and adrenaline and rush them into the bloodstream, where they get
delivered to various parts of the body via nerve fibers. The body
responds with increased strength, raised blood pressure and other
assistance needed to resist or run. There have been countless
stories of people who exhibited unusual strength in a crisis. I
heard of a petite young mother who actually lifted the back of a
car under which her child had been trapped. Of course a crisis is
not limited to threats of physical danger. The threat of losing a
job or a loved one, or even the excitement of a happy occasion can
cause the brain to put the body on high alert. The adrenal glands
do not attempt to distinguish between negative or positive
excitement. Once the crisis is over, the excess hormones need to be
dissipated out of the bloodstream. This is where exercise plays a
critical role. Regular physical activity helps to burn these extra
chemicals so your body can return to normal. Imagine their buildup
if you tend to live in a period of stress day in and day out. In
addition to its positive impact on stress, physical activity
provides us with numerous other benefits, including better
resistance to illness, stronger bones, more energy and stronger
muscles. What activity is best? The best form of exercise is the
one you enjoy and find the most convenient. These are the two
biggest reasons why most of us fail to be consistent in following
an exercise program. First, we either lose interest in the activity
because we dont really get a lot of satisfaction out of doing it. I
have had beginning lessons in almost every sport two or three times
for some. Secondly, we tend to not be consistent in an activity if
it requires too much time or effort to access. Whether a brisk walk
or a high-energy fitness class almost any physical activity will
help you let off steam, distract you from your source of stress and
improve your mood. It also relaxes and reenergized your body. The
duration of the exercise should be a minimum of 30 minutes of
physical activity a day at least five days a week. Doing more is
even better. Some fitness gurus suggest that if you cannot carve
out 30 minutes at a time, grab 10 minute segments throughout the
day. There are also other benefits to making exercise the center of
your stress-busting program. People who are routinely active tend
to eat better. In addition, physical activity can help you lose
weight, keep it off and feel better about yourself. Feeling
physically inadequate can be a stressor in itself. Stress can wear
your body down mentally and physically; however, a healthy body can
cope with stress better than an unhealthy one. Schedule your day
wisely Each new day presents us with 1440 minutes to use at our
discretion. If we dont consciously decide how we will spend them,
we will look up and realize they passed us by without our ever
starting the tasks we desired to complete. The best approach to
manage stress is to prepare and follow a wisely prioritized to-do
list. I should warn you up front that the list itself can become a
source of stress if you include too many tasks. I use an electronic
calendar and I categorize every activity by its importance. Every
activity is not equally important. You really can put off until
tomorrow those insignificant things that would stress you if you
were to do them today. If you are not in the habit of developing a
to-do list, you may wander aimlessly throughout the day without a
sense of focus. A simple handwritten list will provide the same
sense of accomplishment as you strike off the completed items. As
you plan your schedule, do not plan on doing too many things at the
same time. Studies have linked chronic, high-stress multitasking
under intense pressure to short term- memory loss. Further, experts
have concluded that multitasking actually makes a person more
inefficient because it reduces the brain power needed to perform
each task. If you feel you must be productive during all of your
waking minutes, its time to redefine productive. Solitude is
productive. Taking a mental time out while waiting in line is
productive. Praying for each member of your family while sitting in
traffic is productive. Solidify your support system No man is an
island. No man stands alone. Just as God created our physical
bodies in such a way that our various internal systems support each
other, so it is in our relationships. Everybody needs a support
system. Resolve Conflicts There are few things I find more stress
generating than unresolved conflict. It keeps my adrenaline on high
alert and consumes my thoughts until I have resolved it.
Consequently, I try to confront offenses and misunderstandings
right away. If we are going to manage the stress in our lives, we
must develop the skills needed to address the conflicts which are
sure to arise for conflicts are inevitable. Further, the problem
with failing to confront an issue is that it is likely to occur
again. Strife is stressful and it is to our advantage to keep it at
bay. We cannot eliminate conflicts from our lives because we are
all unique individuals with different backgrounds, communications
styles and preferences. However, we can confront the issues,
resolve them and grow as a result. Admit your mistakes and
shortcomings Im sorry I was wrong. My mistake! I dont know. These
are words that some people find hard to say. Staying blameless is a
hard and stressful position to maintain. Everybody makes a mistake,
misjudges an issue or otherwise messes up something at some point.
Its called being human. Oddly enough, mistakes are one of the major
ways we learn. However, because of our fear of being judged
negatively or losing face, we often try to cover up our mistake
which opens the door wide for stress. On the other hand, admitting
a mistake is a surefire stress-buster. It is a relief to yourself
and an inspiration to others when you show the courage and the
confidence to acknowledge you mistake without defining yourself by
them. The only real tragedy about mistakes is if you dont learn
anything from them. Refusing to admit a mistake closes the door for
growth. In addition to creating stress, there is another downside
to an attempt to be blameless. When you deny your shortcomings and
mistakes, people are likely to label you as arrogant and proud. The
irony is that others connect with you better and will declare you
humble when you admit your weaknesses. Humility is one of the
traits that people admire most in others; pride is detested even by
other proud folks. Humans make mistakes. They have blind spots.
Peace comes when we start confessing our faults to one another.
Taking a time-out short breaks are essential in managing stress.
Longer breaks are equally critical. You have to begin to deem your
leisure time as important as any other commitment. Time-outs wont
happen without a firm resolve and careful planning. Release your
tension In addition to walking, running or other physical
activities; we must practice ways to release the tension that
builds up in us when we experience temporary stress. I have set
forth a few strategies: Take a deep breath. Taking a deep breath
can do wonders in diffusing the tension you may be feeling. Deep
breathing relaxes you because it lowers your heart rate and
circulates extra oxygen to various parts of the body. Squeeze an
antistress ball or gadget. Simply squeezing it as tightly as youd
like relieves tension. Sing. Like in the Bible, when Paul and Silas
were jailed for preaching the gospel, they chose to sing. I have
found that a nice worship song ushers me into the presence of God
and floods my soul with peace. Self-massage. Learn to massage you
tense areas yourself. Laugh Humor has been a key stress reliever
for me for as long as I can remember/ In fact, many people have
told me they assumed I had no problems because I always seem so
happy/ What they do not realize is that if I thought about it or
more than a minute, I could find something to cry about each day.
Rather than focusing on what isnt Ive made a conscious decision to
maintain a merry heart. The impact of laughter on stress is well
documented Studies show that laughter lowers blood pressure and
reduces hypertension. It reduces stress hormones and cleanses the
lungs and body tissues of accumulated stale air because laughter
empties more air out than it takes in. It boosts immune functions
in the body. In addition to all of the preceding benefits, laughter
triggers the release of endorphins those feel good chemicals in the
brain that make you feel good and elated. Swap jokes with friends.
Let people know you enjoy a good laugh. Dont be shy about sharing
your most embarrassing moments. Laugh at your mistakes especially
on the job. Be a good sport. Laughter can also take your mind off
whats stressing you. Maintain a positive outlook Maintaining
appositive outlook requires not only faith but also mental
discipline. While you may believe that God is in control of your
life, oftentimes the reality of a situation can overwhelm your mind
and threaten to negate your faith. As you arrest those negative
thoughts, fix your thoughts on what is true and honorable and
right. Think about things that are pure and lovely and admirable.
Think about things that are excellent and worthy of praise. The
amount of stress you experience in a situation will be determined
by your attitude toward what is happening. If you start confessing
that you are overwhelmed, then you will experience what you have
heard, for faith comes hearing. A positive attitude will not only
minimize how much stress affects you but also has a direct
correlation to how our bodies respond to diseases. Numerous studies
have shown that optimistic people who are diagnosed with terminal
illness tend to live way beyond the normal predicted life span A
relaxed attitude lengthens life. Exploring Brain and Behavior
Correlates of Stress ManagementWhen individuals are stressed, the
sympathetic nervous system stimulates the body to release adrenalin
and cortisol in preparation for a "fight or flight" response to
actual or perceived alterations in the surrounding environment. By
virtually effecting the entire body and mind with neurohormonal and
neurochemical level shifts, this often overlooked primitive brain
function has significant power over perceptions of crisis
situations and subsequent decision making. For those experiencing
chronic stress, the body is continually activating the sympathetic
nervous system which can exhaust the body, result in repetitive
response patterns to emergent and effectively charged situations,
and ultimately result in health problems such as those previously
described. The brain is responsible for interpreting events and
psychosocial situations as stressful or not; therefore, when the
brain perceives stress, the nervous system reacts with a stress
response. Conversely, when individuals effectively gain control
over affective and behavioral responses to events through
stress-management techniques, the brain subsequently has become
able to examine the event, interpret it within a proactive frame of
possible solutions, including previously established self-soothing
techniques, and alternate effective responses follow (APA, 2004;
Benson, 1975).Stress and CopingKozier, Barbara et al. Fundamentals
of Nursing, 7th Edition. Stress and Coping. Philippines Pearson
Education South Asia PTE LTD. 2004.Stress is a universal
phenomenon. All people experience it. Parents refer to the stress
of raising children, working people talk of the stress of their
job, and students at all levels talk of the stress of school.
Stress can result from both positive and negative experiences. The
concept of stress is important because it provides a way of
understanding the person as a being who responds in totality (mind,
body, and spirit) to a variety of changes that take place in daily
life.Stress is a condition in which the person responds to changes
in the normal balanced state. A stressor is any event or stimulus
that causes an individual to experience stress. When a person faces
stressors, responses are referred to as coping strategies, coping
response, or coping mechanisms.There are many sources of stress.
They can be broadly classified as internal or external stressors,
or developmental or situational stressors. Internal stressors
originate within a person, for example, cancer or feelings of
depression. External stressors originate outside the individual,
for example, a death in the family, or pressure from peers.
Developmental stressors occur at predictable times throughout an
individuals life. Within each developmental stage, certain tasks
must be achieved to prevent or reduce stress. Situational stressors
are unpredictable and may occur at any time during life.Stress can
have physical, emotional, intellectual, social, and spiritual
consequences. Usually the effects are mixed, because stress affects
the whole person. Physically, stress can threaten a persons
physiologic homeostasis. Emotionally, it can produce negative or
non-constructive feelings about the self. Intellectually, stress
can influence a persons perceptual and problem-solving abilities.
Socially, stress can alter a persons relationship with others.
Spiritually, it can challenge ones belief sand values. In
Stimulus-Based Model, stress is defined as a stimulus, a life
event, or a set of circumstances that arouses physiologic and/or
psychological reactions that may increase the individuals
vulnerability to illness. While according to the Response Based
Model, Selye (1956-1976) defined stress as the non-specific
response of the body to any kind of demand made upon it. Schafer
(2000) defined stress as the arousal of mind and body in response
to demands made upon it.Cosmopolitan, January 2009 Edition.
Philippines: Cosmo Summit Media; Get a LifeBy: Zo AguilaStress is
an epidemic today, and to make it worse, we are in a situation
where we are clueless about what is bugging the life out of us.
According to the Foundation for Integrated Research in Mental
Health in 2007, more than three out of five doctor visits all over
the world are for stress related problems. And, while Filipinos are
among the happiest people in the world, according to a study by
World Value Survey, we are still subject to a lot of stress and
suffer illnesses caused and made worse by it: high blood pressure,
stroke, diabetes, ulcer, and heart disease.Todays stressors are so
real and so self-created that you wonder why they are there in your
life at all (Ashima Puri, R.N.). And, the problem expectedly is, we
all end up lamenting the symptoms instead of the main issue by bad
moods and temper tantrums, lost appetites, nail biting and nasty
headaches, and a million by-products in between.Stress is not all
bad news. A certain level of pressure is good for us. The buzz of
new challenges or the excitement of a new relationship keeps life
interesting. What we call stress is more often than not, not really
stress. According to the Encyclopedia of stress, stress is one of
the most frequently used but ill defined words in the English
language.Stress can affect our physical capabilities by giving us
headaches, bad tummy or feeling sick, back pain, trembling,
sweating, sleeping difficulties, colds, or infections. It can also
change our mental status such as feelings of panic or anxiety,
irritability, depression, poor concentration, feeling helpless,
lacking confidence, and not wanting to socialize. Thats why this
article sited 5 Save Your Soul Strategies: a.) Cognitive Behavioral
Therapy (CBT), b.) Stress management programs, c.) Aromatherapy,
d.) Biofeedback, and e.) Swedish and Shiatsu Massage.
Foreign
Literature(http://libportal.medilam.ac.ir/documents/10129/36342/A+longitudinal+study+of+stress+and+self-esteem+in+student+nurses.pdf)Stress
and Self Esteem Among Nursing StudentsMore recently, studies among
Project 2000 students (Brown andEdelmann, 2000; Evans and Kelly,
2004; Hamill, 1995; Jones andJohnston, 1997, 1999; Timmins and
Kaliszer, 2002a; Tully, 2004) have identied specic academic and
clinical stressors throughout the program of study. A number of
academic stressors for rst year students which included lack of
free time, long hours of study, college response to student need
and fear of failing (Jones and Johnston, 1997).Several studies have
reported academic stressors for students in their nal year and
these include not being treated as an adult learner, confusing
assignment guidelines and the amount of self directed learning
(Hamill, 1995), nancial concerns and relationships with teaching
related staff (Timmins and Kaliszer, 2002a). Where studies have
investigated academic stress throughout the entire program of study
the issues that caused them stress included examinations (Evans and
Kelly, 2004; Lindop, 1999), the intense amount of work (Evans and
Kelly, 2004; Tully, 2004), nding the academic work difcult, being
faced with study (Evans and Kelly, 2004) and nancial concerns
(Brown and Edelmann, 2000). The clinical stressors identied by
research studies for students in their rst year of study were lack
of practical skills, negative attitudes of ward staff and
misunderstanding of supernumerary status (Hamill, 1995), whereas
for nal year students the stressors were identied as death of a
patient and relationships with clinical related staff (Timmins and
Kaliszer, 2002a). Where studies have investigated clinical stress
throughout the entire program of study the issues that cause them
concern have been identied as the theory to practice gap,
atmosphere among clinical staff, being reprimanded in front of
staff and patients (Evans and Kelly, 2004) and the death of a
patient (Rhead, 1995). The most recent study conducted found that
stress in nursing students arises from a combination of personal
and extracurricular factors rather than from the educational
programme itself (Pryjmachuk and Richards, 2007). While there are
signicant number of studies showing levels and contributors to
stress among students, there is little evidence of how these levels
change over time. The one longitudinal study to examine this issue
(Deary et al., 2003) found increasing levels of stress and use of
emotion-oriented, avoidance and distraction coping strategies, as
the programme progressed. Stress was measured at baseline and at
the end of the rst year whereas all other variables were measured
again during the second and third year. Burnard et al. (2008)
reported data from a series of cross-sectional surveys in student
nurses in each year of training, and found no evidence of changes
in the intensity of stress during the course of training.
Accordingly, there is need of a longitudinal study of student
stress over time. Self-esteem has long been identied as an
important predictor of adjustment to stress (Lazarus and Folkman,
1984). Now considered a multidimensional construct that can change
over time in response to a variety of external and internal
inuences (Greenier et al., 1995), high levels of self-esteem are
considered important in terms of both managing the demands placed
on nurses during their training and for developing a strong and
therapeutic relationship with a patient (Ohlen and Segesten, 1998).
Although a number of studies have shown how self-esteem varies over
the course of the training period, there is little consensus within
the data (Begley and Glacken, 2004; Lees and Ellis, 1990; Randle,
2003; Sasat et al.,2002). Different aspects of self-esteem (social,
personal and general) in nursing students were investigated across
three years of nurse training programmes in two countries and no
relationship as found between self-esteem and year of study (Sasat
et al., 2002).The three longitudinal studies conducted in the UK
provided conicting evidence. Randle (2003)found that although the
majority of students commenced their nurse training with average
levels of self-esteem as classied by the Tennessee Self Concept
Scale, by the time they nished their education their self-esteem
had fallen to the point that 95% of the students perceived
themselves as anxious, depressed and unhappy. By contrast, Begley
and Glacken (2004) found that students self-esteem rose as they
neared the end of their education programme, although their overall
self-esteem levels at their highest were only average. Lees and
Ellis (1990) revealed that self condence and self-esteem was higher
at the beginning of the nursing program and decreased with each
subsequent year.In view of these contradictory or preliminary
ndings, there is a clear need for more data concerning the
longitudinal course of both stress and self-esteem in student
nurses. This study provides such data. The aim of the study was to
investigate nursing students experiences of stress and levels of
self-esteem during three years of their undergraduate nursing
programme and whether changes occur over this time. The is the rst
study of its kind which has explored stress and self-esteem. The
study was longitudinal and prospective, and followed an entire
year-of-entry cohort at one University (including nurses from
adult, child and mental health training pathways).
(http://www.foxbusiness.com/personal-finance/2011/03/31/stress-college-causes-combat/#ixzz2MvQeL4NX)College
StressIts no secret that many college students spend most of their
time on campus stressed out. Balancing classes, tests, projects,
extra-curricular activities and work is enough to make anyone feel
overwhelmed, especially with final exams right around the
corner.College life has become a lot more competitive--its much
harder to get into schools, its gotten a lot more expensive, says
Elizabeth Scott, stress management expert. There are a lot of
things that are factors that have made society more stressful, and
that really translates to college life as well.Having stress in
your life is unavoidable, but there are steps students can take to
mitigate its effects on their lives and health.Healthy worry is
felt in the feeling of uneasiness and concern, saysBarbara Rubel,
stress management counselor and speaker. Unhealthy anxiety is when
uneasiness and concern fills them with apprehension and they are
constantly worried and cannot control their anxiety level.We talked
with some stress and health experts about the presence of stress in
college and why its important to identify certain types of stress
and learn how to cope.
Why College is StressfulGoing off to college involves
significant adjustments to your daily routine; your sleeping and
eating habits, time-management skills, and stress levels will be
altered in one way or another. And even though its been barely
three months since you left high school, you are now expected to be
more independent and self sufficient.Adapting to this new life
stage and the inevitable stress that comes with it (both good and
bad) affects students differently. A lot of people are going away
to school, so theyre moving away from their social support network
and thats a pretty huge change right there, Scott says. At the same
time, they have a lot of new things they have to navigate--not just
getting around campus and living on their own, but choosing their
classes, choosing what direction they want to go in their lives and
choosing who to hang out with.Striking a balance between school and
personal life takes discipline and strong time-management stills,
something that not every student comes equipped with as a
freshman.We have more ways to help ourselves and more ways to
distract ourselves, says Dr.Gregory Jantz, psychologist and author
of How to De-Stress Your Life. We actually create more stress
because we end up not being good time stewards.Relationships can
also be a source of stress for students. Wishy-washy friends who
are supportive one minute and negative and insulting the next adds
unnecessary stress, and according to Scott, can be worse for your
health than having a completely conflicted relationship with an
enemy.Knowing who is toxic to you and safe guarding a little bit
[can] keep the stress from happening, she says. Theres going to be
conflict in every relationship at some point. Working on conflict
resolution skills and communication skills in yourself can really
help you manage the conflicts that come along.Effects of StressA
constant state of stress can affect all aspects of students bodies:
physical, mental, emotional, cognitive, and behavioral functions
can go haywire under duress.Scott points out that stress has a
profound effect on your immune system and your state of
equilibrium. Prolonged stress and sleepless nights can compromise
your health, adding another thing for a student to stress
about.When people are stressed, they tend to not take care of
themselves as well, says Scott. They dont do healthy behaviors like
eating right, exercising and even going to the doctor as much as
they need to. Youre attacking your health on several different
fronts.Stress can also impact relationships in your life, whether
its with friends, family, classmates or teachers. Jantz explains
that stress distorts emotions, and you may be more irritable and
defensive as a result.If you are stressed out, you are not going to
be able to form these bonds or you're going to have problems
maintaining relationships, says Rubel.Chronic StressWhile it is
perfectly normal, and even healthy to feel stressed out from time
to time, there is a point where stress crosses the line into what
experts call chronic stress.Jantz explains that constant levels of
tension can cause adrenal glands to release too much cortisol,
keeping the body in a physiological state of stress.Chronic stress
diminishes the amount of time you spend in the sleep cycles that we
need to stay in [and] affects our digestion and our bodies, he
says.Scott says that chronic stress is aggravated by not allowing
your body to recover and return to a normal, relaxed state. It can
either be because your body is being triggered over and over again
in a period of time, or it can be a constant stream of stress and
you never recover from it, she says.In addition to strain on your
body, Jantz points out that under chronic stress, you may subside
to unhealthy behaviors. If they're under chronic stress, maybe
they're going to drink more or use [drugs], he says. We tend to
look for more destructive outlets alternately.How to Relieve
StressThe experts agree that it is important for students to have
stress-relief techniques that help them return to a calm and
relaxed state of mind, even if the stress is still
present.De-stressing techniques vary, and what works for one
student might not work for others.Jantz says to restore your
sanity, some people may only need something as simple as taking
themselves out of their normal setting. Going outside and sitting
under a tree can help regroup thoughts and let out some
stress.Maybe theres too much stimuli and you have to remove
yourself from distraction, he says. Use a different environment to
help calm you down.Taking care of your body is also a simple, yet
efficient way to curb anxiety and stress overload. Students should
schedule in exercise so it becomes a part of your daily routine. If
you can, avoid processed foods, too much sugar, and energy drinks,
which the experts unanimously agree can agitate stress levels.The
body can get dehydrated, so [hydration] is another way of helping
your mind, says Jantz. Water improves concentration.If projects,
papers and tests are the main source of your stress, Rubel
recommends not procrastinating and keeping a tight schedule and
organized notes and work area.Although it may seem impossible to
reinforce the good things in your life when you feel like tearing
your hair out, constructive thinking can help you see the
proverbial glass as half-full.Students can change the way they
think about things, says Rubel. Maintain an optimistic, positive
attitude with high self-esteem. Keep boundaries in place, laugh
when you can, and share that laughter with others.
(http://onsopcontent.ons.org/Publications/StudentVoice/Nov04/article5.html)Stress
Management is the key during Nursing SchoolOne important thing that
I always tell my students is to take care of them. If they cannot
take care of themselves, how will they be able to take care of the
clients they encounter throughout their nursing career? Nursing is
the one profession with the most "dropouts." Nurses change careers
because of high stress levels or "burnout," which is synonymous
with total exhaustion.Nursing school is very stressful. Students
experience increased tension prior to their clinical rotations or
their written examinations, especially their finals. The major
sources of stress experienced are interpersonal relationships and
performance demands. Nursing school is very demanding with its
paperwork and skill performance. Multiple stressors combine and
result in cumulative stress. Research shows that catastrophic life
events correlate more highly with subsequent illness than joyful
life events.Nursing students need to assess their stress levels and
determine what will decrease their tension. Important ways to
reduce stress include avoiding change, blocking time, becoming
skilled in time management, and setting goals. To avoid change, we
need to try to keep the same routines. I always tell students to
eat before a clinical rotation or an examination. Even if they have
no time, just taking one minute to place a tablespoon of peanut
butter in their mouths will give them some protein and energy to
perform better.The second important point is taking time. Take time
to address important goals. For a student, setting aside a block of
time to study before an examination or setting aside time to
complete a client database for a clinical rotation are important.
Cramming for the examination or staying up all night to complete a
client database will increase anxiety, frustration, and chances for
failure. Scheduling fun time is also important. You need to leave
the hospital or the nursing school environment behind at times and
enjoy something that will bring happiness into your life. This will
make it easier to come back to the school or the hospital. Go out,
explore creation, and enjoy the sunset, or go home and enjoy your
family or a special relationship.Spiritual resources also help the
student nurse to adapt to stress. I enjoy singing with my church
choir. We always have a special concert before the Christmas Eve
service, when all of the choir members dress up in their finery and
sing beautiful Christmas music. The choir members support me
spiritually and emotionally in many projects that I have completed.
My friends were my walking and running mates during the 2002 Relay
for Life in Austin, for which I was the chair. In 2003, they helped
me plan the Luminaria ceremony [explain what this is?] and
participated again during the Relay for Life.The third way to
reduce stress levels is time management. Establishing goals and
having the time available to accomplish those goals are important.
Tasks can be reduced into smaller parts. Tasks not related to
school can be delegated to other family members or delayed in favor
of more important tasks. Avoid waiting too long to begin a task.
This will only increase anxiety and tension. Schedule
activities-this will increase positive tensions and promote growth.
Forget those all-nighters! Get control over the situation. Make
time in your schedule for studying and sleeping at night, and eat
during the day. I carry many small snacks such as nuts, cheese, and
vegetables (little carrots and tomatoes), which I can eat
throughout the day when I know I will not be able to sit down for a
meal. You can place snacks in plastic bags the night before a
clinical rotation or a long school day.Exercise is a wonderful
stress reducer. I have made that the priority in my own life.
Schedule 30 minutes of vigorous exercise three times per week, and
you will increase your strength and stamina, which are needed in
nursing school. I cannot stress enough the importance of taking
care of yourself. My family has been a great support to me
physically and emotionally. Although my family members live far
away, we are close. We call one another often, plan family
reunions, and take vacations together. These are very special and
joyful times of my life.Create a strong social support network.
Friends and family can provide encouragement and emotional support.
Create a relationship with someone who can be your mentor, someone
who will not only encourage and support you but also give advice
about your nursing career and guidance to achieve your goals in
nursing school, advice that you will fall back on throughout your
nursing career. I have had many incredible mentors throughout my
nursing career. I would not be where I am today, a clinical
instructor of holistic adult health, without these mentors. Visit
your teachers, and ask for feedback about how you are performing.
Teachers can help with developing your clinical assessment skills.
Use your health resources at school. Visit the skills laboratory to
gain competence in your nursing skills. Visit your coordinator of
learning enhancement to discuss test taking strategies or help
establish goals to reduce stress. Establish supportive
relationships with your fellow students. You can help each other to
deal with stress, encourage each other, and provide emotional
support during those stressful times in nursing school.Do plan
ahead for the holiday overload of stress. Make room in your
calendar for those important people in your life. Turn down
requests and people who make demands on your life. Get plenty of
rest and sleep during the holidays, and take care of yourself
(Davis,
2004).(http://www.medicalnewstoday.com/releases/160265.php)Significant
Sleep Deprivation and Stress Among College StudentsStressabout
school and life keeps 68 percent of students awake at night - 20
percent of them at least once a week. Stress affects the quality of
their sleep far more than alcohol, caffeine or late-night
electronics use, a new study shows.Not only that, more than 60
percent of college students have disturbed sleep-wake patterns and
many take drugs and alcohol regularly to help them do one or the
other.
The study of 1,125 students appears online in theJournal of
Adolescent Health. It found that only 30 percent of students sleep
at least eight hours a night - the average requirement for young
adults. On weeknights, 20 percent of students stay up all night at
least once a month and 35 percent stay up until 3 a.m. at least
once a week. Twelve percent of poor sleepers miss class three or
more times a month or fall asleep in class.
"Students underestimate the importance of sleep in their daily
lives. They forgot sleep during periods of stress, not realizing
that they are sabotaging their physical andmental health," said
study co-author Roxanne Prichard, an assistant professor of
psychology at the University of St. Thomas, in St. Paul, Minn,
where the study took place.
Impairments in the immune and cardiovascular systems are health
risks associated with insufficient sleep, as is weight gain,
Prichard said.
Daniel Taylor, an assistant professor of psychology at the
University of North Texas, said, "We know little about the health
of this age range even though the consequences - substance use,
psychopathology, poor grades, dropout and subsequent unemployment -
of sleep disturbance could be greatest."
Of concern to researchers was the students' tendency to use
alcohol and drugs to regulate their cycles. Poor sleepers are more
likely than good sleepers are to use medication to stay awake or
fall asleep, and twice as likely to use alcohol to induce sleep.
Alternating between stimulants and sedatives has been associated to
a higher risk ofaddiction.
Prichard said that physicians, counselors and student health
professionals should be more aware of and proactive in helping
students realize the importance of sleep.Jones, M.C. &
Johnston, D.W. Distress, Stress and Coping in First-Year Student
Nurses. Journal of Advanced Nursing. 1997 and Cottrell, S.
Occupational Stress and Job Satisfaction in Mental Health Nursing:
Focussed Interventions Via Evidence-Based Assessment. The Journal
of Psychiatric and Mental Health Nursing. 2000.Stress During
Nursing TrainingStress from many sources has been reported for some
time by student nurses. Academic sources of stress include
examinations, long hours of study, assignments and grades, lack of
free time, faculty response to student need and lack of timely
feedback (Beck & Srivastava 1991). Specific elements of the
academic programme, e.g. palliative care experiential workshops
(Lawrence et al. 1985), produce stress reactions in
students.Clinical sources of stress include working with dying
patients, interpersonal conflict with other nurses, insecurity
about personal clinical competence, fear of failure, interpersonal
problems with patients, work overload and concerns about nursing
care given to patients (Parkes 1985). Learning psychomotor skills,
e.g. administering injections (Speck 1990) and performing female
catheterization (Bell 1991), have been associated with high levels
of anxiety, and a perceived lack of practical skills is a common
worry for many students (Hamill 1995).The atmosphere created by
clinical faculty, patient care responsibilities, working with
HIV/AIDs (Mueller et al. 1992) and supernumery status itself
(Wilson-Barnett et al. 1995) are all clinical sources of stress.The
setting in which student nurses are placed may also have an impact
on affective well-being. Initial ward placements produce greater
anxiety for students than for any other period in the early part of
training, regardless of whether the experience is in a male/female,
or a medical/surgical placement (Parkes 1982). Changes in ward
allocation have also been shown to be a source of stress for
student nurses (Jack 1992).Examples of this three-level approach
can be summarised as follows:Individual perspective: Stress
reduction - personal stress profile feedback, time management
training, career and training consultations, assertiveness
training, communication skills development and psycho-education.
Stress management - health lifestyle promotion, reflection,
clinical supervision, mentorship,buddysystems, relaxation and
home/work interface. Stress treatment - counselling, psychotherapy,
occupational health interventions and physical wellness: diet,
exercise, addictions, lifestyle work.Team perspective: Stress
reduction - team building, team role analysis and boundary
clarification. Stress management - group development diagnosis and
intervention, clinical team supervision, dependency/skill mix and
workload analysis and review. Stress treatment - therapeutic
remedial team work and work group role negotiation.SYNTHESIS:
StressStress as defined by Arnold Burnout as exhaustion of physical
and emotional strength. It plays a great part not only on students
but in every individuals daily living. He further states that
sustained, intense stress decreases productivity and narrows the
individuals perceptions. Too much stress blocks learning and
decreases problem solving ability (Burnout, 1989). Stress is a
universal phenomenon. All people experience it. Parents refer to
the stress of raising children, working people talk of the stress
of their job, and students at all levels talk of the stress of
school (Kozier, 2004)Stress can result from both positive and
negative experiences. The concept of stress is important because it
provides a way of understanding the person as a being who responds
in totality (mind, body and spirit) to a variety of changes in
life. Stress is a condition in which the person responds to changes
in the normal balanced state (Kozier, 2004). Stress is the arousal
of mind and body in response to demands made upon it (Schafer,
2000).Stress is the non-specific response of the body to any kind
of demand upon it (Selye 1956-1976). Stressors A recent article
reads as follows: common stressors for the nurses are environmental
conditions, emotional problems and management of stress. A stressor
is any event or stimulus that causes an individual to experience
stress. When a person faces stressors, responses are referred to as
coping strategies, coping responses or coping mechanisms (Kozier,
2004). Academic sources of stress among nursing students include
examinations, long hours of study, assignments and grades, lack of
free time, faculty response to student need and lack of timely
feedback (Beck & Srivasta, 1991). Clinical sources of stress
among nursing students include working with dying patients,
interpersonal conflict with other nurses, insecurity about personal
clinical competence, fear of failure, interpersonal problems with
patients, work overload and concerns about nursing care given to
patients (Parkes, 1985). Levels of StressNursing students need to
assess their stress levels and determine what will decrease their
tension. Important ways to reduce stress include avoiding change,
blocking time, becoming skilled in time management and setting
goals. Stress ManagementManaging you stress includes restoring your
sanity, some people may only need something as simple as taking
themselves out their normal setting. Taking care of your body is
also a simple, yet efficient way to curb anxiety and stress
overload. Students should schedule in exercise so it becomes a part
of your daily routine. If you can avoid processed foods, too much
sugar and energy drinks which the experts unanimously agree that it
can agitate stress levels. the body can get dehydrated, so
hydration is another way of helping your mind, says Janta. Water
improves concentration. If projects, papers and tests are the main
sources of your stress, Rebel recommends not procrastinating and
keeping a tight schedule and organize notes and work area (Rubel,
2005). Students can change the way they think about things.
Maintain an optimistic, positive attitude with high self-esteem.
Keep boundaries in place, laugh when you can and share that
laughter with others (Rubel, 2005).To avoid change, we need to try
to keep the same routines. Second, take time to address important
goals. Third is time management. Spiritual resources also help the
student nurse to adapt to stress. Exercise is also a wonderful
stress reducer. Create a strong social support network. Friends and
family can provide encouragement and emotional support. Do plan
ahead for holiday overload stress. Make room in your calendar for
those important people in your life. Turn down request and people
who make demands on your life. Get plenty of rest and sleep during
the holidays and take care of yourself (Davis, 2004). Chapter
IIIMethodologyThis chapter will present the research design,
sampling procedure, description of subjects and description of
research locale. RESEARCH DESIGN In this study, the design that was
applied is the correlational descriptive research which examines
the extent of the relationship between the levels of stress and
stress management techniques utilized by Bachelor of Science in
nursing students of Saint Gabriel College. The study will determine
if the relationship of variables will have a direct or indirect
relationship. SAMPLING SIZE AND POPULATION The population of
regular and irregular Bachelor of Science in nursing students from
1st year to 4th year enrolled in the school year of 2012-2013 is
225, excluding the researcher. The sample size will be 69. Sample
size will be computed using the Sloven Formula with 90% level of
confidence where in 10% error will be used.
Whereas: N= Populatione= Percentage of Errorn= Sample SizeUsing
the formula: = 69
SAMPLING METHOD: The sampling method that was utilized in this
study was the non-random sampling method. The sampling design of
which will be snowball or networking sampling design. The
researcher will gather 69 respondents from different year levels
which will be 17 students from each class, approaching those
students who meet the inclusion criteria then refer to other
students who meet the criteria as well. The students of which will
be respondents should be on their free time and become available to
the researcher. There will be no manipulation or experimentation
that will be involved.
DESCRIPTION OF SUBJECTSThe subjects should be regular students
enrolled in Saint Gabriel College, Old Buswang, Kalibo, Aklan
taking up the course of Bachelor of Science in nursing. These
subjects were chosen because the researcher feels that stress in
epidemic in the college today. The inclusion criteria for the
subjects includes: being a male and female, with grades not lower
than 80%, have a moderate or high academic performance in school
and has experienced stress in some point of time. The respondents
should be on their free time, with willingness to answer the given
questionnaires. DESCRIPTION OF RESEARCH LOCALEThe location of the
study will be in the Saint Gabriel College Campus, Old Buswang,
Kalibo, Aklan. The private college was established in 1970 and it
is known as the pioneer nursing school in Kalibo, Aklan. This
location was chosen to determine the levels of stress and stress
management techniques utilized by students under the Bachelor of
Science in nursing curriculum of this college. There are 4
classrooms occupied by the Bachelor of Science in nursing students
in this 4 story building. The researcher will have the availability
and time in this location to conduct the study and the participants
are known to the researcher.