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ABSTRACT
The purpose of this study was to investigate the effects of a 5- week stress management program for 40 junior baccalaureate nursing students. A quasi-experimental pretest-posttest control group design was used. The stress management group included training sessions using cognitive modification techniques and Stroebel's Quieting Response (QR) augmented with biofeedback techniques for self-relaxation.
A significant reduction of state anxiety (P<.001) was reported on the State-Trait Anxiety Inventory (STAI) by the experimental groups, while the state anxiety of the control groups remained relatively unchanged. There were no significant changes in trait anxiety scores. Urinary potassium excretion was measured as an index of the adrenal stress response. Findings revealed no statistically significant correlation between potassium excretion and scores on the STAI.
These results support the benefits of integrating a stress management program into curricula for nursing students.
Introduction
Undergraduate nursing students frequently experience high levels of anxiety, especially during clinical courses. A multitude of situational and developmental stressors impinge on learning as well as physiological health (Beck & Srivastara, 1991; Speck, 1990). Assimilation of the current knowledge explosion is a major stressor. Furthermore, students are often perceived as nurses in terms of accountability and responsibility, rather than learners, when they are in the clinical setting (Infante, 1985). Additionally, many times students find that the reality of being a nurse is unlike their lay perception of the role (Pagana, 1988; Simpson, 1979). Not only can the educational journey be a stressful experience which produces anxiety, but students enter a profession high in potential stressors such as increased acuity of clients, rapid technological advances, and the HIV/AIDS epidemic. (Biggers, Zimmerman, & Alport, 1988; Lees & Ellis, 1990; Parkes, 1985).
Stress is a part of life and is experienced by everyone. However, when stress reaches a high level, the student may start to react with aggressive, submissive, and maladaptive behaviors. These behaviors are damaging to the student and present problems for student and nurse educator (Bell, 1991; Blainey, 1980; Charlesworth, Murphy, & Beutler, 1981; McKay, 1978; Strauss & Hutton, 1983).
While the stressors of nursing students' education have been documented, little attention has been devoted to integration of coping skills into baccalaureate nursing programs (Johansson, 1991; Manderino, Ganong, & Darnell, 1988; Russler, 1991). Academic settings tend to focus...