OJN  Vol.4 No.7 , June 2014
An Exploratory Study: Reducing Nursing Students Stress Levels Facilitate Perceived Quality of Patient Care
Abstract: The aim of this project was to examine if stress levels in Associate Degree (AD) nursing students can affect their perceived quality of care provided to patients. Nursing students experience tremendous amounts of stress especially during their clinical experience. High levels of stress may affect the quality of patient care provided. This project implemented a stress reducing workshop and an instructional deep breathing compact disk (CD) to determine the effects of this intervention upon the stress levels of nursing students and the quality of care provided to patients. Nursing students completed a workshop where recognition of stress producing situations and effective ways to deal with them were discussed. Each student was provided with a CD containing a ten minute instructional deep breathing exercise which they were asked to listen to five times a week for six weeks. Nursing students were asked to complete Cohen’s Perceived Stress Scale (PSS) and the Student Perception of Quality of Patient Care Provided questionnaire prior to and after the implementation of the intervention. The results of the two questionnaires were compared to determine effectiveness of the stress reducing interventions. Using paired t scores, results demonstrated that students’ stress levels were decreased and student’s perception of quality of patient care provided improved after the stress reducing interventions.
Cite this paper: Williams, K. (2014) An Exploratory Study: Reducing Nursing Students Stress Levels Facilitate Perceived Quality of Patient Care. Open Journal of Nursing, 4, 512-519. doi: 10.4236/ojn.2014.47054.

[1]   Lambert, V.A., Lambert, C.E., Itano, J. Inouye, J., Kim, S., Kuniviktikul, W., Sitthimongkol, Y., Pongthavornkamol, K., Gasemgitvattana, S. and Ito, M. (2004) Cross-Cultural Comparison of Workplace Stressors, Ways of Coping and Demographic Characteristics as Predictors of Physical and Mental Health among Hospital Nurses in Japan, Thailand, South Korea and the USA (Hawaii). International Journal of Nursing Studies, 41, 671-684.

[2]   Bourbonnais, R., Comeau, M., Vezina, M. and Guylane, D. (1998) Job Strain, Psychological Distress, and Burnout in Nurses. American Journal of Industrial Medicine, 24, 20-28.<20::AID-AJIM4>3.0.CO;2-U

[3]   Chang, E.M., Hancock, K.M., Johnson, A., Daly, J. and Jackson, D. (2005) Role Stress in Nurses: Review of Related Factors and Strategies for Moving forward. Nursing and Health Sciences, 7, 57-65.

[4]   McVicar, A. (2003) Workplace Stress in Nursing: A Literature Review. Journal of Advanced Nursing, 44, 633-642.

[5]   Li, A., Early, S.F., Mahrer, N.E., Klaristenfeld, J.L. mand Gold, J.I. (2014) Group Cohesion and Organizational Commitment: Protective Factors for Nurse Residents’ Job Satisfaction, Compassion Fatigue, Compassion Satisfaction, and Burnout. Journal of Professional Nursing, 30, 89-99.

[6]   Moscaritolo, L.M. (2009) Interventional Strategies to Decrease Nursing Student Anxiety in the Clinical Learning Environment. Journal of Nursing Education, 48, 17-23.

[7]   Jimenez, C., Navia-Osorio, P.M. and Diaz, C.V. (2010) Stress and Health in Novice and Experienced Nursing Students. Journal of Advanced Nursing, 66, 442-455.

[8]   Billingsley, S.K., Collins, A.M. and Miller, M. (2007) Healthy Student, Healthy Nurse. Nurse Educator, 32, 49-51.

[9]   Cooke, M., Holzhauser, K., Jones, M., Davis, C. and Finucane, J. (2007) The Effect of Aromatherapy Massage with Music on the Stress and Anxiety Levels of Emergency Nurse: Comparison between Summer and Winter. Journal of Clinical Nursing, 16, 1695-1703

[10]   Chiesa, A. and Serretti, A. (2009) Mindfulness-Based Stress Reduction for Stress Management in Healthy People: A Review and Meta-Analysis. The Journal of Alternative and Complementary Medicine, 15, 593-600.

[11]   Praissman, S. (2008) Mindfulness-Based Stress Reduction a Literature Review and Clinician’s Guide. American Academy of Nurse Practitioners, 20, 212-216.

[12]   Hsieh, P. (2011) A School-Based Health Promotion Program for Stressed Nursing Students in Taiwan. Journal of Nursing Research, 19, 230-237.

[13]   Woodhouse, J. (2012) The Use of Visual Methodology in Nursing. Nurse Researcher, 19, 20-25.

[14]   Kanji, N., White, A. and Ernst E. (2006) Autogenic Training to Reduce Anxiety in Nursing Students: Randomized Controlled Trial. Journal of Advanced Nursing, 53, 729-735.

[15]   Higgins, A. and McCarthy, M. (2005) Psychiatric Nursing Students’ Experiences of Having a Mentor during Their First Practice Placement: An Irish Perspective. Nurse Education in Practice, 5, 218-224.

[16]   Chan, D.K., So, W.K. and Fong, D.Y. (2009) Hong Kong Baccalaureate Nursing Student’s Stress and Their Coping Strategies in Clinical Practice. Journal of Professional Nursing: Official Journal of the American Association of Colleges of Nursing, 25, 307-313.

[17]   Papastavrou, E., Lambrinou, E., Tsangari, H., Saarikkoski, M. and Leino-Kilpi, H. (2010) Student Nurses Experience of Learning in the Clinical Environment. Nurse Education in Practice, 10, 176-182.

[18]   Caldwell, R.A. (2000) Quality Nursing Care: An Exploration of Student Nurses’ Perspectives. Doctoral Dissertation, EBSCO CINAHL.

[19]   Hegge, M. and Larson, V. (2008) Stressors and Coping Strategies of Students in Accelerated Baccalaureate Nursing Programs. Nurse Educator, 33, 26-30.

[20]   Jones, M.C. and Johnston, D.W. (2000) Reducing Distress in First Level and Student Nurses: A Review of the Applied Stress Management Literature. Journal of Advanced Nursing, 32, 66-74.

[21]   Callister, L., Khalaf, I. and Keller, D. (2000) Cross-Cultural Comparison of the Concerns of Beginning Baccalaureate Nursing Students. Nurse Educator, 25, 267-269.

[22]   Seyedfatemi, N., Tafreshi, M. and Hagani, H. (2007) Experienced Stressors and Coping Strategies among Iranian Nursing Students. BMC Nursing, 6, 11.

[23]   Burnard, P., Edwards, D., Bennett, K., Thaibah, H., Tothova, V., Baldacchino, D., Bara, P. and Mytevelli, J. (2008) A Comparative, Longitudinal Study of Stress in Student Nurses in Five Countries: Albania, Brunei, the Czech Republic, Malta and Wales. Nurse Education Today, 28, 134-145.

[24]   Cohen-Katz, J., Wiley, S.D., Capuano, T., Baker, D.M., Kimmel, S. and Shapiro, S. (2005) The Effects of Mindfulness-Based Stress Reduction on Nurse Stress and Burnout, Part II: A Quantitative and Qualitative Study. Holistic Nursing Practice, 19, 26-35.

[25]   Williams, K.T. (2011) Student Perceptions of Quality of Patient Care Provided Tool. Unpublished Manuscript.

[26]   Leggett, D. (2011) Deep Breathing Relaxation CD. Weber State University, Ogden Utah.

[27]   Pulido-Martos, J., Augusto-Landa, J.M. and Lopez-Zafra, E. (2012) Sources of Stress in Nursing Students: A Systematic Review of Quantitative Studies. International Nursing Review, 59, 15-25.

[28]   Yamashita, K., Saito, M. and Takao, T. (2012) Stress and Coping Styles in Japanese Nursing Students. International Journal of Nursing Practice, 18, 489-496.

[29]   Reeve, K.L., Shumaker, C.J., Yearwood, E.L., Crowell, N.A. and Riley, J.B. (2013) Perceived Stress and Social Support in Undergraduate Nursing Students’ Educational Experiences. Nurse Education Today, 33, 419-424.

[30]   Rella, S., Winwood, P.C. and Lushington, K. (2009) When Does Nursing Burnout Begin? An Investigation of the Fatigue Experience of Australian Nursing Students. Journal of Nursing Management, 17, 886-897.