Investigation of the Stress Level and Potential Contributive Factors for Japanese College Nursing Students during the Period of Clinical Practicum

Purpose:Clinical practicum plays a crucial role in nursing education. However, it is indicated that students often experience great stress due to various tasks they have to carry out and fulfill as a nursing student in varied types of clinical environment. Purpose of this study was to examine the level of stress of Japanese college nursing students and to detect potential factors that might contribute to their increased level of stress during the period of clinical practicum. In addition, the relationship between students’ level of stress and potential factors were examined. In this study, factors that contribute to students’ stress primarily refer to his or her self-efficacy, career interests, interpersonal relationship in the clinical settings, clinical tasks, as well as demographic factors such as age, gender, and household status and so on.

Methods: A descriptive correlational research design was used in this study. A total of 137 college nursing students who are juniors and seniors was recruited from a national university located in southern Japan to participate in this study by using convenience sampling method. Participants were requested to complete a set of scales used to assess the level of stress and self-efficacy. The scales included the Clinical Practicum Stress Scale, a 24-item questionnaire, developed by the researcher to examine the stress resulted from interpersonal relationships, clinical tasks, and environmental situations, the Stress Checklist Short-Form (Imazu et al., 2006), the Coping Scale (Ozeki, 1993), and the Self-Efficacy Scale(Narita et al., 1995). Participants’ demographic data such as age, gender, household status, engagement in clubs or part-time jobs, and initial career interests were also collected. Data analysis methods used in this study included descriptive statistics, Pearson correlation analyses, independent t-tests, and analyses of variance (ANOVAs). The Pearson correlation was used to examine the correlations among variables, whereas the t-tests and ANOVAs were utilized to evaluate group differences in the level of stress of participants with varied background variables.    

Results:The results showed that variables including the interpersonal relationship in clinical settings, task fulfillment, and lack of confidence in carrying out the care result in a higher level of stress, while factors such as gender, age, household status, and engagement in clubs or part-time jobs were variables that less likely contribute to students’ stress. With respect to the stress reactions, many students reported anxiety and psychosomatic symptoms during the period of clinical practicum. Nevertheless, the results revealed that students with a higher level of self-efficacy had a significant lower degree of anxiety and that students with consistent career interest in nursing showed a significantly lower level of stress. Furthermore, senior nursing students demonstrated significantly a higher level of stress than their junior peers.   

Conclusion:The present study indicated that although college nursing students tend to express anxiety and demonstrate psychosomatic reactions to the stress during the period of clinical practicum, a higher level of perception of self-efficacy may result in a lower level of stress. In addition, it was found that many of the students have a stressful feeling toward interpersonal relationship in the clinical settings. Findings of this study indicated the importance of promoting nursing students’ self-efficacy and ensuring them a warm clinical environment.