Nursing faculty report hearing their students talk about their academic and clinical regimens and the high levels of stress they feel (Ross et al, 2005; Grossman & Wheeler, 1999). A survey of 409 nursing education program deans and heads of affiliated sites revealed high levels of problematic behaviors in class, including inattention, absence and lateness (Lashley & DeMeses, 2001).
Stress may affect memory, concentration, and problem-solving ability and negatively influence coping ability and academic outcomes (Al-Kandari & Vidal, 2007; Dyson & Renk, 2006; Gupchup, Borrego & Kondur, 2004); Higginson, 2006; Wells, 2007). Poor stress management in nursing students affects their ability to provide “comprehensive nursing care” for patients (Kang, Choi & Ruyu, 2009). Stress also negatively impacts communication, interpersonal effectiveness and empathy (Kendrick, 2000; Marcus, 1999.)
Methods: The focus of PACE Brain Boosters program is to enhance learning through the use of well-documented physical activities and an understanding of how these activities promote learning and maintain our general state of alertness and self-regulation. The primary objective of this study was to evaluate the feasibility and effectiveness of a six-week intervention to reduce stress in nursing students at an urban college. Secondary objectives were to: identify associations between stress symptoms and coping styles in PACE intervention participants and explore the subjective experiences of students receiving the PACE intervention.
Investigators provided participants with a training session and six weeks of implementation of the PACE Brain Gym Program, a sensory motor training program. The students were offered an initial training presentation. Before the actual program started, the students were administered stress scales: Ways of Coping and student stress inventory. The training session was about 30 minutes including discussion using a videodisc of the PACE program (which was also be available on a google drive for them), and a program instructor. It was followed up by weekly review sessions of six minutes provided by the instructor. Students were urged to do a daily computer log of the time they spent practicing, and practice the PACE exercises for 6 minutes for a period of six weeks. They added a journal entry if they are so inclined about their observations during the study. At the end of six weeks, the instructor collected the logs and administered the same stress scale to the student participants. Each participant was given a number for their log so that the research cannot identify the author of the log.
The initial demographic survey of the 17 participants revealed that 82% are interested in learning strategies to manage stress; 53% stated that they currently had symptoms of stress; and 70% stated that they have taken prescription medicine for anxiety or depression. Outcomes on Ways of Coping Scales had a P value of .047 on planfull problem solving, 0.20 for escape avoidance, 0.27 for confrontive coping, and 0.41 for positive reappraisal. The Stress Inventory had a P value of 0.13 for frustrations, 0.11 for total reactions to stressors, 0.13 for physiologic stressors, and 0.13 for emotional stressors with a total inventory of 0.043 for stress. Journal entries.
Conclusions
Since Brain Gym practices are associated with mental and physical health benefits, it was our hypothesis that these practices will also decrease stress in this population. Implementing this program in an academic setting will have broad implications for nursing education and nursing practice. Based on the significant outcomes, using the Pace Brain Boosters program seems to enhance learning through the use of physical activities and seems to improve the coping behaviors and lower the stress levels of the nursing students who participated. These findings have implications for lowering the stress levels and improve coping skills once nurses are in the workplace, thus leading to improved patient care. A similar program could be used to cope with stress in the workplace that may reduce burnout and promote staff retention as well as improve patient care. Starting these stress reduction-wellness behaviors as students will hopefully carry over into nurses’ professional lives.