Abstract:

This descriptive study aimed to assess sources of stress, coping strategies and outcomes among nursing students during their initial practice. The Lazarus stress, appraisal, and coping model was employed to guide the study. The participants addressed by the study were sophomore-nursing students, at School of Nursing Ramathibodi, Bangkok, Thailand, during their initial clinical practice on August, 2004. The participants consist of 108 students aged between 19 and 21 years (mean age = 19; SD = 1.8). Students' determined sources of stress providing information on open ended – questions. Content analysis of responses to questions was done to look for categories. Coping strategies were collected using the Jalowiec Coping Scale containing items describing aspects of confrontive, emotive, and palliative coping styles. Level of anxiety was used to evaluate consequent outcomes of coping use.  Results indicated that the students perceived stressful experience on lack of professional nursing skills, communication skill, initial ward experience, environment, inadequate knowledge, health problems, teaching-learning methods, time management, and role of clinical teachers. Confrontive, palliative, and emotive coping strategies were used to manage those stressful events.  The confrontive coping strategy was the most common use following by palliative and emotive strategies.  With the regard to outcomes of coping strategy use, the students felt moderate anxiety.  This study provides evidence for nursing educator that helping students overcome stress during their initial clinical practice is important. Additionally, the availability of student counseling service, peer learners, and preceptorship may be helpful for increasing adaptive coping and decreasing anxiety.