Nursing students are increasingly diverse, with growing percentages of minorities (American Association of Colleges of Nursing, 2018), and males (National League for Nursing, 2018). In 2011, 21% of all college students were over 30, versus 16% of baccalaureate nursing students. Nursing students are younger (National League for Nursing, 2018), extrinsically motivated, have difficulty making choices related to assignments (Twenge & Donnelly, 2016), and focus on what is needed for the grade (Buckner & Strawser, 2016). Research shows that this grade orientation is harmful to learning and grades (Vallade, Martin, & Weber, 2014).
University students experience high anxiety and stress across programs (Noor, Saleem, Azmat, & Arouj, 2017). Some of this stress relates to the extrinsic focus of many students, who see their education as it relates to prestige and earning power, rather than learning (Twenge & Donnelly, 2016). Student performance can be adversely impacted by internal (e.g., academic issues), and external stressors, such as financial/ family obligations (McCarthy et al., 2018; McDonald, Brown, & Knihnitski, 2018).
The demands of education and nursing can be met with resilience, a positive response which can be learned (Allen & Palk, 2018; Smith & Yang, 2017). Resilience is the ability of an individual to prepare for or respond to perceived adversities (Hamby, Grych, & Banyard, 2018). Resilience broadly encompasses three basic themes: resilience as an outcome, a trait, and a process (Happer, Brown, & Sharma-Patel, 2017). It is a dynamic process, which will change depending upon the timing and perceived severity of stressors (Chmitorz et al., 2018; Thomas & Revell, 2016). Many nursing programs, due to the challenging course work, clinical work, and negative student stress reactions, report high levels of attrition (Sigalit, Sivia, & Michal, 2017). Part of developing resilience is learning positive ways to deal with stress (He, Turnbull, Kirshbaum, Phillips, & Klainin-Yobas, 2018).
Researchers have explored the impact of student anxiety and stress reactions on attrition and academic performance among nursing students (Sigalit et al., 2017; Thomas & Revell, 2016; Turner & McCarthy, 2017). In order to promote self-reflection and self-care, as well as teach alternative methods of addressing stress and anxiety, the course faculty designed a program of experiential learning related to stress reduction. Our research question is: What are the effects of an experiential psychiatric/mental health nursing class designed to present methods of stress reduction?
Methods:
A mixed methods study, with a one group pretest-posttest design, QUAL+QUAN is proposed. Students enrolled in a psychiatric nursing course in their second semester will initially complete the Ten Item Personality Inventory (Gosling, Rentfrow, & Swann, 2003) and the Beck Anxiety Inventory (Beck, Epstein, Brown, & Steer, 1988) as a course assignment.
Students will complete an initial journal entry designed to identify their current knowledge about stress and stress reduction, how they feel about the stress that is experiencing at the beginning of the course, and what some of their concerns are about stress as they move through nursing school and into the profession of nursing. Students will participate in experiential activities in seven psychiatric mental health nursing class meetings involving yoga, aromatherapy, mindfulness, mandala coloring, deep breathing, progressive relaxation, and guided imagery. Students will learn one method per class meeting, with a total class time for each method of 10 minutes. Students will then complete a journal entry each week, which includes questions about stress relief, modalities selected, and student concerns as the semester moves forward. Faculty will read and provide feedback but other students cannot access other students’ content within this assignment, which is located inside the course LMS, Blackboard 9.
Students repeat the Beck Anxiety Scale at the course end, and journal about the result and any related changes, positive or negative. Students will also complete the Skovholt Practitioner Professional Resiliency and Self-Care inventory (Skovholt & Trotter-Mathison, 2016) to promote self-reflection and self-care. Pre- and post-test anxiety group mean scores will be compared using the t-test for paired groups; Pearson’s r will be used to analyze possible correlations between personality indicators, anxiety and resiliency.
Journal entries will be examined for themes, using content analysis. Content analysis will be facilitated by converting the text to a table format for coding. De-identified entries will be divided into three groups, and each researcher will read through the assigned text section to identify what the text is communicating overall. Researchers will then use the highlighting feature in Microsoft Word to identify significant segments of text, and initial codes will be created. Coding will be examined using constant comparison, and consensus regarding naming and examples will be reached. Codes will be used to develop themes.
Results: pending
Conclusion: pending