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Table of Contents
Year : 2020  |  Volume : 21  |  Issue : 2  |  Page : 171-175

A Study to assess stress and stressors among Undergraduate nursing students in a selected college at Mangaluru

1 4th Year B.Sc. Nursing Students, Department of Obstetrics and Gynecological Nursing Father Muller College of Nursing, Mangaluru, Karnataka, India
2 Lecturer, Department of Obstetrics and Gynecological Nursing Father Muller College of Nursing, Mangaluru, Karnataka, India

Date of Submission13-Jul-2019
Date of Decision21-May-2020
Date of Acceptance17-Nov-2020
Date of Web Publication19-Feb-2021

Correspondence Address:
Ms. Precilla D Silva
Department of Obstetrics and Gynecological Nursing, Father Muller College of Nursing, Father Muller Road, Kankanady, Dakshina Kannada, Managluru - 575 002, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/IJCN.IJCN_133_20

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Stress is a specific response to the stimulus that disturbs the normal body functions. Stress affects the academic performance and welfare of nursing students. The aim of this study was to identify the severity of stress and the stressors among undergraduate nursing students. Two hundred students in the nursing programme in a college completed a survey on stress and stressors. The tool included demographic characteristics, perceived stress scale and a checklist to assess the stressors. The result was analysed using descriptive statistics. Majority of the students (88%) reported moderate level of stress. Large number of the subjects have stress due to less vacation, and the second major stressor was lack of sick leave. Identification of severity of stress and taking measures will improve the students to cope up with the academic and personal issues. The findings of this study can be used to design effective stress management programme for nursing students.

Keywords: Nursing students, stress, stressors

How to cite this article:
Pinto AC, Francis A, Sabu AR, Biju A, James A, Silva PD. A Study to assess stress and stressors among Undergraduate nursing students in a selected college at Mangaluru. Indian J Cont Nsg Edn 2020;21:171-5

How to cite this URL:
Pinto AC, Francis A, Sabu AR, Biju A, James A, Silva PD. A Study to assess stress and stressors among Undergraduate nursing students in a selected college at Mangaluru. Indian J Cont Nsg Edn [serial online] 2020 [cited 2021 Jun 23];21:171-5. Available from: https://www.ijcne.org/text.asp?2020/21/2/171/309849

  Introduction Top

In the modern scenario, stress is being reported as one of the most common issues.[1] Stress is a nonspecific response of the body to any demand. On other hand, stressor is an event or any stimulus that causes an individual to experience stress.[2] The intensity of stress is recognised as high in health care profession. Studies show that prolonged exposure to the stressful situation has an intense effect on the health.[3] Stress level is reported to increase during the time of training in nursing.[2]

The World Health Organisation has estimated that stress-related disorders will be one of the most leading causes of disabilities by the year 2020.[4] Nursing colleges are now recognised as a stressful environment which often influences the academic performance and the psychological well-being of the students. Improvement in the learning performance of a nursing student is dependent on several stress factors.[3] Individual performance such as concentration, memory, problem-solving abilities is adversely affected due to high stress and anxiety levels.[5] Sometimes the challenges faced in the clinical setting make the student more stressful.[6]

A study was conducted among 61 Filipino nursing students enrolled in a government nursing school to identify the level of stress, and the sources and responses to stress. The level of stress was assessed using perceived stress scale (PSS) and the responses were identified using Physio-psycho-social response scale, and the findings reveal that the student nurses had moderate level of stress. Stress from assignments and workload and stress due to lack of professional knowledge and skill were identified as common stressors. The common reaction to stress was manifested as showing emotional symptoms. However, the physical-psycho-social health and well-being, in general, was good. The results also revealed that perceived stress levels will decrease as the year of study increases.[1]

A descriptive survey was conducted among 100 nursing students in Delhi, revealed that 41% of students suffered from mild stress, 57% from moderate stress, and 2% from severe stress. The cause of stress was lack of professional knowledge and skills in clinical setting, followed by individual and family stressors. The most frequently used de-stressor among student nurses were prayer and reading religious books, thinking a different solution to solve problem, seeking support from parents, shopping, the use of social network and listening to music. Academic overload, examination and result, lack of resources in clinical area and long college hours were among the common academic and clinical stressors bothering the student nurses.[7]

High level of stress can affect student's health, academic and clinical activities. The reason could be mainly related to fear that errors may lead to a person's loss of life. Such challenges in nursing can be very stressful for students. With a busy schedule, workload, examinations and clinical practices at hospital, students may experience high level of stress. Students often become overburdened by many requirements in nursing curriculum. The academic expectations combined with other responsibilities such as family, children and job have the potential to create intense stress in students' lives.[8] Student nurses and trained professionals are the backbone of any health care system. To work efficiently and to take clinical judgement they must be emotionally stable.

The researchers, as student planned to take up this study and help their fellow batch mates and juniors to identify the stressors at the earliest time and inform the measures that could be taken in the available setting to overcome stress.


  1. To identify the severity of stress among undergraduate nursing students
  2. To identify the stressors among undergraduate nursing students
  3. To find the association between stress level and selected demographic variables.


Hypothesis will be tested at 0.05 level of significance.

H1: There will be significant association between the stress level and selected demographic variables.

  Methods Top

A descriptive survey was conducted in a selected college at Mangaluru. Eligibility criteria for inclusion were students studying in I, II, III and IV BSc Nursing students. Two hundred students who gave consent to participate in the study were included in the study.

The tool for data collection along with blueprint was submitted to eight experts to establish the content validity. They were requested to verify the items for their relevance, accuracy and appropriateness. There was agreement on most of the items, but some suggestions and modification were needed on some of the areas which were corrected later and included in the tool. Based on the suggestions given by the validators, necessary modification was made. The final tool had part I: Baseline pro forma that contained eight items, Part II: PSS consisted of ten items, (Standardised tool—permission was obtained through E-mail from the original author) Part III: Checklist for stressors in which the items are divided into four areas: Academic, clinical, family, peer and personal. The reliability of the checklist was found by Spearmen correlation coefficient by test re-test method and was found to be 0.86, which indicated the tool was reliable.

Data collection process

A formal written permission was obtained from the principal of selected College of Nursing Mangaluru. Data were collected from August 02 to 10, 2018. Prior to the data collection, the investigators familiarised themselves with the participants and explained to them the purpose of the study and assured them confidentiality of their response. An informed consent was obtained from the students and the tool was administered in the classroom setting at a comfortable time. It took approximately 30 min for the students to complete the tool.

  Results Top

Frequency and percentages of demographic variables were analysed. Chi-square test was used to find the association.

In the present study, 100% of the samples were female and 58% of students belong to the age group of 17–20 years. There were equal proportions from each batch (25%). Majority of the students were staying in private hostel (93.0%). When compared to the employment status of parents 88.5% of father's and 38.0% of mothers were working. Almost three-fourth of the students studied in English medium (79.5%). Most of the students (47.5%) were elder in their family [Table 1].
Table 1: Frequency and percentage distribution of participants according to their demographic variables

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Majority (88%) of the students reported moderate levels of stress and only 6.5% expressed severe stress [Figure 1].
Figure 1: Distribution of students according to severity of stress

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The mean stress score was 20.17 (53%) indicating that majority of the students reported having moderate level of stress [Table 2].
Table 2: Mean and standard deviation of stress level

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[Table 3] shows that majority of the participants reported stress due to less vacation (83%), and lack of sick leave (72%), lack of sufficient hours for study (70.5%) and the clinical environment (69.1%). The vocabulary used by the teachers was considered as stress by very few (16.5%).
Table 3: Distribution of students based on factors contributing to stress

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There was a significant association between the stress level and native place (P = 0.020, P < 0.05). No other variables had an association with severity of stress [Table 4].
Table 4: Association of level of stress and demographic variables

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  Discussion Top

The study findings reveal that moderate levels of stress are present in nursing students and very few had severe stress. Moderate stress in a professional course is an expected finding and has been found in similar studies.[1],[7] A study was conducted among nursing students at Delhi, 41% reported mild stress, 57.0% reported moderate stress whereas 2% of the students reported severe stress.[7] Although all were female students in this study, one previous study has shown that there were no gender differences in perceived stress in nursing students.[9]

While lack of professional knowledge and skill was reported as one of the major sources of stress in the study in Philippines,[1] in the present study students were stressed about lack of vacation and leave facilities. This may be due to majority of students staying in hostels away from home with stringent rules on attendance in India while in other countries such strict rules are not applied.

In the present study, less vacation (83%), lack of sick leave (72%), lack of sufficient hour (70.5%) and stress in clinical environment (69.5%) were identified stressors by majority of the students. The reasons why students felt more stress in these areas could be because of comparison of nursing course with other non-health professional courses where vacation was more including sick leave benefits. Clinical exposure and clinical hours were less in other courses when compared to nursing. According to the study conducted among health professional students at Makerere University Uganda, the major stressors were academic curriculum (38%), inadequate time for recreation (28.9%), high parental expectations (26.7%), financial problems (24.4%) and performance in examinations (28.3%).[10] Students who belong to a family with higher income tend to perceive higher stress related to their workload and assignment.[1] Medium of education, being a hosteller and marital status had no significant influence on stress level in a study on stress among medical students.[11] Similar associations were not found in this study.

  Conclusion Top

This study has revealed some insights into the levels of stress and the stressors in nursing students in a particular nursing college. Stress and stressors even among the same group of students can differ in different environments and setting and therefore a representative sample from different colleges would provide more accurate reports on stress in nursing students which can be generalised. However, understanding the sources of stress provides opportunities for planning interventions that would reduce the stressors and thereby the stress in undergraduate nursing students.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

Labrague LJ. Stress, stressors, and stress responses of student nurses in a Government Nursing School. Health Sci J 2013;7:12.  Back to cited text no. 1
Robotham D. Stress among higher education students: Towards a research agenda. High Educ 2008;56:735-46.  Back to cited text no. 2
Waghachavare VB, Dhumale GB, Kadam YR, Gore AD. Study of stress among students of professional colleges from an Urban area in India. Sultan Qaboos Univ Med J 2013;13:429-36.  Back to cited text no. 3
Al-Lamki L. Stress in the medical profession and its roots in medical school. Sultan Qaboos Univ Med J 2010;10:156-9.  Back to cited text no. 4
Sherina MS, Rampal L, kaneson N. Psychological stress among undergraduate medical students. Med J Malaysia 2004;59:207-11.  Back to cited text no. 5
Sharma N, Kaur A. Factors associated with stress among nursing students. Nurs Midwifery Res J 2011;7:12-21.  Back to cited text no. 6
Rani S, Sharma V. Stress and De-stressors among student nurses. Ind J Youth Adol M Health 2017:4:51-5.  Back to cited text no. 7
Oermann MH, Lukomski AP. Experiences of students in pediatric nursing clinical courses. J Soc Pediatr Nurs 2001;6:65-72.  Back to cited text no. 8
Ashaari SR. Stress level and its relationship between male and female nursing student during clinical posting. J Eng Health Sci 2017;1:15-26.  Back to cited text no. 9
Amanya SB, Nakitende J, Ngabirano TD. Cross-sectional study of stress and its sources among health professional students at Makerere University, Uganda. Nurs Open 2017;5:70-6  Back to cited text no. 10
Anuradha R, Dutta R, Raja JD, Sivaprakasam P, Patil AB. Stress and stressors among Medical Undergraduate Students: A cross-sectional study in a Private Medical College in Tamil Nadu. Indian J Community Med 2017;42:222-5.  Back to cited text no. 11
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