Background: For many nursing students, clinical training represents a stressful experience. The levels of stress and anxiety may vary during students' educational training, depending on their ability to adopt behavioral strategies for coping with stress, and other factors. This study aimed to investigate the relationship between anxiety, perceived stress, and the coping strategies used by nursing students during their clinical training.
Methods: A cross-sectional correlational descriptive study. The sample consisted of 190 nursing students enrolled in the Nursing Faculty of Ciudad Real University in Spain. Participants provided data on background characteristics and completed the following instruments: the Perceived Stress Scale; the State-Trait Anxiety Inventory and the Coping Behavior Inventory. Relationships between scores were examined using Spearman's rho.
Results: The mean age of participants was 20.71 ± 3.89 years (range 18-46 years). Approximately half of the students (47.92%) indicated a moderate level of stress with a mean Perceived Stress Scale score of 22.78 (±8.54). Senior nursing students perceived higher levels of stress than novice students. The results showed a significant correlation for perceived stress and state anxiety (r = 0.463, p < .000) and also for trait anxiety (r = 0.718, p < .000). There was also a significant relationship between the total amount of perceived stress and the following domains of the coping behavior inventory: problem solving (r = -.452, p < .01), self-criticism (r = .408 p < .01), wishful thinking (r = .459, p < .01), social support(r = -.220, p < .01), cognitive restructuring (r = -.375, p < .01), and social withdrawal (r = .388, p < .01). In the current study, the coping strategy most frequently used by students was problem-solving, followed by social support and cognitive restructuring.
Conclusions: Nursing students in our study presented a moderate level of stress, in addition there was a significant correlation with anxiety. Nursing teachers and clinical preceptors/mentors should be encouraged to develop programs to help prepare nursing students to cope with the challenges they are about to face during their clinical placements.
Keywords: Anxiety; Coping behavior; Nursing students; Perceived stress.