Reducing distress in first level and student nurses: a review of the applied stress management literature

Abstract

Following recent evidence of continuing high levels of distress in both trained and student nurses, a critical review of the stress reduction and stress management literature targeting both trained and student nurses is presented. Using a systematic approach, some 36 studies dating from 1980 until the present day were identified adopting either pre-experimental, quasi-experimental or experimental designs. While many work-site programmes in this series were successful in terms of adaptive changes in problem-solving, self-management skills including relaxation and interpersonal skills, affective well-being, and work performance, a number of design and evaluation inadequacies were identified. The relative lack of home-work interface or organizational level programmes to reduce work-related distress, and the scarcity of interventions targeting aspects of the work environment likely to contribute to such outcomes may have contributed to continuing high levels of distress in trained and student nurses. Recommendations regarding the future design, provision and evaluation of such work-site interventions include the further clarification of the structure of perceived stressors, and development of causal models of the stress process to identify the job characteristics 'causing' work-related distress. Such an approach would inform the design and implementation of evidence-based organizational level interventions augmenting strategies to target the health behaviour, lifestyle/risk factors and self-management skills of practitioners and students with attempts to amend problematic elements of the psychosocial work environment.

Intervention studies on enhancing work well-being, reducing burnout, and improving recovery experiences among Hong Kong health care workers and teachers.

“…The present findings are consistent with previous studies that suggest intervendons focused on individuals in health care professions can be effecdve (Jones & Johnston, 2000;Shapiro et al, 2005). Yang et al (2012) emphasized the role of cultural values (i.e., individualism-collecdvism) in understanding occupational stress process.…”

Health-related quality of life and depressive symptoms in undergraduate nursing students

“…The depressive state can produce feelings of sadness, loss of interest in normal situations, lack of pleasure, emotional instability, and changes in appetite, sleep, and rest, among other aspects. In this study, the nursing students were predominantly young, and in student-professor relationships (21) ; perform and encourage seminars that develop skills, self-control and relaxation in situations that cause anxiety, in order to explore the capacities of the students and to train them in public speaking (22) ; provide interventions to reduce individual and organizational stress through healthier behavior, improved lifestyle, self-esteem (23) and mental health (24) .…”

A study of stress and burnout in nursing students in Hong Kong: A questionnaire survey

“…The UK national workforce projects/workforce review team (Buchan, 2005) reckoned that by 2014 the UK would need twice as many new entrants as it has now just to keep the workforce constant. Identifying the antecedent and consequent correlates of stress, which is a known factor in the attrition of nurses and student nurses (Jones & Johnson, 2000), may illuminate strategies for alleviating it. This could, possibly, lead to strategies for increasing retention of nursing students.…”

“…These nursing students will all be individuals taking into their programmes a range of personality types and coping strategies providing responses to stressful situations; therefore, the interaction between their circumstances and their responses is of interest. In the case of nursing students, the kind of stress resulting from this transaction between stimuli and responses is classified as occupational or workrelated stress (Jones & Johnson, 2000) and specific instruments, one of which will be described in the methods section below, have been developed to measure this kind of stress and some of these are specific to nursing students (Jones & Johnson, 1999;Deary et al, 2003).…”

“…but this remains to be demonstrated (Jones & Johnson, 2000). However, where attrition is low as a result of anathematising leaving a programme, it could be argued that the 23 effects of stress could be severe and adverse in terms of achievement over a longer period.…”