Perceived stress and physio-psycho-social status of nursing students during their initial period of clinical practice: the effect of coping behaviors

Initial clinical practice is stressful. Nursing students entering clinical practice for the first time in a five-year associate degree program in Taiwan are young and have questionable coping skills, all of which can affect their own health. This study examined the following: (1) the degree of stress perceived and types of stressful events; (2) the physio-psycho-social status of nursing students during the practice; (3) the coping behaviors of these students; and (4) the effect of different coping behaviors on their physio-psycho-social health. The subjects were 561 nursing students who had completed their initial clinical practice at the largest nursing school in Taiwan. Three measurements, including Perceived Stress Scale (PSS), Physio-Psycho-Social Response Scale (PPSRS), and Coping Behavior Inventory (CBI), were adopted. Results showed that stress for these students came mainly from the lack of professional knowledge and skills as well as caring of patients. The most common response to stress was social behavioral symptoms. Staying optimistic had a positive main effect, which reduced the occurrence of physio-psycho-social symptoms and improved physio-psycho-social status. Finally, problem-solving behavior also had a positive main effect, while avoidance had a negative main effect, which deteriorated physio-psycho-social status. This study has important implications for nursing educators in helping their students to overcome stress during clinical practice.