Patient-related stressors and coping strategies in baccalaureate nursing students during clinical practice

Introduction
The first clinical experience of nursing students is of great importance in their professional development and the formation of professional competence. The education process is a stressful experience. This is due to the large emotional commitment, responsibility for health and life, and struggling with the problems of patients. To fully benefit from this experience, it is necessary that students successfully cope with stress.

Aim of the research
To assess patient-related stressors and coping behaviours of nursing students during clinical practice.

Material and methods
The study was conducted among 786 first-year nursing students at universities in southern Poland in 2015 and 2016. Diagnostic survey and evaluation methods, as well as surveying and scaling techniques, were used, and the research tools were of the demographic characteristics form – Perceived Stress Scale (PSS-10), Inventory for Coping with Stress (Mini-COPE) to measure coping with stress. Verification of differences between variables was made using the Mann-Whitney test and Kruskal-Wallis test. The relationship between variables was determined by calculating the Spearman rank correlation and multidimensional logistic regression. The adopted level of significance was  = 0.05.

Results
Nursing students struggled with many difficult situations and experienced moderate to severe stress, presenting a variety of different coping strategies. As the stress level increased, the frequency of coping with difficult situations by using avoiding behaviour increased (rho = 0.195; p < 0.0001). Students in difficult situations more often relied on problem-focused strategies rather than emotion-focused strategies.

Conclusions
It is advised that nursing students develop active ways to deal with difficult situations, especially those students displaying helplessness and avoiding behaviours.