Ranking undergraduate nursing student perceived stress using Q-methodology
Reid, Anna
Reid, Anna
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2024-12-18
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Abstract
Background: Stress in clinical settings creates unsafe patient conditions and causes poor nursing student performance. Stress during clinical experiences leads to unsafe conditions, negative learning outcomes, and mistakes. We know clinical causes stress, but a gap exists in how students rank various stressors.
Purpose: This research aimed to describe what nursing students report most stressful during clinical experiences.
Methods: Using Q-methodology, guided by the Transactional Model of Stress and Coping, 52 undergraduate nursing students sorted 46 statements. Statements described Perceived Stress Scale and Nursing Student Stress Scale stressors or focus group responses. Participants sorted statements from most to least stressful using quasi-normal distribution grids, scored from 6 to -6. We analyzed data using Spearman correlation and centroid factor analysis with varimax rotation to identify viewpoints. Watts and Stenner?s methodology was used to qualitatively analyze viewpoints. We compared demographics using Chi-square or Mann-Whitney U. Limitations include method generalizability and homogenous sampling.
Results: Three main viewpoints emerged from the study, explaining 39% of study variance. Across the three distinct viewpoints, external, patient-related, and knowledge-based stressors were considered as the three biggest stress sources, respectively. All participants agreed nursing professionalism was moderately stressful in the clinical setting. External stressors included preceptor behaviors, instructor decisions, and nursing coursework. Difficult patient interactions and nursing roles characterized patient-related stress. Unfamiliarity with nursing skills and procedures created the most knowledge-based stress. There were significant degree entry and healthcare role experience differences.
Implications: This paper provides nurse educators with knowledge about what students rank most stressful during clinical experiences and may help in the reduction of stress and the identification of at-risk situations.