Nursing students’ perceived stress and clinical learning experience

BackgroundStressors among nursing students arise from both academic activities and clinical placement. Understanding how nursing students perceive academic and clinical stressors and the clinical learning environment could help develop useful approaches to reducing levels of stress and contribute to the maintenance of a good learning environment. There is a paucity of studies that investigated associations between the clinical learning environment and the stress of nursing students.ObjectivesTo investigate the relationship between the perception of the clinical learning environment and stress in nursing students; to compare the perception of the clinical learning environment and stress in terms of the year and terms of the organization of supervision.DesignCross-sectional correlation studySettingsUniversityParticipantsThe sample consisted of 155 nursing students in the bachelor's degree program. During the four academic years, students of individual years of the bachelor's study program were included in the study after completing all clinical placements in a given academic year.MethodsThe following instruments were used for the data collection: Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale, Perceived Stress Scale; Physio-Psycho-Social Response Scale and Coping Behaviour Inventory. Correlation analysis and multiple linear regression analysis using stepwise methods were used to determine the relationships between the variables.ResultsThe clinical learning environment is a strong predictor of students' perceptions of stress related to teachers and nursing staff. Types and degrees of stressful events during clinical practice varied between years of study. The experience with supervision was related to the overall perception of the clinical learning environment, but not to the students' physio-psychosocial status, types of stressful events during clinical practice and coping behaviors. Also, the differences in the students' physio-psychosocial status were not significant in terms of individual years of study and method of supervision.ConclusionsThere is a significant relationship between the clinical learning environment and the perception of academic stress. The attitude of the teacher and the medical staff can thus be important in influencing the level of stress in nursing students.     

The relationship between fatigue,coping behavior,and inflammation in patients with rheumatoid arthritis

Abstract

This research investigated the relationships among the severity of inflammation, the extent of fatigue, and fatigue symptoms, and the relationship between fatigue and coping behavior in patients with rheumatoid arthritis (RA). Our study group consisted of 177 female patients with RA (105 women with CRP > 0.5 mg/dl and ESR > 30 mm/h (inflammatory group) and 72 women with CRP ≦ 0.5 and ESR ≦ 30 (noninflammatory group)) and 81 age-matched healthy women (control group) who were given self-assessment questionnaires. The extent of fatigue was higher in the inflammatory group than in the noninflammatory and control groups. The characteristics of fatigue symptoms in the inflammatory group were “decline in the strength to carry on the activities of daily life” and “difficulty in performing daily activity.” The patients in the inflammatory group adopted a technique of "reducing the burden on the body" as a pattern of coping behavior for reducing fatigue. The extent of fatigue and fatigue symptoms perceived by RA patients is strongly related to the severity of inflammation, and these patients adopt a coping behavior in response to the extent of fatigue and subjective symptoms.     

对原发性高血压患者采用自测血压干预的效果评价

目的评价自测血压对高血压患者的行为依从性、生活方式及血压的影响。方法 118名老年原发性高血压患者随机分为对照组和自测血压组。6个月后测量各组患者的血压,评价其行为依从性水平,了解其生活方式。结果与对照组相比,自测血压组患者行为依从性提高,舒张压[(74.85±14.19)vs(82.12±13.64)mmHg(1 mmHg=0.133 kPa)]、男性腰围[(78.03±6.68)vs(81.94±7.36)cm]、膳食盐[(7.56±2.34)vs(8.76±1.96)g/d]、油摄入量[(26.17±6.60)vs(29.85±6.12)g/d]、吸烟率(3.4%vs 15.5%)降低,积极参加运动的比例升高(P0.05);体质量指数、收缩压、女性腰围差异则没有统计学意义(P0.05)。结论高血压患者实施自测血压有助于提高治疗行为依从性,建立健康的生活方式,更好地控制舒张压。     

综合医院低年资护士心理健康与应对方式及社会支持的相关性研究

目的探讨低年资护士的心理健康状况及其与应对方式和社会支持的相关性,为改善低年资护士心理状况及采取相应的干预措施提供科学依据.方法采用症状自评量表、社会支持评定量表和简易应对方式问卷对231名注册<5年的低年资护士进行问卷调查.结果本研究中低年资护士在强迫、敌对、恐怖、偏执、精神病性等5项症状上均高于全国护士常模,差异有统计学意义(P<0.05),抑郁因子得分低于全国护士常模组,差异有统计学意义(P<0.05);低年资护士积极应对维度平均分高于消极应对维度平均分,两种应对方式的差异有统计学意义(P<0.05);本科及以上学历的护士和大专及以下学历的护士在客观支持方面差异有统计学意义(P<0.05),而其他社会支持方面差异无统计学意义;社会支持得分与SCL-90的9个因子得分呈负相关,而消极应对得分与SCL-90的9个因子得分呈正相关.结论本研究中低年资护士存在一定的心理健康问题,社会支持可促进护士心理健康状况,消极应对方式不利于其心理健康,因此提示护理管理者加强低年资护士应对方式的培训,帮助其学会利用各种有效的社会支持资源,以保持良好的心理健康状态,从而为患者提供优质护理服务.     

Helicobacter pylori infection and short-term intake of low-dose aspirin have different effects on alpha-1 antitrypsin/alpha-1 peptidase inhibitor (α1-PI) levels in antral mucosa and peripheral blood

Objective. Irritable bowel syndrome (IBS) is common in the population, but not all subjects seek professional health care for their symptoms. The aim of this study was to compare consulters in secondary/tertiary care with those in primary care and non-consulters by using questionnaires to investigate factors of importance for health-care seeking in IBS. Material and methods. The study included 218 subjects with IBS: 70 non-consulters, 53 patients from primary care and 95 from secondary/tertiary care. The subjects completed questionnaires on gastrointestinal (GI) and psychological symptoms, coping resources, health-related quality of life (HRQOL) and reasons for not seeking health care. Results. Consulters (primary and secondary/tertiary care combined) had poorer HRQOL, more severe psychological symptoms, higher levels of GI-specific anxiety and poor coping resources compared with non-consulters, but the GI symptom severity was similar. Mental health and poor social, emotional and physical functioning were independently predictive of being a health-care seeker (r²=0.41). Independent predictors for being a consulter in secondary/tertiary care were a high degree of anxiety, low scores on physical functioning, physical role and food (IBSQOL) (r²=0.65). Several non-consulters reported mild symptoms and ability to control symptoms as reasons for not seeking health care. Having a close relative with similar symptoms reduced the need to seek health care. Thirty-six non-consulters had sought alternative care or advice from friends and/or relatives about their GI symptoms. Conclusions. GI symptom severity alone cannot explain the illness behavior in IBS. HRQOL and psychological symptoms are important for experience of GI symptoms and the health-care seeking pattern in IBS.     

Caregiver Coping Strategies

Abstract

Wife (n= 39) and daughter (n= 32) caregivers completed the Revised Ways of Coping Checklist and measures of caregiver burden, perceived stress, depressive symptoms, and anger expression. Although wives and daughters did not differ in psychological variables, daughters were more likely than wives to use problem-focused coping, blame of others, and self blame. However, the proportion of effort devoted to each of the eight coping strategies did not differ by caregiver relationship. The relationships between coping strategies and psychological measures were stronger for wives, with avoidance, blame of others, and wishful thinking related to higher levels of caregiver burden, stress, depression, and anger- in, and lower levels of anger control. For daughters, self-blame was associated with greater anger in and problem-focused coping was associated with greater anger control. Depressive symptoms were significantly associated with perceived stress, subjective burden, anger-out, anger-in, and anger-control. Our results underscore that daughters and wives experience and cope with caregiving differently and may have different needs for assistance. Other factors that were not assessed, including role strain and role satisfaction, may have a greater impact on caregiving daughters' psychological well being.     

Coping strategies in individuals after traumatic brain injury: associations with health-related quality of life

Abstract

Purpose: This study investigates coping strategies after traumatic brain injury (TBI) and their associations with health-related quality of life (HRQoL). Methods: Participants were 141 adults followed up 3 months to 15 years after TBI of all severity degrees. Coping was assessed by the Freiburg Questionnaire of Coping with Illness (FQCI) and HRQoL by the Quality of Life after Brain Injury (QOLIBRI) scale and the Short Form-36 Health Survey (SF-36). Coping dimensions were extracted by principal component analysis. Multiple linear regression analysis was used to identify predictors of coping strategies. Results: Two factors for coping after TBI were extracted: Action/Distraction and Trivialisation/Resignation. The Trivialisation/Resignation strategy was negatively correlated with all aspects of HRQoL, while relationships with the Action/Distraction strategy were positive and significant for two domains. These two factors also showed significant associations with anxiety, depression, recovery, cognitive status, mood states and trauma severity. Multiple regression analysis identified recovery status as a predictor for the maladaptive Trivialisation/Resignation strategy. Conclusion: Two coping factors were identified, which were differentially associated with HRQoL. Maladaptive coping strategies play a particularly important role, and less reliance on such strategies is associated with better HRQoL; use of adaptive strategies should correspondingly be fostered.

• Implications for Rehabilitation

• This study highlights the relationship of coping strategies and HRQoL after TBI.

• For the assessment of HRQoL a novel disease-specific instrument was applied, that provides in detail TBI-relevant aspects of well-being and HRQoL.

• Individuals after TBI use two main sets of coping strategies that are differentially associated with HRQoL (and clinical variables). One is adaptive and the other maladaptive for HRQoL after TBI.

• Maladaptive and adaptive coping strategies used by the individual should be identified and considered in rehabilitation efforts to improve HRQoL after TBI.

     

Post-polio syndrome: impact of hope on quality of life

Purpose: To determine the effect of future-oriented coping strategies on the quality of life (QOL) of individuals with post-polio syndrome (PPS). Methods: A correlative study, in which a cohort of 61 patients was surveyed and a group of 40 healthy, age-matched individuals served as controls. Patients were surveyed as to their QOL, levels of hope and utilization of proactive coping, employment status and degree of functionality. Results: PPS patients had lower total, physical and mental QOL indices compared to controls. Future-oriented coping strategies associated with hope were positively associated with physical and mental QOL in the PPS group, but not in the controls. In a multivariate analysis, hope and employment status predicted higher QOL among those with PPS. Conclusions: Future-oriented coping strategies, particularly hope are distinctively associated with improved QOL benefits in PPS patients. Fostering future-oriented coping related to hope may improve the self-perceived mental and physical status of patients with PPS.

Implications for Rehabilitation

• Coping styles of individuals with post-polio can be conceptualized in terms of positive-optimistic psychological constructs rather than the traditional negative frame of reference.

• Hope is distinctively associated with improved quality of life among post-polio patients.

• Enhancing hope through psychotherapy may improve mental and physical health of individuals with postpolio.

     

Higher social distress and lower psycho-social wellbeing: examining the coping capacity and health of people with hearing impairment

Abstract

Purpose: The objectives of this paper are as follows: (1) propose an explanatory model as to how hearing disability may impact on health and (2) examine the model’s utility. Methods: Data were collected on the psycho-social wellbeing, disability and physical health of farmers (n?=?56) participating in an intervention to manage the social impacts of hearing disability. Two models were proposed and examined using multiple hierarchical linear regression. Model 1 used self-rated quality of life and model 2 used capacity to manage hearing and listening impairments, as dependent variables. Results: The analyses found that physical measures of hearing impairment (audiograms) were not correlated with physical or mental health outcomes. However, in model 1, self-confidence and self-rated ability to manage hearing impairment were most closely associated with reduced quality of life (anxiety and diastolic blood pressure were positively associated with quality of life). In model 2, higher anxiety and reduced self-confidence were associated with decreasing ability to successfully manage one’s hearing impairment. Conclusions: The findings support the explanatory model that stress is higher and wellbeing lower when the fit between the person’s coping capacity and environmental demands is poor.

• Implications for Rehabilitation

• This paper demonstrates that anxiety is associated with coping with the psycho-social aspects of hearing disability.

• This finding has important implications for the many hearing services, which only provide assessment and devices.

• To negate anxiety and its long-term impacts, rehabilitation providers need to ensure people with hearing disability have the capacity to manage the psycho-social aspects of communication breakdown.