Department of Mental Health Nursing, Amala College of Nursing, Thrissur, Kerala, IndiaIndia
Department of Community Health Nursing, Amala College of Nursing, Thrissur, Kerala, IndiaIndia
Also available as PDF (figures and tables appear in the PDF).
This study examines the impact of Self-Reliance Training on stress and coping abilities among first year B.Sc. Nursing students in a specific nursing college in Central Kerala, South India. The objectives include evaluating stress and coping levels, assessing the training's effect on these levels, and exploring the relationship between stress, coping, and sociodemographic factors. Employing a p re-experimental one-group pretest-post-test design, the study focuses on first-year B.Sc. N ursing students meeting inclusion criteria. A total of 50 participants were purposively sampled. The pretest involved administering a structured questionnaire covering sociodemographic variables, along with the Perceived Stress Scale and Brief-COPE scale. Following a 6-day Self-Reliance Training, a post test was conducted after one month. Statistical analysis revealed that most participants experienced moderate stress (72%), with 24% experiencing high stress and 4% reporting low stress levels . Regarding coping mechanisms, 82% exhibited moderate coping, while 18% displayed high coping . Post-test results indicated a significant decrease in stress levels (6.0±8.0) compared to pre-test levels (23.50±13.25), with a highly significant reduction observed (p=0.0001, p<0.05). Additionally, p ost test coping levels (91.56) surpassed pre-test levels (76.76), with a highly significant improvement noted (p=0.0001, p<0.05). These findings underscore the effectiveness of Self-Reliance Training in reducing stress and enhancing coping abilities among the participants. Furthermore, a statistically significant association was identified between age and stress levels (p=0.019, p<0.05).
Keywords: Self-reliance training; resilience building; psychological empowerment; self-management intervention; Self-reliancetraining; resiliencebuilding; psychologicalempowerment; self-managementintervention
Stress is a universal phenomenon to which every personisexposedto. Itcancomefromanyeventor thoughtthatmakesyoufeelfrustrated.Itisgenerally agreeduponthatbeingastudentcanbethebesttime ofaperson’slife,therearenumerousfactorsthatcould stressstudentsout, particularlywhilejugglingtheir personalandacademiclives[1-2].Severalacademic, personal, social, environmental, and psychological challengesarefacedbycollegestudentsinthenew campussetting,whichmayhaveanimpactontheir psychosocialwelfareandeducationalperformance[3] Today’sstudentsfaceamyriadofstress-relatedchallenges,bothacademicallyandpersonally.Thesepressurescontributetoaconcerningriseinmentalhealth issuesand,alarmingly,suiciderates.Acriticalfactorin thesesituationsisthedifficultymanystudentsexperienceinrecognizingtheirownstressorsandunderstandinghowtocopeeffectivelywithoutexternalsupport [4].
Copingstrategiesplayasignificantroleinshapinghow individualsperceiveandhandlestress.Whilecollege presentsnumerouschallenges,masteringstressmanagementtechniquescangreatlyaidstudentsinnavigatingacademicpressuresandachievingafulfilling collegeexperience.Studentsencounteramultitudeof stressors,suchasacademicdemands,thepressureto excel,uncertaintyaboutthefuture,andtheprocessof adaptingtothecollegeenvironment[5-7].Nursingstudents,inparticular,faceongoingstressorsthroughout theirdegreeprogramandtraining,whichcanhinder theirabilitytolearnandperformeffectively[8]. Adescriptivecross-sectionalstudywasundertakento examinetheperceivedstresslevelamong282undergraduate student nurses in Haryana. The results indicatedthatfemalestudentsexperiencedhigherlevelsofstress(31.33%)comparedtotheirmalecounterparts(26.01%)[9].Additionally,first-yearstudentsreportedthehighestlevelofstress(29.66%).Thesefindingsunderscorethenecessityforimplementingstress managementinterventionswithinnursingcolleges[10- 12].Consequently,theresearcherbelievesit’scrucial toempowerstudentstohandlestressindependently throughvariouscopingmechanisms,withoutnecessarilyrelyingonexternalassistance.Studentsshould betaughttoassesseventsorsituationscognitivelyto enhancetheirchancesofsuccess.
Thus,theresearcherisdriventoconductaninterventionstudyinvestigatingtheimpactofself-reliancetrainingonstressmanagementandcopingabilitiesamong first-yearBScnursingstudentsatachosencollegein Thrissur.Thisinitiativeisaimedatidentifyingstressors instudents’livesearlyonandofferinginterventionsto alleviatethem.
Inrecentyears,asignificantbodyofresearchhasfocusedoninterventionsaimedatreducingstressand improvingcopingmechanismsamongstudents.These studieshaveoftenemphasizedtheimportanceofseeking help from others be it friends, family, or mental healthprofessionals.Whiletheseapproachesareundoubtedlyvaluable, myresearchshiftsthefocustowardsfosteringself-reliance,encouragingstudentsto independentlyidentifytheirstressorsanddeveloppersonalcopingstrategies[13].
Bypromotingself-reliance,mystudyaddressesagap inexistingresearch.Itempowersstudentstotakeownershipoftheiremotionalwell-beingbyequippingthem withtoolstoidentifystressorsandimplementcoping strategiesindependently.Thisself-directedapproach notonlyfostersresiliencebutalsopreparesstudents forfuturechallengeswhereexternalsupportmaynot bereadilyavailable.
Preliminaryfindingsfrommystudyindicatethatstudentswhoengagedinself-relianceexercisesreported agreatersenseofcontrolovertheirstresslevels.They learnedtorecognizetheiruniquestresstriggersand developedpersonalizedcopingmechanisms, which seemedtoenhancetheiroverallwellbeing.Thisstands incontrasttotraditionalinterventionsthatmayinadvertentlyfosterdependenceonexternalsupportsystems.Theeffectivenessofthisapproachsuggeststhat self-reliancecanbeapowerfultoolinastudent’smentalhealthtoolkit.
By facilitating an environment where students can exploretheirinnerresources, weencourageamore sustainableformofstressmanagementthatcanlead to long-term benefits. The findings of my research hold significant implications for both future studies and practical applications in educational settings. Encouraging self-reliance could shift the paradigm fromseekinghelpasaprimarystrategytoequipping students with the skills necessary for independent coping [14-15]. This could reduce the stigma associated with needing help and promote a culture of self-efficacyamongstudents.Moreover,incorporating self-reliance strategies into existing mental health programscouldenhancetheireffectiveness,making themmoreholisticbycombiningbothsupport-seeking andself-sufficiency.
The research employed a quantitative preexperimental design, specifically a one-group pretestposttestapproach,withbothdescriptiveand inferential analyses. The population of the study consisted of 50 first-year B.Sc. Nursing students meetinginclusioncriteriafromAmalaCollegeofNursing, Thrissur, in 2023. Samples were selected using purposive sampling. Data collection tools included a structured questionnaire for sociodemographic variables,thePerceivedStressScaletogaugestress levels,andtheBriefCOPEScaletoassesscopinglevels amongstudents.
Following Institutional Ethics Committee clearance and university approval, formal permission was takenfromthePrincipalofAmalaCollegeofNursing, Thrissur.DatacollectiontookplacefromApril24,2023, toMay29,2023.Aftertheinvestigator’sintroduction andexplanationofthestudy’saim,informedconsent wasobtainedfromthestudents.
Thepretestwasinitiatedonthefirstday,involvingdata collectionwiththementionedinstruments,followed bya6-dayinterventionperiodofSelf-RelianceTraining.SelfRelianceTrainingdenotesastructuredinterventionprogramcraftedbytheresearchertofostera senseofproficiencyamongparticipantsinrecognizing theirownstressorsandenhancingcopingstrategies through problem-focused, emotion-focused coping, andself-refinementmethods. Thistraininginvolved computer-assistedlecturesanddemonstrations.
Thepost-test,utilizingthesameassessmenttools,was administeredafteraone-monthinterval. Ethicalapprovalforthisresearchwasobtainedundertestnumber17/EC/22/AIMS-16fromtheEthicalCommitteeof AmalaInstituteofMedicalSciences,Thrissur.
Self-Reliance Training refers to a structured interventionalprogrammeddesignedbytheinvestigator to develop a sense of competence in the subjects in identifying their own stressors and to improve them coping strategies using problem-focused and emotion-focused coping as well as self-refining measures through computer-assisted lectures and demonstration.
• Tomakethesubjectsrecognizethestressorsin theirlives,bythemselves.
• Toeasethelevelofstressamongthesubjects. • Toimprovetheircopingskillsusingvarioustechniques.
• Toinstillcourageinthemtodealwithasituation head-on.
Intermsofage,mostofthesubjects(44%)belongto theagegroupof19years.Intermsofgender,mostof thesubjects(88%)arefemale. Accordingtoreligion, themajorityofthesubjects(70%)areChristian. The majorityofsubjects(84%)livesinpanchayath.Interms ofpreferreddietmostofthesubjects(96%)consume mixedmeals. Accordingtothecurrentplaceofresidence,mostofthesubjects(70%)liveinahostel.Accordingtotheboardofeducation,68%ofthesubjects studiedunderstateboard.Themajorityofthesubjects (36%)haveamonthlyfamilyincomeof<30,000rupees. 48%ofthesubjectswerethefirstchildtobebornto theirparents.84%ofstudentsusespsychologicalcopingstrategiescurrently. Intermsofpreferredleisure activity,50%ofthesubjectsspendtheirfreetimeby listeningtomusic.Consideringtheoccupationofthe father,42%areself-employed.Consideringtheoccupationofthemother,56%arehomemakers.Interms oftheeducationofthefather,36%ofthemhaveahigh schooleducation.Themothersof52%ofthesubjects areundergraduates. Intermsofchoiceofnursingas aprofession,themajorityofthesubjects(66%)opted forthecoursevoluntarily.
Inthepretest,themajorityofthesamples(72%)hada moderatelevelofstressand24%ofstudentshadahigh levelofperceivedstress.Inthepretest,themajorityof thestudents(82%)hadamoderatelevelofcopingand 18%ofstudentshadahighlevelofcoping.
Distribution of the first-year B.Sc. Nursing students accordingtothelevelofstressandcoping.
The median post-test stress score is 6.0 with an interquartilerange(IQR)of8.0,whilethemedianpre-test stressscoreis23.50withanIQRof13.25.Theimpact of Self-Reliance Training on stress was evaluated usingtheSignRanktest,yieldingacalculatedvalueof 5.911andap-valueof0.0001,indicatingastatistically significant difference between pretest and post-test stressscores.
Themeanpre-testcopingscoreis76.76withastandard deviationof9.87,andthemeanpost-testcopingscore is91.56withastandarddeviationof9.72.Theeffectof Self-RelianceTrainingoncopingwasassessedusinga pairedt-test,resultinginacalculatedt-valueof10.297 andap-valueof0.0001,suggestingastatisticallysignificantdifferenceincopinglevelsbetweenpretestand post-test.Fisher’sExactTestwasemployedtoidentify anyassociations.
Asignificantcorrelationwasdiscoveredbetweeninitial stresslevelsandage,asdeterminedbyFisher’sExact Test.However,nosuchcorrelationwasfoundbetween
Recognizingownstressors.
Practicesession
•Relaxationtraining.
-Deepbreathingexercise.
DAY3-6 Jacobson’sprogressivemuscle 30Minutes
stresslevelsandvarioussociodemographicfactors,includinggender,religion,residentialarea,dietarypreferences,educationalbackground,familyincome,birth order,copingstrategies,leisureactivities,andparental occupationsandeducation.
Similarly, there was no significant relationship observed between coping mechanisms and sociodemographicvariablessuchasage,gender,religion, residential area, dietary preferences, educational background, family income, birth order, coping strategies,leisureactivities,andparentaloccupations andeducation.
In the present study, it is observed that 88% of the studentsarefemale,with44%fallingwithintheage groupof19years.Regardingparentaleducation,36% offathershavecompletedhighschool,while52%of mothersholdanundergraduatedegree.Theseresults alignwithastudyconductedinEgypt,whichfoundthat 77%ofparticipantswereagedbetween19-24years, with91.4%beingfemale.Additionally,approximately halfofthesubjects’fathers(46.2%)hadahighschool education,while48.8%ofmothershadcompletedundergraduatedegrees.
Intermsofstresslevels,themajorityofsubjects(72%) inthecurrentstudyexperiencemoderatestress,with 24%reportinghighperceivedstressand4%experiencinglowstresslevels.Thisfindingisconsistentwitha
Lecturecum 15minutes
Lecturecum 1Hour discussion.Modelof timeplanning.
Exhibitionon positiveaffirmations.
DemonstrationDemonstration &Livepractice
Minutes
studyinKashmir,where54%ofnursingstudentsexperiencedhighstress,42%reportedmoderatestress, and4%hadlowstresslevels[16-17].
Inthisstudy,it’sapparentthatmoststudents(82%) possessmoderatecopingabilities,with18%exhibitinghighcopingskills.ThisalignswithresearchinRajasthan,wherethemajorityofparticipants(66.6%)also showedmoderatecopingstrategies[18].
Regardingstresslevels,themedianpost-testscoreis 6.0withanIQRof8.0,andthemedianpretestscoreis 23.50withanIQRof13.25. ThecalculatedSignRank testvalueis5.911withap-valueof0.0001.Themean pretestcopingscoreis76.76withastandarddeviation of9.87,whilethemeanpost-testscoreis91.56with astandarddeviationof9.72. Thecalculatedt-value forcopinglevelsis10.297withap-valueof0.0001,indicatingastatisticallysignificantdifferencebetween pre-testandpost-teststressandcopinglevels. TheseresultsmirrorastudyinTamilNadu,whichfound asignificantdiscrepancyinscoresbetweenthecontrol andexperimentalgroups(t-valueof13.66,p-value< 0.001),indicatinganotabledecreaseinstresslevels andincreaseincopingbehaviorsamongstudentsin theinterventiongroupcomparedtothecontrolgroup [19-20].