Nursing and midwifery students' stress and coping during their undergraduate education programmes: An integrative review.

OBJECTIVES: The aim of this review is to examine the literature related to the sources of stress, coping mechanisms and interventions to support undergraduate nursing and midwifery students to cope with stress during their undergraduate education. DESIGN: Integrative literature review. DATA SOURCES: The databases CINAHL, PubMed and PsycINFO were searched for articles published between 2010 and 2016. Search terms in various combinations were used for example; student nurse, student midwife, undergraduate, stress, coping and interventions. REVIEW METHODS: An integrative review based on Whittemore and Knafl's approach was used to conduct the review. RESULTS: The search generated 25 articles that met the inclusion criteria. The key sources of stress emanated from clinical, academic and financial issues but predominantly from the clinical environment. Students used a variety of coping strategies, both adaptive and maladaptive. These appear to be influenced by their past and present circumstances such as, their needs, what was at stake and their options for coping. Interventions for student nurses/midwives to cope with stress were varied and in the early stages of development. Mindfulness showed some promising positive results. Interventions focussed on the individual level excluding the wider social context or organisation level. CONCLUSIONS: Stress is pervasive in all aspects of undergraduate nursing and midwifery education. Nursing and midwifery educators need to be aware of this impact and provide appropriate support to students in both the clinical and academic environments. Further research is needed to capture the experience of stress from the students' perspective as well as the barriers and facilitators to supporting students from the preceptors'/mentors' perspectives. Finally, more intervention studies are needed to identify and compare what interventions are effective in supporting students to cope with stress during their undergraduate education.

Coping with stressful events: A pre-post-test of a psycho-educational intervention for undergraduate nursing and midwifery students.

BACKGROUND: Knowledge of coping mechanisms is important for nursing and midwifery students to cope with stressful events during undergraduate education. OBJECTIVES: To evaluate the impact of a psycho-educational intervention "Coping with Stressful Events" with first year undergraduate nursing and midwifery students. DESIGN: A quasi-experimental, one-group pre-post-test. SETTINGS: One school of nursing/midwifery in one university in Ireland. PARTICIPANTS: A convenience sample of all first year undergraduate nursing and midwifery students (n=197). Of these 166 completed the pretest and 138 students completed the post test. METHODS: Using the COPE Inventory questionnaire (Carver et al., 1989) data was collected pre and post-delivery of the psycho-educational intervention "Coping with Stressful Events" by two research assistants. Data were analysed using the IBM SPSS Statistics version 22 (NY, USA). RESULTS: Results demonstrated improved coping skills by students. There were statistically significant differences between pre and post intervention for some coping subscales. For example, the mean subscale scores were lower post-intervention for restraint and mental disengagement, and higher for use of emotional and instrumental social support indicating improved coping strategies. CONCLUSIONS: This intervention has the potential to influence undergraduate nursing and midwifery students coping skills during their first year of an undergraduate programme.