“A STUDY TO ASSESS THE KNOWLEDGE

REGARDING STRESS COPING STRATEGIES IN FIRST

YEAR GNM STUDENTS IN SELECTED COLLEGE OF
AURANGABAD.”

A DISSERTATION SUBMITTED TO

MAHARASHTRA UNIVERSITY OF HEALTH SCIENCE, NASHIK

IN PARTIAL FULFILLMENT OF THE

BASIC B.SC. DEGREE IN NURSING
2019- 2020
 “A STUDY TO ASSESS THE KNOWLEDGE
REGARDING STRESS COPING STRATEGIES IN FIRST
YEAR GNM STUDENTS IN SELECTED COLLEGE OF
AURANGABAD.”

BY

MR. ANUJ KALASKAR,

A DISSERTATION SUBMITTED TO

MAHARASHTRA UNIVERSITY OF HEALTH SCIENCE, NASHIK

DISSERTATION GUIDE

MS. AJILA R SINGH

IN PARTIAL FULFILLMENT OF THE

BASIC B.SC. DEGREE IN NURSING
2019- 2020
 CERTIFICATE

This is to certify that the research project, “A study to assess the

knowledge regarding stress coping strategies in first year GNM students in
selected college of Aurangabad.” being submitted by Mr. Anuj Kalaskar,
Student in the partial fulfillment of Basic B.Sc. Nursing degree of Maharashtra
University of Health Sciences, Nashik embodies the work carried out by the
Candidate under my guidance at the Kamalnayan Bajaj Nursing College,
Aurangabad.

This work is original and has not been submitted, either in part or full,
for the award of any other degree or diploma of any other university.

Ms. Ajila R Singh Dr. Supriya

Chinchpure Guide Principal
KBNC, Aurangabad. KBNC, Aurangabad.
 DECLARATION

This is to certify that the work reported in this Basic B.Sc. Nursing
thesis is entirely original and has been carried out by me under the guidance
and supervision of Ms. Ajila Singh at the Department of Nursing, Clinical
Instructor (Medical Surgical Nursing), Kamalnayan Bajaj Nursing College,
Aurangabad, Maharashtra, India. This work has not been submitted, either in
part or full, for the award of any other degree or diploma of any other
University. Submitted By: Mr. Anuj Kalaskar.

Mr. Anuj Kalaskar

IV Basic B.Sc. Nursing Student,
Kamalnayan Bajaj Nursing College,
Aurangabad.
 ACKNOWLEDGEMENT

Gratitude unlocks the fullness of life. It gives what we have into enough
and more. Gratitude makes sense of our past, brings peace for today and
creates vision for tomorrow.

At the beginning we express our deep gratitude and praise and thank
almighty god whose abundant grace and blessing have given us strength and
courage to complete this study.

This effort in our academic endeavor would not have been a reality but
for the constructive and purposeful support, and encouragement rendered by
a number of people, whose help us special recognize through this
acknowledgement.
I am immensely grateful to the institutional ethical committee, for giving
me an opportunity to undertake this study.
I express my sincere thanks to our respected Principal Madam Dr.
Supriya Chinchpure Kamalnayan Bajaj Nursing College Aurangabad for her
expert guidance, valuable suggestions and advice in subject matter which
helped a lot in completing this study successfully.
I wish to express my profound sense of gratitude and heartfelt thanks
Mrs. Vaibhavi Duraphe, Vice Principal, Kamalnayan Bajaj Nursing College,
Aurangabad for her constant support encouragement and guidance
throughout this study.
I wish to express my profound sense of gratitude and heartfelt thanks to
Ms. Pradnya Waghmare and Samta Patel Clinical Instructor of Kamalnayan
Bajaj Nursing College for her constant support encouragement and guidance
throughout this study.
I would like to thank Ms. Ajila Singh Clinical Instructor of Kamalnayan
Bajaj Nursing College, she has made available her support in number of
ways, specially towards the completions of this dissertations. I gratefully
acknowledge that her contribution was instrumental in developing the
dissertation.

i
 I am grateful to all the teaching faculty of Kamalnayan Bajaj Nursing
College Aurangabad for their valuable comments and suggestion at various
stage of the study.
I express my thanks to our college Librarian Mr. Suresh Kulkarni for his
assistance in providing library facilities throughout the study.
I pay my deep respect to our parents for their constant support during
the course of study: Mr. Anuj Kalaskar

ii
 ABSTRACT

TITLE

“A study to assess the knowledge regarding stress coping

strategies in first year GNM students in selected college of Aurangabad.”

OBJECTIVE:

1. To assess the knowledge regarding stress coping strategies in first

year GNM nursing students at selected nursing colleges of
Aurangabad.
2. To find out significant association between the knowledge in first year
GNM nursing students and selected demographic variable

RESEARCH METHODOLOGY

RESEARCH APPROACH: Descriptive Approach.

RESEACH DESIGN: Descriptive Research Design.

POPULATION: First year GNM Nursing students, Aurangabad.

SAMPLE SIZE: 100

SETTING: The study was conducted in MGM INE, Aurangabad.

SAMPLING TECHNIQUE: Non probability Convenience Sampling

TOOL: Structured knowledge questionnaire including demographic variables

will be used for the study.

SAMPLING CRITERIA

1. INCLUSION CRITERIA:
Student who are willing participation in the study.
Student who are available at the time of data collection.
 2. EXCLUSION CRITERIA:
Students who are studying other than the nursing institutions.
Students who were absent at the time of data collection

FINDINGS
A study data was used to assess the knowledge regarding stress
coping strategies in nursing students, the Data was collected from various
colleges and 100 sample was collected. Data was analyzed using knowledge
questionnaire. The following are the major findings of the study with
discussion.
The Mean percentage of the knowledge regarding stress coping
strategies is 21.83% and standard deviation value is 5.8 and according to
study the result is about 25% of GNM students is Poor, 65% of GNM nursing
students are Average and 10% of GNM nursing students is Good according to
the result.
There was no significant association between knowledge score and selected
demographic data: Age (x2 = 2.15), Gender (x2 = 1.21), Religion (x2 = 5.65),
Area (x2 = 1.10), Family Income 2.47), Academic Result (x2 = 3.81), Marital
Status (x2 = 2.11), Method of Relaxation (x2 = 5.70), Psychiatric Illness
Present in Family (x2 = 0.71).
CONCLUSION
After detail analysis this study lead to following conclusion that
this study reflects that there is lack of adequate knowledge and less stress
coping strategies in first year GNM nursing students and A descriptive study
was conducted among 100 GNM nursing students of selected nursing
colleges of Aurangabad. The data analyzed in terms of achieving objectives of
the study using descriptive and inferential statistics findings and % were
analyzed to assess the knowledge and demographic variables regarding
stress coping strategies among nursing students in selected nursing colleges
of Aurangabad.
 LIST OF CONTENT

Sr. No. CONTENT Page No.

1 Acknowledgement i-ii

2 Abstract iii-iv

3 Table of v-ix

4 content List of x

5 Tables List of xi-xii

6 figures xiii

List of Annexure

Sr. No. TITLE Page No.

I CHAPTER I 1-9

1.1 Introduction 1-2

1.2 Background of study 2-3

1.3 Need of the study 3-4

1.4 Problem statement 4

1.5 Objective 4

1.6 Operational definition 4-5

1.7 Assumptions 5

1.8 Limitations 5

1.9 Delimitation 5

1.10 Ethical consideration 5

V
1.11 Conceptual framework 6-7

1.12 Summary 9

II REVIEW OF LITERATURE 10-17

2.1 Introduction 10

2.2 Literature related to assess knowledge 11-13

regarding stress among nursing students.

2.3 Literature related to stress coping strategies. 14-16

2.4 Summary 17

III RESEARCH METHODOLOGY 18-26

3.1 Introduction 18

3.2 Research approach 18

3.3 Research Design 18

3.4 Research setting 19

3.5 Variables of the study 19

3.6 Population 19

3.7 Sample and sampling technique 19-20

3.8 Inclusion and exclusion criteria 20

3.9 Delimitation 20

3.10 Tool presentation 21

3.11 Validity 22

3.12 Reliability 22

3.13 Pilot study 22

V
3.14 Method of data collection 23

3.15 Plan for data analysis 24

3.16 Summary 26

IV ANLYSIS AND INTERPRETATION OF 28-42

DATA

4.1 Introduction 27

4.2 Problem statement 27

4.3 Objectives 27

4.4 Hypothesis 27

4.5 organization of study finding 27-28

4.5.1 Section I 29-47

4.5.2 Section II 43-44

4.5.3 Section III 45-46

4.6 Summary 47

V DISCUSSION, SUMMARY, 48-55

CONCLUSIONFINDINGS AND
RECOMMENDATIONS

5.1 Introduction 48

5.2 Problem statement 48

5.3 Objective 48

5.4 Hypothesis 48

5.5 Research approach 48

V
 5.6 Research Design 48

5.7 Tool and technique of Data Collection 49

5.8 Pilot study 49

5.9 Validity and reliability 49

5.10 Findings of the study and discussion 49

5.10.1 Section A 50-51

5.10.2 Section B 51

5.11 Summary 51

5.11.1 Methodology 51

5.11.2 Result 51

5.12 Interpretation and Conclusion: 52

5.12 Nursing implications 52

5.13 Nursing and practice 52

5.14 Nursing education 52

5.15 Nursing administration 52

5.16 Nursing research 52

5.18 Recommendation for future study 53

BIBLIOGRAPHY 54-55

V
 LIST OF TABLES

Table No. Title Page no.

3.1 The scoring pattern of knowledge 22

4.1 Distribution of GNM students according to 29-30

their demographic characteristics.

4.2 Distribution of knowledge of students 43

regarding stress coping strategies of
undergraduate nursing students.

4.3 Association of knowledge of students 44-45

with the selected demographic
characteristics.

I
 LIST OF FIGURES

Fig no. Title Page no.

1.1 Conceptual framework based on Bertalanffy 8

General System Model theory

3.1 Schematic presentation of research design 25

4.1 Distribution of students according to their 31

Age

4.2 Distribution of students according to their 32

gender

4.3 Distribution of students according to 33

Religion

4.4 Distribution of students according to Area. 34

4.5 Distribution according to monthly income. 35

4.6 Distribution of students according to 36

Support System.

4.7 Distribution of students according Type to 37

Family.

4.8 Distribution of students according to 38

Residence.

X
4.9 Distribution of students according to 39
Previous Academic Result.

4.10 Distribution of students according to Marital 40

Status.

4.11 Distribution of students according to Method 41

of Relaxation.

4.12 Distribution of students according to 42

Psychological illness present in family.

4.13 Distribution of knowledge of students 44

regarding stress coping strategies

X
 LIST OF ANNEXURES

Annexure Title Page no

no.

1 ANNEXURE I - ABBREVIATION a

2 ANNEXURE II - HEAD LETTER b

3 ANNEXURE III c

ANNEXURE IV - CONSENT LETTER

4 d
FROM PARTICIPANT

ANNEXURE V - CRITERIA CHECKLIST

5 e-n
FOR VALIDATION OF THE TOOL

X
 CHAPTER I

INTRODUCTION

1.1 INTRODUCTION
“The greatest weapon against stress is our ability to choose one thought
over another”
WILLIAM JAMES
Life is a precious gift of god. Every human being has to live a happy and
peaceful life. This is possible only when a person can balance every situation or
stress in life every human being finds a way to solve a problem for every situation.
According to Merriam Webstear’s Dictionary, stress is a state resulting from
factors that tend to alter an existent equilibrium. To have a happy stress-free life that
makes life challenging a person needs good environment, good lifestyle, and good
financial condition. and a person should also have to be spiritual wellbeing with good
morals in today’s day to day life a person is not able to cope up with stress however
the various strategies of coping stress but cannot be implanted in day to day life
because of busy lifestyle, every person from adult to child has stress that reflect its
effect in the mental ‘wellbeing of normal living.1

Moreover, the transition between the middle childhood and adolescence

represents a confluence of social, academic, cognitive, physiological, and physical
changes. Pubertal maturation brings changes heralding reproductive maturity as well
as increase in gonadal hormones which influence central and peripheral stress
response system throughout the body and brain, thus stress among young brings
social emotional changes.

Nursing is a Nobel profession to give the professional care to patient, to

promote health of the community people and prevent from various diseases. It needs
love and compassion in nursing student they experience increased tension prior to
their clinical posting and where they have to care for the ill and sick patients. They
undergo emotional stress in other academic activities like written and practical
examinations.2

1
 One of the skills that a nursing student should develop is learning to cope with
stress which is necessary for everyday life and nursing career. Coping is the ability
to appraise the stressful situation with the goal of adaptation or adjustment to the
change in order to regain balance and develop the power and ability to meet new
challenges.

It is necessary to set priorities, plan ahead and organize oneself so as to

reduce the negative consequence of stress. Nursing students have to be fully
prepared for the clinical experience on the wards and community settings which is
accompanied with a lot of anxiety. Students worry about working with dying patients
or patients with terminal diseases, interpersonal conflicts with nurses, problem of
incompetency, fear of making mistakes or failure, relating effectively with the patients
and their relations, work overload and the outcome of nursing care to the patient.

Furthermore, other sources of stress for nursing students. Unrealistic

deadlines for submission of assignment, unclear assignments, excessive homework,
un-conductive learning environments and poor interpersonal relationship with faculty
members.

Other sources of stress include working with dying patient, intrapersonal

conflicts, competence and fear of failure and interpersonal relation with patient.3

1.2 BACKGROUND OF THE STUDY

Researcher have been identified as, in the modern world students feel difficult
to control their emotions in order to face various situations in their academic as well
as personal life. Success in academics can be predicted more by emotional
measures and stress coping strategies, a student must be mentally healthy so that
he can achieve good academic results also.

According to Dopp & Parrish; Tansy & Roe, (2009) College presents myriad
of new experiences and many of these experiences are stressful. Students
simultaneously face academic challenges as well as family or social crisis. Many
balance irregular or extended workloads, have difficulty with time management and
may have fears over loss of financial scholarship support.

2
 According to Feldt (2008); Ahern & Norris (2011) Other areas of concern for
students include housing, being away from parents for the first time, attainment of
personal goals, being overwhelmed with difficulties and loss of personal control.

According to American college health association national college health

assessment (ACHA, 2009, 2010) the data revealed over one third of all post-
secondary education students ranked stress as their highest health impediment,
followed with sleep issues, depression and anxiety of the 30,000 traditional students
surveyed, 38.7% reported “moderate” stress, and 8.7% of the students reported
“tremendous” stress.4

According to Hockenberry & Wilson (2011) the majority nursing students,

age 18-24 years old, are describes as young adults, or emerging adults. Goals for
this developmental stage include developing personal independence and self-
sufficiency.

According to Mahmood, Staten, Hall and Lennie (2012) the maladaptive

coping, adaptive coping, life satisfaction, social status, living alone, religion and class
standing were in young adults in college. Their study recommended on-campus
screening program to increase student awareness, with an emphasis on students
with maladaptive coping styles.5

1.3 NEED FOR STUDY

The purpose of the study was to identify the stress coping strategies of
students at selected nursing colleges of Aurangabad. In this regard, this study will
identify the end exploring the pattern of stressor would provide an understanding of
how the education system and cultural norms could affect personal and academic
tasks in college.

Review of literature and clinical experience made the investigation to realize

that stress causes health problems youngsters are more at risk because of
unhealthy life style. This motivated the investigation to undertake a study on
knowledge regarding stress coping strategies in nursing students.6

According to Shamar and Kaur (2011) Using 37 Nursing students in a private

nursing institute in Punjab, Affiliated to Baba Farid University of Health Science, also

3
revealed that 97 % of participants had moderate level of stress with 3 % having
severe stress.

According to Decker & Shallenberger (2012) professional job stress has

been studied and identified often in occupation with high physical and psychological
demands and low personal autonomy. Nursing is a typical example of a high stress
occupation, as nurses must interact with other professionals frequently to perform
required work

According to Watson & Yanhua (2013) the nursing student share many of the
same stressors as qualified nurses, they are at the lowest level of the hierarchical
ladder. They share responsibilities for the patient and family with the bedside nurse
charge nurse and clinical nursing instructor.7

Past research has indicated all college students are vulnerable and
experience stress. In\addition to traditional academic stressors, nursing students
experience clinical stress. Extremes of too much stress or too little stress may have
a negative impact on a student's health. Ideally, students develop positive coping
strategies, to maintain optimal balance between the two extremes.

Nursing student stress is widely recognized, especially in the clinical setting.

With frequent changes and challenges in health care and technology, the clinical
setting has the potential to become even more stressful. Increasing numbers of non-
traditional students are entering the nursing profession. Many of these adult students
have work and life experiences unrelated to the nursing field. Often these same
students must balance home, employment, and educational responsibilities. With the
increase or change in responsibilities, the students face greater risks of maladaptive
coping strategies. The lack of self-care in students may progress to burnout,
depression or substance abuse. The purpose of this research is to assess three
grades levels of nursing students ' stress at one point in time during their course of
study.8

1.4 PROBLEM STATEMENT

"A study to assess the knowledge regarding stress coping strategies in first
year GNM students in selected college of Aurangabad.”

4
1.5 OBJECTIVES
1. To assess the knowledge regarding stress coping strategies in first year GNM
nursing students at selected nursing colleges of Aurangabad.
2. To find out significant association between the knowledge in first year GNM
nursing students and selected demographic variable.

1.6 OPERATIONAL DEFINITIONS:

1) Assess - Dictionary meaning of assess is to determine or evaluate. In this study

assess refers to appraisal of knowledge score of students participating in
research.
2) Knowledge - Dictionary meaning of knowledge is the fact of knowledge
about something. In this study it refers to expressed feeling, opinions, and
beliefs of nursing students regarding stress coping strategies students.
3) Nursing students – In this study it refers to first year nursing students of
selected college of Aurangabad.
4) Stress – Dictionary meaning of stress is a mental or emotional strain or tension
resulting from adverse or demanding circumstances. Stress is a “State produce
by change in the environment that is perceived as challenging, threatening or
damaging to person.”
5) Coping strategies - Dictionary meaning of coping strategies is the conscious
effort to reduce stress. “Study the strategies techniques that people use to handle
stress. These techniques or behaviours are called Coping strategies.
6) Selected Colleges: It includes MGM INE, Aurangabad.

1.7 ASSUMPTIONS:

1 Students of first year GNM possess some knowledge regarding stress

coping strategies.
2 Knowledge of students may vary according to socio demographic variables.

1.8 LIMITATIONS:
The study was limited for students of first year GNM who were studying in
selected nursing colleges.

1.9 DELIMITATION
The study was delimited to the students, who are not co-operative and willing.

5
1.10 ETHICAL CONSIDERATION:
Research problem and objectives were approved by the research committee
of KBNC. The permission was taken from principal of MGM INE, Aurangabad. Prior
to study written informed consent is taken from the participants.

1.11 CONCEPTUAL FRAMEWORK:

Nursing science is deeply involved in the body of knowledge essential nursing
research and positive practice. Identification of knowledge based requires the
development and the reorganization of concepts and theories specific to nursing.

Conceptual framework is interrelated concept or abstract that are assemble

together in some rational scheme by virtue 0of their relevance to a common theme.
Each conceptual framework proposes a different view of the meta-paradigm
concepts which provides clear description of variables, suggesting ways or method
to conduct the study and guiding the interpretation of the significant findings. In the
present study the investigator adapted the modified conceptual framework based on
modified Ludwig von Bertalanffy's 1968 General System model.

According to this model all living systems are open systems, which promote
the exchange of matter, energy and information with the other system and
environment. The exchange within open system, between open system and their
supra system is continuous. The dynamic balance within the supra system helps to
create and maintain internal stability. The change in one part of the system creates
change in other part. In all systems activities can be recorded into an aggregate of
feedback in circuits such as input, throughput and output. The openness of the
human systems made the investigator to assess the relationship among the factors
that affect the person which includes the influence of subsystem and supra system.

Ludwig open theory model focuses on three areas:

 Input
 Throughput
 Output
 Feedback

6
INPUT: -
Input refers to the matter, energy, or information received from the
environment into the system. In this study, the nursing students and their age,
religion, type of family, residence, income of family, support system considered
as inputs.

THROUGHPUT: -
Throughput refers to the process by which matter, energy and information
is modified or transform within the system. In the present study throughput is
structured knowledge questionnaire regarding stress coping strategies.

OUTPUT: -
Output in this model refers to matter, energy and information that are
released from the system into the environment.

In this present study output includes the level of knowledge of first year
GNM students i.e. Poor, Average and good regarding stress coping strategies by
using structured knowledge questionnaire.

FEEDBACK:

Feedback is processing whereby the output of the system is redirected to

throughput of the same system. Feedback can be measured by the output,
whether there is significant gain or no gain in knowledge of the students
regarding stress coping strategies or positive attitude.

7
 INPUT THROUGHPUT

OUTPUT

STRUCTERED KNOWLEDGE QUESTIONARIES REGARDING STRESS AND COPING ST

GAIN IN KNOWLEDGE OF FIRST YEAR NUR

DEMOGRAPHIC STRATEGIES
DATA
Age
Gender
Religion
Area
Family income
Support system
Type of family
Residence
Previous academic results
Marital status
Method of relaxation
Psychological
illness

8
POOR AVERAGE GOOD
 FEEDBACK

FIG.1. CONCEPTUAL FRAMEWORK BASED ON BERTALANFFY GENERAL SYSTEM MODEL THEORY.

8
1.12 SUMMARY

This chapter deals with introduction background of study, need of the study,
objective, operational definition, delimitation, ethical consideration and conceptual
frame work.

9
 CHAPTER II

REVIEW OF LITERATURE

Review of literature is a key step in research process. it is referring to an

extensive, exhaustive and systematic examination of publications relevant to the
research project. nursing research may be considered a continuing process in which
knowledge gained from earlier studies is an integral part of research in a general.
before any research can be started whether it is a single study or an extended
project, a literature reviews of previous studies an experience related to the
proposed investigations should be done. one of the most satisfying aspect of the
literature review is the contribution it makes to the new knowledge insight, and
general scholarship of researches.

The review of literature is presented under the following headings:

2.1 Literature related to assess knowledge regarding stress among nursing students.

2.2 Literature related to stress coping strategies in undergraduate nursing students

2.1 LITERATURE RELATED TO ASSESS KNOWLEDGE REGARDING

STRESS AMONG NURSING STUDENTS:

Shamar and Kaur (2011), research conducted an experimental study with 37

nursing in a private nursing institute, affiliated to Baba Farid University of Health
Science students, also revealed that 97 % of the participants had moderate levels of
stress with 3 % having severe stress. Khater, Akhu Zaheya and Shaban, (2014)
reported on the perceived stress level among 597 Jordanian nursing students and it
was discovered that 286 (47.82 %) had stress level above mean.9

Seyedfatemi (2007) and Samson-Akpan (2016), conducted an experimental

study on students utilizing many coping strategies such as " ventilation, diversion,
relaxation, self-reliance, social peer group support, avoidance, praying, day
dreaming, listening to music and smoking, drinking, joking” among others.Rejesh
Kumar in 2007 reported that majority of the respondents in her study totalling 180
nursing students in a private nursing institute in Punjab, affiliated to Baba Farid
University of Health Science, use good adaptive measures as compared to
maladaptive ones. “ Seeking diversion" was mostly used while seeking “ professional
support" was the least common coping strategy utilized by nursing students (Rajesh
Kumar, 2007; Samson-Akpan et al. 2016) .Pheukpan (2009) also highlighted that
self-reliance and humour were used by nursing students in Australia (AU) to manage
stress while according to Khater, Akhu-Zaheya and Shaban, (2014), Jordanian
baccalaureate nursing students used mainly problem solving as a coping measure
".A study was conducted to determine the level of stress, its sources and coping
strategies among nursing students from three countries: Greece, the Philippines and
Nigeria using a descriptive, comparative research design, 547 nursing students
participated in the study from august 2015 to april2016. Two standardised
instruments were used, the perceived stress scale and coping behaviour inventory.
Moderate level of stress is present in the students and stress level varied according
to country. 10

Timmins F and Kaliszer M (2002), research conducted on aspects of nurse

education programme that frequently cause stress to nursing students a fact findings
sample survey. A questionnaire was distributed to 110 nursing students and the
result indicate that stress exists for students in both the clinical and academic
aspects of programme. In clinical area stress level is severe.11

Burnard p, Edward d, thaibai h (2008), research conducted on a

comparative study of stress in student nurses in five countries was conducted by The
study was undertaking using a descriptive quantitative design using the stress in
nurse education questionnaire with 1707 students across five countries are Albania,
Brunai, Czech Republic, Malta and wales. The mean score for the total sample for all
the items on the stress scale was 52.3 %. Half of the student having severe type of
stress present.12

Cavalheiro Moura, DF jr. LOPES (2008), conducted a comparative study on

stress .The present study aimed to identify the presence of stress in nurses working
in intensive care units, the stressing agents and symptoms associated to the nurse’s
perceptions of stress.75 nurses took part in this study. The data was collected by
questionnaire, analysed with the Pearson correlation coefficients and adjusted by
general linear model. This study shows the presence of stress related to work
dissatisfaction; activities regarded as critical situation in intensive care units. Nurses
working in the intensive care unit having stress level is moderate to severe.13

Kenny, Kidd, Nankervis and Connell (2011), conducted a research study on

a mature age student which focused on steps educators could take to strengthen
educational access for mature students. The study included flexibility of class
scheduling, clinical placement during school hours or on weekends, and financial
support as stress reducing strategies. Older students entering the nursing profession
often already have degrees in other fields, such as in psychology or biology. These
students were academically successful and highly competitive. Weitzel and
McMahon (2008) researched accelerated baccalaureate nursing students ' stresses
and supports, and reported nursing faculty have the ability to decrease potential
stress as expected, mature students reported the work load stressful, in addition to
family responsibilities. Faculty can contribute to lower stress levels by decreasing
time spent in classroom work groups. Often, mature students do not care for group
class work, especially if they feel a classmate is not doing their share of the work,
providing the potential of bringing down their grade (Weitzel and McMahon, 2008).
Educators were encouraged to evaluate students' reading and written assignments
following core curriculum learning objectives (Weitzel & McMahon, 2008). Family
support, peer and faculty support, especially from nursing advisors, were reported as
valuable by the students. significant effects on their basic nursing education and
future studies.14

Melincavage's (2011) and Smedley and Morey (2010), research conducted

on Multiple researchers have concluded nursing students have increased stress or
anxiety when they begin clinical work. research agreed with that a positive clinical
atmosphere, provided by both staff and faculty, decreased student anxiety and
increased self-esteem. Three main themes emerged from Nelwati and Plummer's
research (2013) on nursing students ' perceptions of stress in the clinical setting.
Feelings of pressure were described as most stressful, and included preparing for
clinical patients, lack of sleep, overlapping assignments, and timely submission of
assignments instructors Challenging relationships was the second theme noted, and
included interactions with patients and families, communication with clinical staff, co-
operative peer work, and social relationships with families and the community. The
use of coping strategies was the third theme of the study. Students described their
response to a stressful situation, and what coping strategies they utilized to relieve
the stress. Responses were both physiological and psychological. Sleep deprivation,
altered appetite, and headaches were reported. Physiological responses to stress
were noted as being upset, panic, anxiety, sadness, withdrawal, sensitivity, and
mood changes. Students may be unaware of their perception to stressors, and may
need assistance with coping strategies (Lazarus and Folkman, 1984).15

2.2 LITERATURE RELATED TO STRESS COPING STRATEGIES.

The study population consisted of all nursing students totalling 527 in the
Nursing Science Department. However, students in 300 to 500 levels were used for
the study. These students were selected because it is in their third to fifth year that
most of the nursing courses are offered. Therefore, proportionate samplings of 50%
of students in all strata (300 to 400 to 500 levels) were used. Therefore, a simple
random sampling method with replacement was used to select the 154 students out
of 308 which constitute 50% of the respondents.16

Saudi Arabia in (2007) and hamaideh SH (2007), conducted a study which

aim to identify levels and types of stressors among nursing students during their
clinical training and coping behaviour. Data was collected using a purposive
sampling method from 100 nursing students using a self-reported questionnaire
composed of perceived stress scale coping behaviour Inventory. Results showed
that assignments and workload as well as teachers and nursing staff Were the
highest sources of stress in clinical training. J PROF, in year 2009, the study
examined Hongkong baccalaureate nursing students stress and their coping
strategies in clinical practice 205 nursing students completed a self-administrative
survey including demographic, perceived Stress scale, and coping behaviour
inventory. Results showed that students perceived a moderate Level of stress. The
most common stressor was lack of knowledge and skills.17

TULLY A. (2009), conducted a study to measure levels of distress, sources

of stress and ways of coping of a convenience sample of psychiatric nursing
students (n = 35). Instruments used were of 30 general health questionnaires, the
jones and Johnson student nurse Stress index, parks way of coping questionnaire
and a demographic questionnaire finding reveals that all students Were significantly
distressed, exceeding a conventional cut off score of 5 on 30 questionnaire.18

WANG H.F. (2005), conducted a study with sample 441 third year nursing
students of vocational high Schools in northern Taiwan, recruited by convenience
sampling. Three measurement were Adopted; stress perceived scale, coping
behaviour inventory and Chinese health questionnaire Result showed that the five
main stressors of entrance exam stress, in descending order, were taking test, the
student own aspiration, learning task, teacher aspirations and parent aspiration.19

Afaf Ibrahim Meleis and Eun-OkIm (2008), research conducted on literature

search was performed using key terms of stress, college student stress, Millennials,
mature college student stress, student nurse education, student nurse clinical
education, nurse stress, nursing student anxiety, graduate nurse retention and
burnout; with a focus on research in nursing student stress since 2009. Only articles
in English were selected. Databases searched included CINAHL, ProQuest,
PubMed, and PsycInformaion Reference lists in all retrieved journal articles were
reviewed. An additional list of search terms included middle range theory and
transition theory, Review of middle range theories indicated were highly regarded
worldwide in their research and publications, with other nursing researchers also
using Meleis ' Transition Theory in broad areas of practice.20

Beck & Srivastava (1991), Beck and Srivastava (1991) research conducted
on the literature review demonstrated changes over time in the areas of nursing
student stress evaluated by researchers. Past researchers evaluated student nurses
in regard to stress in the clinical setting and the developmental phase of the students
Stress both novice and experienced nursing students was explored by Jimenez et al.
(2009), revealing stress at similar levels from three grade levels. noted lower stress
scores in baccalaureate registered nurses compared to pre-licensure students and
attributed the lower perceived stress scores to maturity, previous experience, and
better problem-solving and time management skills Research studies with part-time
nursing students noted students must be educated on the demands of the nursing
program they are entering,21
 Levett-Jones (2007) & McMillan (2009), conducted research on Clinical
experience remains an integral component of nursing education. It provides nursing
students with the opportunity to demonstrate physical competency, utilize critical
thinking skills and incorporate didactic nursing theory under supervision of a clinical
nursing instructor. Nursing students ' initial clinical experiences may have Additional
stress may come from a continually changing clinical environment. Students need
some time to develop a working relationship with a new clinical advisor, settle into a
new environment, become familiar with the routines and norms on the new clinical
area, and become acquainted with friendly supportive floor staff to develop a sense
of belonging Unfortunately, hospital staff nurses are often part of nursing students'
stress. Researchers found evidence of horizontal violence or hostility from
experienced nurses towards student nurses. Descriptive terms used by the
students included words like sarcastic, patronizing, degrading, overbearing, and
condescending. Hansberger’s (2009) research demonstrated violence was observed
by student nurses All of the student nurses who responded to the survey had either
personally experienced violence or observed it. One-half of the violence was directed
toward the students by staff, and verbal abuse was predominant (69 %) followed by
bullying (21 %). Hathorn, Machtmes and Tillman's (2009) research agreed with
previous studies, and added that poor treatment received by nursing students
reduced the quality of care given to the patient. The word " anxiety" has also been
substituted for " stress" by some researchers. Although of small sample size,
research by reported nursing students ' self-reported anxiety increased significantly,
especially when performing skills in the clinical area along with a fear of being
demeaned, exposed or abandoned. Students also sensed a competition among their
clinical peers for the instructor's positive support. The study reported students
experienced anxiety due to inexperienced faculty and staff, and noted demeaning
remarks from both inexperienced floor staff and clinical instructors (Melincavage,
2011).
2.3 SUMMARY

This chapter had dealt with the review of research literature related to the
problem stated. Twenty-two studies were reviewed from primary sources and it
has helped the researchers to understand the impact of the problem under
study. It has also enabled the investigator to design the study, to develop the
tool, to plan for data collection procedure and analyze the data.
 CHAPTER III

RESEARCH METHODOLOGY

3.1 INTRODUCTION
Research methodology defines what the activity of research is how to proceed,
how to measure progress, and what constitute success. The methodological decision
paves crucial implication for validity and creditability of the study findings. Methodology
of research indicates the general pattern for organizing the procedure for the empirical
study together with the method of obtaining valid and reliable data for an investigation.
This chapter deals with the methods and techniques adapted for the study. The
methodology is the general pattern of organizing the procedure of gathering valid and
reliable data for the problem under proper investigation. It includes the research
approach, research design, independent, dependent variable population, sample,
sampling technique, sample size, development of data collection tool, data analysis,
pilot study, setting of study, period of study, plan for data analysis.

3.2 RESEARCH APPROACH

The research approach indicates the basic procedure for conducting research.
The choice of and appropriate approaches depends on the purpose of study. The
descriptive approach was used to a study to assess the knowledge regarding stress
coping strategies in first year GNM nursing students of selected nursing colleges of
Aurangabad.

3.3 RESEARCH DESIGN

The research design was descriptive research design the plan, structure and
strategy of investigate of answering the research question is the overall plan or blue
print the researcher selected to carry out their study.
This researcher was adopted non-probability convenience sampling with control
of group to evaluate to a study to assess the knowledge regarding stress coping
strategies in first year GNM students in selected college of Aurangabad. It provided best

1
frame work for the study. in the present study non probability convenience sample size
was be used.

3.4 SETTING OF THE STUDY

The present study was conducted in MGM INE, Aurangabad. The setup of
students of class wise first year GNM nursing students who are present.

3.5 VARIABLES OF THE STUDY

3.5.1 DEPENDENT VARIABLE:

The variable that changes as the independent variable is manipulated by the

researcher called as dependent variable. GNM Dependent variable nursing for students
present. study is knowledge regarding stress coping strategies in first year.

3.5.2 INDEPENDENT VARIABLE:

Independent variable for this study is Age, gender, religion, area, family income,
support system, type of family, residence, academic result during education, marital
status, method of relaxation, psychological illness presents in family.

3.6 POPULATION

" Population is complete set of person or objects that possess some common
characteristics that is of interest of researcher." The population for the study usually is
describing as being a composed two groups. The target population and accessible
population.

3.6.1 TARGET POPLUATION

It comprises of all the GNM nursing students of selected college of Aurangabad.

3.6.2 ACCESSIBLE POPULATION

It comprises selected GNM nursing students of selected college of Aurangabad.

3.7 SAMPLE
In the present study samples was students of MGM INE college, Aurangabad.

1
SAMPLING TECHNIQUE

Sampling is the process of selection a portion of population to represent the

entire population so that inference about the population can be made.
For the present study non probability convenience sampling was used to select
100 students of MGM INE, Aurangabad and who met the designed set of criteria.
Non probability convenience sampling was used most random available people
as study participants.

SAMPLING SIZE
The sample size was selected for the study was 100. it includes nursing students
in MGM INE, Aurangabad. Only those who fulfilled the sampling criteria and expressed
willingness to participate in the study we are selected.

3.8 SAMPLING CRITERIA

3.8.1 INCLUSION CRITERIA: students who are

- GNM nursing student

- Willing for participation in study
- Can read and write English and Marathi
- Male and Female
3.8.2 EXCLUSION criteria: Students who are
- Absent at time of data collection
- Not willing to participate
- Below 17 years.

3.9 DELIMITATION

 This study is delimited to nursing students.

 This study is delimited to selected nursing college.

METHOD OF DEVELOPING THE TOOL

The tool was used to assess knowledge regarding stress coping strategies
among GNM nursing students.

2
primary source:
GNM nursing students of selected nursing colleges.

3.10 TOOL PRESENTATION

The tool was prepared to as es knowledge regarding stress coping strategies in First
year GNM nursing students. Under the following steps:

 Review of related literature

 Preparation of tool
 Consultation of experts

PREPARATION OF TOOL

It is comprised of two sections:

 SECTION A: Demographic Characteristics.

It consists of demographic characteristics like age, gender, religion, income,

support system, Residency.

 SECTION B: Knowledge regarding stress coping strategies

It consists of knowledge questionnaire. It consists of 25 items for assessing

knowledge of assessing knowledge regarding stress coping strategies of MGM INE
college, Aurangabad.

SCORING PROCEDURE
To assess the knowledge regarding stress coping strategies in GNM nursing
students, Score was group into 3 levels like poor, First Class, Distinction based on
percentage of scores.

2
Table 3.1 - The scoring pattern of knowledge

Sr. no. Total Score Percentage Level of Knowledge

1 0-8 0-50% Poor

2 9-17 51-75% Average

3 18-26 76-100% Good

3.11 VALIDITY
The validity refers to whether a measurement instrument accurately measure
what it is supposed to measure. When an instrument is valid, it’s truly reflected the
concept, it is supposed to measure. The conducted tool where given to 8 experts in the
field of nursing. The experts are requested to give an opinion regarding relevance,
accuracy and appropriateness of the level of analysis for the further modification.
Content validity was established in consultation guide and experts. The validity was
established by consulting the experts from disciplines such as department of community
health nursing, department of mental health nursing, department of child health nursing.

3.12 RELIBILITY:

The content validity of the tool was done by 20 nursing students. The
reliability for the questionnaire was calculated by using split half method. The tool is
said to be reliable if the co-efficient is more than 0.8. The reliability co-efficient (r) of the
tool was 0.93 which was more than 0.8 hence the tool was found to be reliable.

3.13 PILOT STUDY:

The main objective of the pilot study was to help the researcher to become
familiar with the use of tool and to find out any difficulties in conducting the main study.
It is the trial run study conducted before the actual study in a different population with
similar characteristics.

The permission was obtained from the concerned departmental head. Subject
was chosen based on the criteria. The purpose of pilot study was explained and

2
informed consent was obtained to get their co-operation. On 08 Jan 2021 the pilot study
was conducted by using self-administration questionnaire. It was conducted on 20
students of MGM INE of college, to assess the feasibility of study. The study was found
to be feasible in terms of time and availability of subjects.

3.14 METHOD OF DATA COLLECTION

Data was collected by implementing self-structure knowledge questionnaire to 20
selected first year GNM students in selected nursing colleges of Aurangabad – Tool
was provided to samples at a same approximately 20-30 min were given to them for
solving the knowledge questionnaire.

Formal permission from the concerned authorities

Written informed consent from the subject

Selection of samples by non-probability purposive sampling technique

Administration of self-structured questionnaire

25-30 minutes time was allotted to all the participants

Data collected & analysed

2
3.15 PLANS FOR DATA ANALYSIS

Data analysis is the systemic organization and synthesis of research data and
testing of hypothesis using those data will be entered into the master sheet.

Description and inferential statistic will be used for the data analysis. Data
collected was analysed tabulated by using descriptive statics such as mean, standard
deviation & mean percentage to know the knowledge regarding stress coping strategies
among GNM nursing students. Inferential statistics like chi-square test was used for
finding the association of the knowledge with selected demographic variables, figures &
graphs were used as ad when needed.

2
 SAMPLE SIZE & DEMOGRAPHI
POPULATION SAMPLING DATA COLLECTION
C
-AGE TOOL &
-SAMPLE SIZE; 100
FIRST YEAR -RELIGION KNOWLEDGE BASED
-UNDERGRADUATE
UNDERGRADUATE NURSING STUDENTS -AREA QUESTIONNAIRENAIRE
NURSING WERE PREPARED
-SAMPLING TECHNIQUE -FAMILY INCOME
STUDENT CONSTRUCTED 12
-NON-PROBABILITY -SUPPORT SYSTEM DEMORAPHIC
CONVEINIENCE QUESTIONNAIRES &
-TYPE OF FAMILY
TECHNIQUE 25 STRUCTURED
KNOWLEDGE
QUESTIONNAIRENAIRE
DATA ANALYSIS

BY USING DESCRIPTIVE STATISTICS LIKE;

PERCENTAGE
MEAN
MEAN PERCENTAGE
STANDARD DEVIATION
CHI-SQUARE TEST
DEGREE OF FREEDOM
PROBABILITY OF CHI SQUARE

FIG.2 SCHEMATIC PRESENTATION OF RESEARCH DESIGN

2
3.16 SUMMARY:
A non-experimental exploratory study was carried out on GNM nursing
students to assess knowledge regarding stress coping strategies, structural
questionnaire was administered them and validity was obtained.

2
 CHAPTER IV

DATA ANALYSIS AND INTERPRETATION

4.1 INTRODUCTION

Analysis is the process of organizing and synthesizing the data so as to

answer research questionnaires and test hypothesis.
Analysis is a process of fitting data together data together of making;
invisible obvious of linking and attributing consequences to antecedent is a
process of conjecture and verification of correction and modification of
suggestion and defense ‘Morse J.M. and field P. A. (2005)’. This chapter deals
with analysis and interpretation of data collected from 100 GNM nursing
students.
The present study was designed to assess the knowledge regarding
stress coping strategies. The data is coded and analyzed as per the objectives of
study. The data is presented under the following heading.

SECTION - I
Description of students according to their demographic variables.

SECTION - II

Assessment of knowledge of students regarding stress coping strategies of GNM

nursing students.

1. Assessment of level of knowledge score.

SECTION - III

Association of knowledge of first year GNM nursing students with selected

demographic variables.

2
 SECTION I

Section I: Description of students according to their demographic variables.

This section deals with the description of GNM students according to their
demographic characteristics. frequency and percentages are used to describe the
demographic characteristics of the study subjects.

Table 4.1: Distribution of GNM students according to their demographic

characteristics.

n=100

S. N Demographic Variables Frequency Percentage

1 Age
17-18 years 28 28%
18-19 years 57 57%
19-20 years 12 12%
20 and above 3 3%
2 Gender
Female 44 44%
Male 56 56%
3 Religion
Hindu 73 73%
Muslim 3 3%
Christian 15 15%
Other 9 9%
4 Area
Rural 36 36%
Urban 64 64%
5 Family Income
4000-6000 Rs 17 17%
6000-8000 Rs 5 5%
8000-10000 Rs 22 22%
10000 & above 56 56%

2
6 Support system
Friend 19 19%
Group 9 9%
Family 72 72%
7 Type of family
Nuclear 52 52%
Joint 48 48%
8 Residence
Hostel 24 24%
With Family 40 40%
With residence 20 20%
Rented room 16 16%
9 Academic result
Poor 47 47%
Average 40 40%
Good 13 13%
10 Marital status
Married 4 4%
Unmarried 96 96%
11 Method of relaxation
Yoga 11 11%
Medication 12 12%
Exercise 27 27%
Music therapy 50 50%
12 Psychiatric Illness present in family
Yes 6 6%
No 94 94%

2
 Fig. 4.1 Distribution of students according to Age

Distribution of students according to Age

60 57%

50

40
FREQUEN

3028%

20

12%
10

3%
0
AGE
17-18 years 18-19 years 19-20 years 20 and above

Fig. no.: 4.1. Shows that the percentage wise distribution of nursing students
according to age that highest percentage wise 57% were in the age group of 18years
& lowest percentage 3% i.e. above 19 years.

3
 Fig. 4.2. Distribution of students according to gender

Distribution according to gender

11%

89%

Female Male

Fig. no.: 4.2. Reveals that the percentage wise distribution of students according to
gender lowest percentage i.e. 11% belongs to Male & highest 89% belongs to
female.

3
 Fig. 4.3. Distribution of students according to Religion

DISTRIBUTION ACCORDING TO RELIGION

80 73%

70

60

50
FREQUEN

40

30

20
15%
9%
10 3%

0
TYPE OF FAMILY

HinduMuslimChristianOther

Fig. no.: 4.3. Reveal that the percentage wise distribution of students according to
Religion that highest percentage i.e. 73% belongs to Hindu family & lowest to 3% i.e.
Muslim.

3
 Fig. 4.4. Distribution of students according to Area.

Distribution of students according to Area.

64%
Urban
AR

36%
Rural

0 10 20 30 40 50 60 70
FREQUENCY

Fig. no.: 4.4. Reveals that the percentage wise distribution of students according to
area the highest percentage is 64% belongs to urban area and lowest percentage
belongs to 36% for rural area.

3
 Fig. 4.5. Distribution according to monthly income.

Distribution according to monthly income.

17%

5%

56%

22%

4000-6000 Rs 6000-8000 Rs 8000-10000 Rs 10000 & above

Fig. no.: 4.5. Reveals that the percentage wise distribution of students according to
income that highest percentage i.e. 56% having family income 1000 and above &
lowest percentage i.e. 5% i.e. 6001-8000.

3
 Fig. 4.6. Distribution of students according to Support System.

Distribution according to Support System.

80

72%
70

60

50
FREQUEN

40

30

20
19%

10
9%

0
SUPPORT SYSTEM

FriendGroupFamily

Fig. no.: 4.6. Reveals that the percentage wise distribution of students according to
support system that the highest percentage is for family support system. And the
lowest is for group support system.

3
 Fig. 4.7. Distribution of students according Type to Family.

Distribution of students according Type to

Family.

48 %
Joint
FAMI

52 %
Nuclear

46 47 48 49 50 51 52 53
FREQUENCY

Fig. no.: 4.7. Reveals that the percentage wise distribution of students according to
gender highest percentage i.e. 52% belongs to Nuclear family & lowest 48% belongs
to Joint family.

3
 Fig. 4.8. Distribution of students according to Residence.

Distribution of students according to Residence.

16%
24%

20%

40%

Hostel With Family With residence Rented room

Fig. no.: 4.8. Reveals that the percentage of distribution of students according to
residence that the highest rate is with family and average with the rented room.

3
 Fig. 4.9. Distribution of students according to Previous Academic
Result.

Distribution of students according to Previous

Academic Result.

47%
50

45 40%
40

35

30
FREQUEN

25

20
13%
15

10

poor 1st Class Distinction

ACADEMIC RESULT

Fig. no.: 4.9. Reveals that the percentage of distribution of students according to
Previous Academic Result i.e. 47% of student is having poor academic result, for 1 st
class academic result there are 40% students, and with academic result as
distinction there are 13% students.

3
 Fig. 4.10. Distribution of students according to Marital Status.

Distribution of students according to Marital Status.

96%
Unmarried
MARITAL

4%
Married

0 102030405060708090100
FREQUENCY

Fig. no.: 4.10. Reveals that the percentage of distribution of nursing student
according to Marital Status i.e. 96% students are Unmarried & married students up
to 4%.

3
 Fig. 4.11. Distribution of students according to Method of
Relaxation.

Distribution of students according to Method of

Relaxation.

11%

12%

50%

27%

Yoga Medication Exercise Music therapy

Fig. no.: 4.11. Reveals that the percentage of distribution of students according to
method of relaxation i.e. 50% is music therapy method used by students, exercise is
27% used by students as method of relaxation, 12% is medication used by students,
yoga is 11% used by students as method of relaxation.

4
 Fig. 4.12. Distribution of students according to Psychological
illness present in family.

DISTRIBUTION OF STUDENTS ACCORDING TO PSYCHOLOGICAL ILLNESS PRESENT IN FAMIL

YesNo

6%

94%

Fig. no.: 4.12. Reveal that the percent wise distribution of students according to
psychological illness present in family i.e. highest percentage is 94% which has no
psychological illness in family and lowest i.e. 6% have the psychological illness in
family.

4
 SECTION II

4.5.2 Section II: Assessment of knowledge of students regarding stress

coping strategies of GNM nursing students.

1. Assessment of mean, standard deviation and mean percentage of knowledge

Table 4.2: Distribution of knowledge of students regarding stress coping

strategies of GNM nursing students.

Knowledge of Score Percentage Knowledge Score

student
regarding stress
coping strategies score Frequency
Percentage

Poor 0-8 0-50% 25 25%

Average 9-17 51-75% 65 65%

Good 18-26 76- 100% 10 10%

Minimum score 10

Maximum score 65

Mean Score 21.88

Standard deviation 5.8

The above table shows that (25%) indicate poor knowledge score, (65%) indicates
average knowledge and (10%) indicates good knowledge score. The minimum score
was 10 and the maximum score was 65, the mean score was 21.88 and standard
deviation was 5.8.

4
 Fig. 4.13.: Distribution of knowledge of students regarding stress
coping strategies

Distribution of knowledge of students regarding

stress coping strategies
70

60

50

65%
40
FREQUEN

30

20
25%

10

10%
0
RANGE

poor Average Good

Fig. no.: 4.13. Reveal that the percent wise distribution of knowledge of students
regarding stress coping strategies, about 25% of GNM students is Poor, 10% of
GNM nursing students is Good according to the result.

4
 SECTION III

4.5.3 Section III: Association of knowledge of first year GNM nursing students
with selected demographic variables.

Table 4.3: Association of knowledge of students with the selected

demographic characteristics.

n=100

Samp Degree
Demographic Level of
le Poor Avera Good chi
of
Variables Significance
ge
freedom
Age
17-18 years 28 6 11 11
19-20 years 57 9 34 14 4 2.15 N.S
21-22 years 12 2 5 5
23 and above 3 0 2 1
Gender
Female 89 40 45 4 2 1.21 N.S
Male 11 3 6 2
Religion
Hindu 73 11 50 12
Muslim 3 0 0 3 6 5.65 N.S
Christian 15 0 4 11
Other 9 0 4 5
Area
Rural 36 5 15 16 2 1.10 N.S
Urban 64 6 33 25
Family Income
4000-6000 Rs 17 1 8 8
6000-8000 Rs 5 1 2 2 4 2.47 N.S
8000-10000 Rs 22 3 6 13
10000 & above 56 6 32 18

4
Support system
Friend 19 3 8 8
Group 9 0 2 7 3 2.65 N.S
Family 72 8 48 16
Type of family
Nuclear 52 7 30 15 2 0.65 N.S
Joint 48 4 28 16
Residence
Hostel 24 5 8 11
With Family 40 4 18 18 4 3.53 N.S
With residence 20 0 7 13
Rented room 16 2 5 9
Academic result
Poor 47 6 17 24
Average 40 2 15 23 4 3.81 N.S
Good 13 3 6 4
Marital status
Married 4 0 3 1
Unmarried 96 11 35 50 2 2.11 N.S
Method of
relaxation
Yoga 11 4 3 4
Medication 12 1 4 7 6 5.70 N.S
Exercise 27 4 11 12
Music therapy 50 2 20 28
Psychiatric
Illness present
in family
Yes 6 1 3 2 2 0.71 N.S
No 94 10 49 25

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4.6 SUMMARY

This chapter deals with the data analysis & interpretation which includes
distribution of demographic data by frequency and percentage and overall
knowledge score obtained by the study and association of knowledge with selected
demographic variables by using chi square test.

4
 CHAPTER V

SUMMARY, DISSCUSION, CONCLUSIONS, IMPLICATIONS AND

RECOMMENDATIONS

5.1 INTRODUCTION
This chapter deals with the summary of the study undertaken including the
conclusion from the findings, implications and discussion of the findings of the study,
and thus it helps to put together all the pieces of research the study. this chapter
ends with suggestions and implications to nursing and recommendations for future
research in this field. the study is conducted with a purpose to “a study to assess the
knowledge regarding stress coping strategies in first year GNM students in selected
college of Aurangabad”.

5.2 STATEMENT OF THE PROBLEM

“A study to assess the knowledge regarding stress coping strategies in first
year GNM students in selected college of Aurangabad.”

5.3 THE OBJECTIVES OF THE STUDY WERE

1. To assess the knowledge regarding stress coping strategies in first year GNM
nursing students at selected nursing colleges of Aurangabad.
2. To find out significant association between the knowledge in first year GNM
nursing students and selected demographic variable

5.4 ASSUMPTIONS:

1 Students of first year GNM students possess some knowledge

regarding stress coping strategies.
2 Knowledge of students may vary according to socio demographic variables.

5.5 FINDINGS OF THE STUDY AND DISCUSSION

A study data was used to assess the knowledge regarding stress coping
strategies in nursing students, the Data was collected from various colleges and 100
sample was collected. Data was analyzed using knowledge questionnaire. The
following are the major findings of the study with discussion.

4
The findings discussed under following heading.

 Description of students according to their demographic characteristics.

 Assessment of mean, standard deviation, means percentage of knowledge
of GNM nursing students in selected nursing colleges of Aurangabad.
 Assessment of level of knowledge.
 Assessment of association of knowledge of nursing students with selected
demographic variables.

5.6 SECTION A: DEMOGRAPHIC DATA:

 Percentage wise distribution of nursing students according to age that highest
percentage wise 57% were in the age group of 18years & lowest percentage
3% i.e. above 19 years.
 Percentage wise distribution of students according to gender lowest
percentage i.e. 11% belongs to Male & highest 89% belongs to female.
 Percentage wise distribution of students according to Religion that highest
percentage i.e. 73% belongs to Hindu family & lowest to 3% i.e. Muslim.
 Percentage wise distribution of students according to area the highest
percentage is 64% belongs to urban area and lowest percentage belongs to
36% for rural area.
 Percentage wise distribution of students according to income that highest
percentage i.e. 56% having family income 1000 and above & lowest
percentage i.e. 5% i.e. 6001-8000.
 Percentage wise distribution of students according to support system that the
highest percentage is for family support system. And the lowest is for group
support system.
 Percentage wise distribution of students according to gender highest
percentage i.e. 52% belongs to Nuclear family & lowest 48% belongs to Joint
family.
 Percentage of distribution of students according to residence that the highest
rate is with family and average with the rented room.
 Percentage of distribution of students according to Previous Academic Result
i.e. 47% of student is having poor academic result, for 1st class academic

4
 result there are 40% students, and with academic result as distinction there
are 13% students.
 Percentage of distribution of nursing student according to Marital Status i.e.
96% students are Unmarried & married students up to 4%.
 Percentage of distribution of nursing student according to Method of
Relaxation. i.e. 50% of students were believe on music therapy, up to 27% of
students are doing exercise for relaxation,12% of students were taking
medication, 11% of students are doing yoga for relaxation.
 Percent wise distribution of students according to psychological illness
present in family i.e. highest percentage is 94% which has no psychological
illness in family and lowest i.e. 6% have the psychological illness in family.

5.7 Distribution of knowledge of students regarding stress coping strategies

of GNM nursing students

The above table shows that (25%) indicate poor knowledge score, (65%) indicates
average knowledge and (10%) indicates good knowledge score. The minimum score
was 10 and the maximum score was 65, the mean score was 21.88 and standard
deviation was 5.8.

5.8 Association of knowledge of first year GNM nursing students with selected
demographic variables.

There was no significant association between knowledge score and selected

demographic data: Age (x2 = 2.15), Gender (x2 = 1.21), Religion (x2 = 5.65), Area
(x2 = 1.10),Family Income 2.47), Academic Result (x2 = 3.81), Marital Status (x2 =
2.11), Method of Relaxation (x2 = 5.70), Psychiatric Illness Present in Family (x2 =
0.71).

5.9 INTERPRETATION AND CONCLUSION:

This study reflects that there is lack of adequate knowledge and less stress
coping strategies in first year GNM nursing students.

5
5.10 NURSING IMPLICATION:

Nursing Practice: If student have knowledge regarding stress coping strategies,

they can create awareness and provide knowledge regarding stress coping
strategies to the community. Educating the student regarding stress coping
strategies can reduce the morbidity rate of mental disease. From the study findings
reveals that students of first year GNM nursing college needs the education
regarding stress coping strategies.

Nursing Education: Findings of the study can emphasize to plan new strategies to
improve the knowledge of students regarding stress coping strategies findings of the
study show great need for planning and implementation of mass health education
programmed on stress coping strategies.

Nursing Research: The study focuses on assessment of knowledge regarding

stress coping Strategies in first year GNM nursing students. The findings help
nursing researcher to Develop and carry out research activities on various aspects of
stress coping strategies.

Nursing Recommendation: Replication of the study could be done with larger

sample to validate and generalize the findings stress copings strategies teaching
manual used should be revised to include newer concepts of copings strategies like
meditation and yoga at morning.

Nursing Limitation: Sample size was limited to 100 member and as sample size
was less therefore the result cannot be generalized. Students who were willing to
participate in the study.

Nursing Delimitation: The study was limited to students who were; In first year,
GNM nursing students. Available during data collection Willing to participate in the
study.

5
5.11 RECOMMENDATIONS FOR THE FUTURE STUDY
On the basis of the findings of the study, it is recommended that,
a) A study to assess the knowledge regarding stress coping strategies in first year
GNM nursing students should be under taken with a view to develop problem
specific protocols.
b) A similar study can be undertaken for the large sample to organize the findings.
c) A similar study can be conducted on the effectiveness of pamphlets and self-
instructional modules on knowledge regarding stress coping strategies, strength,
weaknesses.
d) A similar study can be conducted on the effectiveness of the planned teaching
regarding stress coping strategies in GNM among nursing students.

5
 BIBLIOGRAPHY

1. Abasimi, E., Atindanbila, S., Mahamah, M. M., & Gai, X. (2015). The
experience of Stress among nursing students in nursing colleges in Tamale,
Ghana. International Journal of Psychology and Behavioural Sciences, 5 (2),
89-97
2. Aedh, A. 1., Elfaki, N. K., & Mohamed, I. A. (2015). Factors associated with
stress Among nursing students (Najran University-Saudi Arabia). IOSR
Journal of Nursing and Health Science (IOSR-JNHS). 4 (6), 33-38.
3. Alzayyat, A., & Al-Gamal E. (2014). A review of literature regarding stress
among Nursing students during the clinical education. IntNurs Rev. 61: 405-
15 Doi: 10.1111/ inr12114. Epub 2014 Jun 5.
4. Amr, M., El-Gilany, A., El-Moafee, H, Salama, L., & Jimenez, C. (2011).
Stress Among Mansoura (Egypt) baccalaureate nursing students. The Pan-
African Medical Journal. 8:26. Available: http: //www.panafrican-med
Journal.com/content/article/8/26/full.
5. Cohen, S.T., Kamarek T. & Mermelstein, R. (1983). A global measure
of perceived Stress. Journal of Health and Social Behaviour. 24, 385-
396
6. Dahlin, M., Joneborg, N., & Runeson B. (2005). Stress and depression
among medical Students: a cross sectional study. Med Educ. 39, 594-604
7. Deck D. L., & Srivastava, R. (1991). Perceived level and sources of stress in
a Baccalaureate nursing student. Journal Nurse Education. 30 (3), 127-133
8. Dhar, R., Walia, I., & Das, K. A. (2009). Descriptive study to assess the
causes of Stress and coping strategies used by the newly admitted basic
B.Sc. nursing students. Nursing and Midwifery Research Journal 5 (1); 31-37
9. Eswi, A. B., Radi, S., & Youssri H. (2013). Stress/ stressors as perceived
by Baccalaureate Saudi Nursing Students, Middle-East Journal of Scientific
Research. 14 (2): 193-202
10. Evans, W., & Kelly, B. (2004). Pre-registration diploma students nurse stress
and Coping measures. Nurse Education Today 24 (6), 473-482.
11. Fisch, N. M. A. (1996). Health students in college environment. Public
Health Nursing, 104-11
12. Gibbons, C., Dempster, M., & Moutray, M. (2008). Stress and eustress in
nursing students. Journal of advance nursing, 61(83), 282-290. (13). Khater,
W.A., Akhuzehaya, L.m, & Shaban I.A (2004). Sources of stress and coping
behavior in clinical practice among baccalaureate nursing students.
International journal of humanities and social science, 4(6), 194-202
13. LazarusR.S., & Folkman s. (1984). Stress appraisal and coping. New
York: Springer
14. Malahi, A & Damoradan A. (1999). Stress Due to exams in medical students-
role of yoga. Indian journal of physiol, pharmacol. 43, 218-24.
15. Moreira, D.P. & Furegato, A. R. F. (2013). Stress and depression among
students of the last semester in two nursing courses. Revista latino
americana de enfermagem. 21 (jan/feb) Available from:
http://www.scielo.php?script=sci_arttex&pid=S0104-11692013000700020.
16. Nicholl GNM, H., & nursing Timmins students, F. (2005. Journal).
Programmed of Advanced-related Nursing stressors. 50 (among 1), 93-100
part-time
17. Patterson, J. M., & McCubbin H I. (1987). Adolescents coping style and
behavior- Conceptualization and measurement. Journal of Adolescent. 10 (2),
163-186
18. .18. Pheukphan, A. P. (2009). Stress and coping strategies among AU
(Australian) Nursing students. Available from http://www.nurse.au.edu
19. Pryjmachuk, S., & Richards, D. A. (2007) Predicting stress in pre-registration
Nursing students. British Journal of Health Psychology, 12, 125-144.
20. Rajesh Kumar, N. (2011). Stress and coping strategies among
nursing students. Nursing and Midwifery Research Journal, 7 (4), 141-
151.
21. Samson-Akpan, P. E., John, M. E., Edet, O. B., & Uka, V. K. (2016). GNM
Nursing students’ experiences with stress in Nigeria. Poster presentation
during College of Nursing International Nursing Research Conference, 6-8
April, 2016. University Edinburgh, Scotland.
22. Shamar, N., & Kaur, A. (2011). Factors associated with stress among nursing
students. Nursing and midwifery research journal. 7(1):12-21
23. Seyedfatemi N. Tafreshi. M., & Hagani Journal, (2007). Experienced stressors
and coping Strategies among Iranian nursing students. BMC Nursing 6 (1)
Available http: /ww.bimedical.com/
 ANNEXURE- I

ABBREVIATIONS

N Total Number of Sample

X2 Chi-Square

SD Standard Deviation

% Percentage

P Prevalence Rete

R Realibility

P-test Probability test

A
ANNEXURE- II (HEAD LETTER)

B
 ANNEXURE-III

From,

Mr. Anuj R. Kalaskar

Final year basic B.Sc. Nursing

Kamalnayan Bajaj nursing college

To,

Sub: Requesting opinion and suggestion from expert for establishing content
of the research tool

Respected sir/madam

As a final year basic BSc nursing student of Kamalnayan Bajaj Nursing

College, Aurangabad in partial fulfilment of Basic BSc Nursing degree selected the
topic mention below for research project.

"A study to assess the knowledge regarding stress coping strategies in first
year GNM students in selected college of Aurangabad.”

We wish to request you to kindly go through the content of data collection.

Tool is enclosed here in term of its relevance and accuracy.

Thanking you,

Enclosures:

Research Proposal

Copy of content validity Performa

Copy of content Validity Certificate

C
 ANNEXURE-IV

CONSENT LETTER FROM PARTICIPANT

I am ..................................................

I am willing to participate in research study conducted by Fourth year BSc.

Nursing student of Kamalnayan Bajaj Nursing College Aurangabad. The study
mentioned to me is on,
"A study to assess the knowledge regarding stress coping strategies in first
year GNM students in selected college of Aurangabad.”

I have been correctly informed and explained about the brief aspects of the
study and the policies regarding the confidentiality of personal information.
I have completely understood my role in the study and I am therefore willing to
participate in the study.

Date:

Time:

Signature:

D
 ANNEXURE-V

CRITERIA CHECKLIST FOR VALIDATION OF THE TOOL

Instruction:

Kindly review the items in the structured questionnaires for assessing

knowledge and attitude regarding stress coping strategies. Give your suggestions
regarding accuracy, relevance and appropriateness of the content. There are two
columns, namely agree and disagree. Kindly place a tick mark (√) in the relevant
column and give your suggestions in the remark column.

STRUCTURE QUESTIONNARIE

 Please read instructions carefully and place a tick mark () against your
appropriate response.
 Avoid over writing, tick only one option for each question
 Attempt all question

SECTION-A

DEMOGRAPHIC CHARACTERSTICS

1) Age (Years):

a.17-18

b.18-19

c.19-20

d.20 and above

2) Gender:

a. Male

b. Female

E
3) Religion:

a. Hindu

b. Muslim

c. Christian

d. Other

4) Family Income (per month)

a. Rs. 4000-6000

b. Rs.6001-8000

с. Rs.8001-10,000

d. Rs.10000 and above

5) Support system:

a. Teachers

b. peer Group

C. Family

d. Relatives

6) Type of family:

a Nuclear

b. Joint

7) Area of permanent residence:

a. Rural

b. Urban

F
8) Present residence:

a. Hostel

b. Home

c. With relatives

d. Rented room

9) Previous academic result during education

A. 40% to 50%

b. 51% to 60%

c. 61% to 70%

d. 71 to 80%

10) Marital status

a. Married

b. Unmarried

c. separated

d. Divorced

11) Do you avail scholarship

a. Yes

b. NO

12) Psychological illness presents in family:

a. No

b. Yes, if yes provide details……….

G
 SECTION: -B

 Knowledge regarding stress coping strategies:

1) Stress is

a. External force

b. Internal resistive force

c. Axial force

d. Radial force

2) gland in our body is responsible for the stress response

a. Lymph
gland

b. Pituitary gland

c. Salivary gland

d. Thyroid gland

3) The situation that causes stress known as

a. Obesity

b. Stress response

c. Stressor

d. Malnutrition

4) A person’s affect the stress among the student

a. Attitude

b. Body size

c. Culture

d. Habits

H
5) Stress is a response to

a. Event

b. Stressor

c. Demand

d. Illness

6) Environmental stressor is

a. Financial problems

b. Family problems

c. Weather problems

d. Emotional problems

7) Type of stress is all except

a. Positive stress

b. Negative stress

c. Natural stress

d. Environmental stress

8) The most common stress is

a. Academic grade

b. Financial burden

c. No job

d. Time management

9) is characteristics of stress-free human being

a. Irritable

b. Depressed

I
c. Happy, positivity

d. Anxious

10) Good stress is known as

a. Distress

b. Eustress

c. Hypo-stress

d. Hyper-stress

11) Bad stress is known as

a. Distress

b. Eustress

c. Hypo-stress

d. Hyper-stress

12) Example of negative stress is

a. Failure

b. Positivity

c. Spirited

d. Dynamic

13) Example of positive stress

a. Energetic

b. Anxious

c. Depressed

d. Demotivated

J
14) Stress is moral physical response to event that makes a person

a. Feel upset in some way

b. Happy

c. Excited

d. Cheerful

15) The physical symptom of anxiety

a. Restlessness

b. Happiness

c. Cheerfulness

d. Kindness

16) During Stress, individual feel they cannot

a. Cope with demand

b. Feel happy

c. Get their daily food

d. Get a shelter

17) Symptoms of acute stress

a. Eye irritation

b. Palpitation

c. sneezing

d. Hiccup

18) The group of students prone to stress are

a. New joined students

b. Passed out students

K
c. Older students

d Interns

19) Coping strategies are meant to cope with

a. Situation

b. Life

c. Stressor

d. Life style

20) Effective way to deal with stress

a. Meditation

b. Give up

c. Quieting

d. Ignoring

21) Relaxation strategies are all except

a. Exercise

b. Mediation

c. Working

d. Prayer

22) Stress response can save our life by facing to defend ourselves

a. Anxiety

b. Extra strength

c. Challenges

d. Fear

L
23) Various coping strategies used by student are

a. Diversion therapy

b. Studying

c. Earning

d. Sleeping

24) Stress Coping strategies depend on

a. Personality

b. Income

c. Religion

d. Culture

25) Adaptive Coping strategies are all except

a. Awareness

b. Relaxation

c. Meditation

d. Refusal to food

M
ANSWER KEY

1. B
2. B
3. C
4. A
5. B
6. C
7. D
8. A
9. C
10. B
11. A
12. A
13. A
14. A
15. A
16. A
17. B
18. A
19. A
20. A
21. C
22. C
23. A
24. A
25. D