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Open Access 01-12-2021 | Care | Research

Perceived stress, stressors, and coping strategies among nursing students in the Middle East and North Africa: an overview of systematic reviews

Authors: Sonia Chaabane, Karima Chaabna, Sapna Bhagat, Amit Abraham, Sathyanarayanan Doraiswamy, Ravinder Mamtani, Sohaila Cheema

Published in: Systematic Reviews | Issue 1/2021

Abstract

Background

In nursing students, high stress levels can lead to burnout, anxiety, and depression. Our objective is to characterize the epidemiology of perceived stress, stressors, and coping strategies among nursing students in the Middle East and North Africa region.

Methods

We conducted an overview of systematic reviews. We systematically searched PubMed, Embase, PsycInfo, and grey literature sources between January 2008 and June 2020 with no language restrictions. We included any systematic review reporting measurable stress-related outcomes including stress prevalence, stressors, and stress coping strategies in nursing students residing in any of the 20 Middle East and North Africa countries. We also included additional primary studies identified through a hand search of the reference lists of relevant primary studies and systematic reviews.

Results

Seven systematic reviews and 42 primary studies with data from Bahrain, Egypt, Iraq, Jordan, Oman, Pakistan, Palestine, Saudi Arabia, and Sudan were identified. Most studies included nursing students undergoing clinical training. The prevalence range of low, moderate, and high perceived stress among nursing students was 0.8–65%, 5.9–84.5%, and 6.7–99.2%, respectively. Differences related to gender, training period, or the type of tool used to measure stress remain unclear given the wide variability in the reported prevalence measures across all stress levels. Common clinical training stressors were assignments, workload, and patient care. Academic training-related stressors included lack of break/leisure time, low grades, exams, and course load. Nursing students utilized problem focused (dealing with the problem), emotion focused (regulating the emotion), and dysfunctional (venting the emotions) stress coping mechanisms to alleviate their stress.

Conclusions

Available data does not allow the exploration of links between stress levels, stressors, and coping strategies. Limited country-specific prevalence data prevents comparability between countries. Reducing the number or intensity of stressors through curriculum revision and improving students’ coping response could contribute to the reduction of stress levels among students. Mentorship, counseling, and an environment conducive to clinical training are essential to minimize perceived stress, enhance learning, and productivity, and prevent burnout among nursing students.

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Barry S, Ward L. Undergraduate nursing students’ understandings of mental health: a review of the literature. Issues Ment Health Nurs. 2017;38(2):160–75. https://doi.org/10.1080/01612840.2016.1251515.CrossRefPubMed

Moreira DP, Furegato ARF. Stress and depression among students of the last semester in two nursing courses. Rev Lat Am Enfermagem. 2013;21(spe):155–62. https://doi.org/10.1590/S0104-11692013000700020.CrossRefPubMed

Rudman A, Gustavsson JP. Burnout during nursing education predicts lower occupational preparedness and future clinical performance: a longitudinal study. Int J Nurs Stud. 2012;49(8):988–1001. https://doi.org/10.1016/j.ijnurstu.2012.03.010.CrossRefPubMed

Tung YJ, Lo KKH, Ho RCM, Tam WSW. Prevalence of depression among nursing students: A systematic review and meta-analysis. Nurse Educ Today. 2018;63:119–29. https://doi.org/10.1016/j.nedt.2018.01.009.CrossRefPubMed

Phillips A. Nursing Education in Saudi Arabia. Ann Saudi Med. 1989;9(2):195–7. https://doi.org/10.5144/0256-4947.1989.195.CrossRef

The American Association of Colleges of Nursing (AACN). Nursing Education Programs / Baccalaureate Education. 2020. Available from: https://www.aacnnursing.org/Nursing-Education-Programs/Baccalaureate-Education. Accessed 20 May 2020.

Moffat KJ, McConnachie A, Ross S, Morrison JM. First year medical student stress and coping in a problem-based learning medical curriculum. Med Educ. 2004;38(5):482–91. https://doi.org/10.1046/j.1365-2929.2004.01814.x.CrossRefPubMed

Elliott M. The clinical environment: a source of stress for undergraduate nurses. Aust J Adv Nurs. 2002;20(1):34–8.PubMed

Newbury-Birch D, Walshaw D, Kamali F. Drink and drugs: from medical students to doctors. Drug Alcohol Depend. 2001;64(3):265–70. https://doi.org/10.1016/S0376-8716(01)00128-4.CrossRefPubMed

10.

Ashton CH, Kamali F. Personality, lifestyles, alcohol and drug consumption in a sample of British medical students. Med Educ. 1995;29(3):187–92. https://doi.org/10.1111/j.1365-2923.1995.tb02828.x.CrossRefPubMed

11.

Woloschuk W, Harasym PH, Temple W. Attitude change during medical school: a cohort study. Med Educ. 2004;38(5):522–34. https://doi.org/10.1046/j.1365-2929.2004.01820.x.CrossRefPubMed

12.

Gibbons C. Stress, coping and burn-out in nursing students. Int J Nurs Stud. 2010;47(10):1299–309. https://doi.org/10.1016/j.ijnurstu.2010.02.015.CrossRefPubMed

13.

Xie Z, Wang A, Chen B. Nurse burnout and its association with occupational stress in a cross-sectional study in Shanghai. J Adv Nurs. 2011;67(7):1537–46. https://doi.org/10.1111/j.1365-2648.2010.05576.x.CrossRefPubMed

14.

Mészáros V, Cserháti Z, Oláh A, Perczel Forintos D, Adám S. Coping with work-related stress in health care professionals -- strategies for the prevention of burnout and depression. Orv Hetil. 2013;154(12):449–54. https://doi.org/10.1556/OH.2013.29572.CrossRefPubMed

15.

Institute for Health Metrics and Evaluation (IHME). Findings from the global burden of disease study 2017. Seattle: IHME; 2018.

16.

World Health Organization. Depression and other common mental disorders: global health estimates. Geneva: World Health Organization; 2017.

17.

Ferrari AJ, Somerville AJ, Baxter AJ, Norman R, Patten SB, Vos T, et al. Global variation in the prevalence and incidence of major depressive disorder: a systematic review of the epidemiological literature. Psychol Med. 2013;43(3):471–81. https://doi.org/10.1017/S0033291712001511.CrossRefPubMed

18.

Young CB, Fang DZ, Zisook S. Depression in Asian–American and Caucasian undergraduate students. J Affect Disord. 2010;125(1):379–82. https://doi.org/10.1016/j.jad.2010.02.124.CrossRefPubMed

19.

Buchanan JL. Prevention of depression in the college student population: a review of the literature. Arch Psychiatr Nurs. 2012;26(1):21–42. https://doi.org/10.1016/j.apnu.2011.03.003.CrossRefPubMed

20.

Steptoe A, Tsuda A, Tanaka Y, Wardle J. Depressive symptoms, socio-economic background, sense of control, and cultural factors in university students from 23 countries. Int J Behav Med. 2007;14(2):97–107. https://doi.org/10.1007/BF03004175.CrossRefPubMed

21.

Olvera Alvarez H, Provencio-Vasquez E, Slavich G, Laurent J, Browning M, McKee-Lopez G, et al. Stress and health in nursing students. Nurs Res. 2019;68(6):453–63. https://doi.org/10.1097/NNR.0000000000000383.CrossRefPubMedPubMedCentral

22.

Shukri R. Status of nursing in the Arab world. Ethn Dis. 2005;15(1 Suppl 1):S1-88–9.

23.

Sheikh JI, Cheema S, Chaabna K, Lowenfels AB, Mamtani R. Capacity building in health care professions within the Gulf cooperation council countries: paving the way forward. BMC Med Educ. 2019;19(1):83. https://doi.org/10.1186/s12909-019-1513-2.CrossRefPubMedPubMedCentral

24.

Courage MM, Godbey KL. Student retention: policies and services to enhance persistence to graduation. Nurse Educ. 1992;17(2):29–32. https://doi.org/10.1097/00006223-199203000-00015.CrossRefPubMed

25.

Smith-Wacholz HC, Wetmore JP, Conway C, McCarley M. Retention of nursing students: an integrative review. Nurs Educ Perspect. 2019;40(6):328–32. https://doi.org/10.1097/01.NEP.0000000000000477.CrossRefPubMed

26.

Lindop E. Individual stress and its relationship to termination of nurse training. Nurse Educ Today. 1989;9(3):172–9. https://doi.org/10.1016/0260-6917(89)90041-5.CrossRefPubMed

27.

Lindop E. Factors associated with student and pupil nurse wastage. J Adv Nurs. 1987;12(6):751–6. https://doi.org/10.1111/j.1365-2648.1987.tb01379.x.CrossRefPubMed

28.

Shikai N, Uji M, Chen Z, Hiramura H, Tanaka N, Shono M, et al. The role of coping styles and self-efficacy in the development of dysphoric mood among nursing students. J Psychopathol Behav Assess. 2007;29(4):241–8. https://doi.org/10.1007/s10862-007-9043-3.CrossRef

29.

Harrington R, Fudge H, Rutter M, Pickles A, Hill J. Adult outcomes of childhood and adolescent depression: I. Psychiatric status. Arch Gen Psychiatry. 1990;47(5):465–73. https://doi.org/10.1001/archpsyc.1990.01810170065010.CrossRefPubMed

30.

Hofstra MB, Van der Ende JAN, Verhulst FC. Continuity and change of psychopathology from childhood into adulthood: a 14-year follow-up study. J Am Acad Child Adolesc Psychiatry. 2000;39(7):850–8. https://doi.org/10.1097/00004583-200007000-00013.CrossRefPubMed

31.

Kim-Cohen J, Caspi A, Moffitt TE, Harrington H, Milne BJ, Poulton R. Prior juvenile diagnoses in adults with mental disorder: developmental follow-back of a prospective-longitudinal cohort. Arch Gen Psychiatry. 2003;60(7):709–17. https://doi.org/10.1001/archpsyc.60.7.709.CrossRefPubMed

32.

Hofstra MB, Van Der Ende JAN, Verhulst FC. Child and adolescent problems predict dsm-iv disorders in adulthood: a 14-year follow-up of a dutch epidemiological sample. J Am Acad Child Adolesc Psychiatry. 2002;41(2):182–9. https://doi.org/10.1097/00004583-200202000-00012.CrossRefPubMed

33.

Deary IJ, Watson R, Hogston R. A longitudinal cohort study of burnout and attrition in nursing students. J Adv Nurs. 2003;43(1):71–81. https://doi.org/10.1046/j.1365-2648.2003.02674.x.CrossRefPubMed

34.

Voltmer E, Kötter T, Spahn C. Perceived medical school stress and the development of behavior and experience patterns in German medical students. Med Teach. 2012;34(10):840–7. https://doi.org/10.3109/0142159X.2012.706339.CrossRefPubMed

35.

Castaldelli-Maia JM, Lewis T, Marques dos Santos N, Picon F, Kadhum M, Farrell SM, et al. Stressors, psychological distress, and mental health problems amongst Brazilian medical students. Int Rev Psychiatry. 2019;31:7–8, 603–7.

36.

Shawi AFA, Abdullateef AN, Khedher MA, Rejab MS, Khaleel RN. Assessing stress among medical students in Anbar governorate, Iraq: a cross-sectional study. Pan Afr Med J. 2018;31:96.PubMedPubMedCentralCrossRef

37.

Heinen I, Bullinger M, Kocalevent R-D. Perceived stress in first year medical students - associations with personal resources and emotional distress. BMC Med Educ. 2017;17(1):4. https://doi.org/10.1186/s12909-016-0841-8.CrossRefPubMedPubMedCentral

38.

Melaku L, Mossie A, Negash A. Stress among medical students and its association with substance use and academic performance. J Biomed Educ. 2015;2015:9.CrossRef

39.

Ludwig AB, Burton W, Weingarten J, Milan F, Myers DC, Kligler B. Depression and stress amongst undergraduate medical students. BMC Med Educ. 2015;15(1):141. https://doi.org/10.1186/s12909-015-0425-z.CrossRefPubMedPubMedCentral

40.

Abdulghani HM, AlKanhal AA, Mahmoud ES, Ponnamperuma GG, Alfaris EA. Stress and its effects on medical students: a cross-sectional study at a college of medicine in Saudi Arabia. J Health Popul Nutr. 2011;29(5):516–22.PubMedPubMedCentralCrossRef

41.

Abdulghani HM. Stress and depression among medical students: a cross sectional study at a Medical College in Saudi Aarabia. Pak J Med Sci. 2008;24(1):12–7.

42.

Dahlin M, Joneborg N, Runeson B. Stress and depression among medical students: A cross-sectional study. Med Educ. 2005;39(6):594–604. https://doi.org/10.1111/j.1365-2929.2005.02176.x.CrossRefPubMed

43.

Sherina MS, Rampal L, Kaneson N. Psychological stress among undergraduate medical students. Med J Malaysia. 2004;59(2):207–11.PubMed

44.

Kiessling C, Schubert B, Scheffner D, Burger W. First year medical students’ perceptions of stress and support: a comparison between reformed and traditional track curricula. Med Educ. 2004;38(5):504–9. https://doi.org/10.1046/j.1365-2929.2004.01816.x.CrossRefPubMed

45.

Esan O, Esan A, Folasire A, Oluwajulugbe P. Mental health and wellbeing of medical students in Nigeria: a systematic review. Int Rev Psychiatry. 2019:1–12.

46.

Elzubeir MA, Elzubeir KE, Magzoub ME. Stress and coping strategies among Arab medical students: towards a research agenda. Educ Health (Abingdon). 2010;23(1):355.

47.

Witt K, Boland A, Lamblin M, McGorry PD, Veness B, Cipriani A, et al. Effectiveness of universal programmes for the prevention of suicidal ideation, behaviour and mental ill health in medical students: a systematic review and meta-analysis. Evid Based Ment Health. 2019;22(2):84–90. https://doi.org/10.1136/ebmental-2019-300082.CrossRefPubMed

48.

Doraiswamy S, Jithesh A, Chaabane S, Abraham A, Chaabna K, Cheema S. Perinatal mental illness in the Middle East and North Africa Region-a systematic overview. Int J Environ Res Public Health. 2020;17(15):5487.PubMedCentralCrossRef

49.

Chaabna K, Cheema S, Abraham A, Alrouh H, Lowenfels AB, Maisonneuve P, et al. Systematic overview of hepatitis C infection in the Middle East and North Africa. World J Gastroenterol. 2018;24(27):3038–54. https://doi.org/10.3748/wjg.v24.i27.3038.CrossRefPubMedPubMedCentral

50.

Chaabane S, Chaabna K, Abraham A, Mamtani R, Cheema S. Physical activity and sedentary behaviour in the Middle East and North Africa: an overview of systematic reviews and meta-analysis. Sci Rep. 2020;10(1):9363. https://doi.org/10.1038/s41598-020-66163-x.CrossRefPubMedPubMedCentral

51.

Chaabna K, Cheema S, Abraham A, Alrouh H, Mamtani R, Sheikh JI. Gray literature in systematic reviews on population health in the Middle East and North Africa: protocol of an overview of systematic reviews and evidence mapping. Syst Rev. 2018;7(1):94. https://doi.org/10.1186/s13643-018-0751-4.CrossRefPubMedPubMedCentral

52.

Becker L, Oxman A. Overviews of reviews. In: Cochrane handbook for systematic reviews of interventions version 510: The Cochrane Collaboration; 2011. p. 607–31. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1002/9780470712184.ch22.

53.

Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol. 2009;62(10):1006–12. https://doi.org/10.1016/j.jclinepi.2009.06.005.CrossRefPubMed

54.

Bougioukas KI, Liakos A, Tsapas A, Ntzani E, Haidich A-B. Preferred reporting items for overviews of systematic reviews including harms checklist: a pilot tool to be used for balanced reporting of benefits and harms. J Clin Epidemiol. 2018;93:9–24. https://doi.org/10.1016/j.jclinepi.2017.10.002.CrossRefPubMed

55.

Higgins J, Green S. Cochrane handbook for systematic reviews of interventions version 5.1.0: The Cochrane Collaboration; 2011. Available from: www.handbook.cochrane.org

56.

Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan—a web and mobile app for systematic reviews. Syst Rev. 2016;5(1):210. https://doi.org/10.1186/s13643-016-0384-4.CrossRefPubMedPubMedCentral

57.

Shea BJ, Grimshaw JM, Wells GA, Boers M, Andersson N, Hamel C, et al. Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews. BMC Med Res Methodol. 2007;7(1):10. https://doi.org/10.1186/1471-2288-7-10.CrossRefPubMedPubMedCentral

58.

Higgins JPT, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ (Clinical research ed). 2011;343:d5928.CrossRef

59.

Institute of Medicine of the National Academies. Finding what works in health care: standards for systematic reviews. Washington, DC: The National Academies Press; 2011.

60.

Daniel WW. Biostatistics: a foundation for analysis in the health sciences. 7th ed. New York: Wiley; 1999.

61.

Sheu S, Lin HS, Hwang SL. Perceived stress and physio-psycho-social status of nursing students during their initial period of clinical practice: the effect of coping behaviors. Int J Nurs Stud. 2002;39(2):165–75. https://doi.org/10.1016/S0020-7489(01)00016-5.CrossRefPubMed

62.

Baqutayan S. Stress and coping mechanisms: a historical overview. Mediterr J Soc Sci. 2015;6(2 S1):479.

63.

Labrague LJ, McEnroe-Petitte DM, Gloe D, Thomas L, Papathanasiou IV, Tsaras K. A literature review on stress and coping strategies in nursing students. J Ment Health. 2017;26(5):471–80. https://doi.org/10.1080/09638237.2016.1244721.CrossRefPubMed

64.

Alzayyat A, Al-Gamal E. A review of the literature regarding stress among nursing students during their clinical education. Int Nurs Rev. 2014;61(3):406–15. https://doi.org/10.1111/inr.12114.CrossRefPubMed

65.

Bhurtun HD, Azimirad M, Saaranen T, Turunen H. Stress and coping among nursing students during clinical training: an integrative review. J Nurs Educ. 2019;58(5):266–72. https://doi.org/10.3928/01484834-20190422-04.CrossRefPubMed

66.

McCarthy B, Trace A, O’Donovan M, Brady-Nevin C, Murphy M, O'Shea M, et al. Nursing and midwifery students’ stress and coping during their undergraduate education programmes: an integrative review. Nurse Educ Today. 2018;61:197–209. https://doi.org/10.1016/j.nedt.2017.11.029.CrossRefPubMed

67.

Labrague LJ, McEnroe–Petitte DM, De Los Santos JAA, Edet OB. Examining stress perceptions and coping strategies among Saudi nursing students: a systematic review. Nurse Educ Today. 2018;65:192–200.PubMedCrossRef

68.

Younas A. Levels of stress and coping strategies used by nursing students in Asian countries: an integrated literature review. J Middle East North Afr Sci. 2016;2(4):50–7. https://doi.org/10.12816/0032673.CrossRef

69.

Labrague LJ, McEnroe-Petitte DM, Al Amri M, Fronda DC, Obeidat AA. An integrative review on coping skills in nursing students: implications for policymaking. Int Nurs Rev. 2018;65(2):279–91. https://doi.org/10.1111/inr.12393.CrossRefPubMed

70.

Amr A, El-Gilany A-H, El-Moafee H, Salama L, Jimenez C. Stress among Mansoura (Egypt) baccalaureate nursing students. Pan Afr Med J. 2011;8:26.PubMedPubMedCentralCrossRef

71.

Madian A, Abdelaziz M, Ahmed H. Level of stress and coping strategies among nursing students at Damanhour University, Egypt. Am J Nurs Res. 2019;7(5):684–96. https://doi.org/10.12691/ajnr-7-5-3.CrossRef

72.

Abd El All NH, Abou Shousha AAEF. Stress factors and coping strategies as perceived by nursing students = عوامل الضغوط و إستراتیجیات المواجهة من وجهة نظر طلبة كلیة التمریض . Zagazig Nurs J. 2015;11(1):16–32.

73.

Elsayes H, Obied H. Association between senior nursing students’ perceived stress and learning environment in clinical practice. J Nurs Educ Pract. 2017;8(3):126. https://doi.org/10.5430/jnep.v8n3p126.CrossRef

74.

Khater W, Akhu-Zaheya L, Shaban I. Sources of stress and coping behaviours in clinical practice among baccalaureate nursing students. Int J Humanit Soc Sci. 2014;4:194–202.

75.

Alsaqri SH. Stressors and coping strategies of the Saudi nursing students in the clinical training: a cross-sectional study. Educ Res Int. 2017;2017:8.CrossRef

76.

Aziz F. Stressors and coping strategies among baccalaureate nursing students at Shifa College of Nursing Islamabad, Pakistan. Int J Nurs Educ. 2012;4:193.

77.

Eswi AS, Radi S, Youssri H. Stress/ stressors as perceived by baccalaureate Saudi nursing students. Middle-East J Sci Res. 2013;14:193–202.

78.

Al-Barrak MY, El-Nady MT, Fayad EA. Sources of stress as perceived by nursing students at King Saud University. Med J Cairo Univ. 2011;79:541–53.

79.

Watson R, Rehman S, Ali PA. Stressors affecting nursing students in Pakistan. Int Nurs Rev. 2017;64(4):536–43. https://doi.org/10.1111/inr.12392.CrossRefPubMed

80.

Kareem MS. Stress level among nursing students in hawler medical university at Erbil CIty-Iraq. Malays J Nurs. 2019;11(1):82–8. https://doi.org/10.31674/mjn.2019.v11i01.012.CrossRef

81.

Basal A. Foundations of stressors and coping behaviors in different clinical practice areas among undergraduate nursing students in faculty of nursing Tanta University; 2018.

82.

Mohamed BM, Ahmed ES. Perception of nursing students towards clinical stressors in the Faculty of Applied Medical Sciences – Al Jouf University – Saudi Arabia. J Am Sci. 2012;8:608–17.

83.

Aedh AI, Elfaki NK, Mohamed IA. Factors associated with stress among nursing students (Najran University-Saudi Arabia). IOSR J Nurs Health Sci. 2015;4(6):33–8.

84.

El Rafaey NM. Clinical setting related stressors perceived by medical surgical nursing students. J Nurs Health Sci. 2020;9(3):01–5.

85.

Shdaifat E. Stress and coping strategies among nursing students. Global J Health Sci. 2018;10(5):33. https://doi.org/10.5539/gjhs.v10n5p33.CrossRef

86.

Parveen A, Inayat S. Evaluation of factors of stress among nursing students. Adv Pract Nurs. 2017;02(2):136.

87.

Afzal M, Hussain M, Waqas A, Sehar N. Sources of stress among the nursing students of private universities of Pakistan. S Am J Nurs. 2016. https://doi.org/10.21522/TIJNR.2015.02.01.Art004.

88.

Bashir R. Sources of stress among nursing students of university of Lahore (LSN): Thesis. University of Lahore; 2014.

89.

Al Zu’bi MAKM, Shawabka GAF. Assessment of stress factors for nursing student toward training in the critical areas of Princess Basma Hospital. J Middle East North Afr Sci. 2018;4(4):8–12.CrossRef

90.

Fashafsheh I, Ayed A, Alkaissi A. Stressors affecting baccalaureate nursing students in the clinical area in Palestinian Universities. J Health Med Nurs. 2015;14:42–52.

91.

Al-Gamal E, Alhosain A, Alsunaye K. Stress and coping strategies among Saudi nursing students during clinical education. Perspect Psychiatr Care. 2018;54(2):198–205. https://doi.org/10.1111/ppc.12223.CrossRefPubMed

92.

Ahmed WAM, Mohammed BMA. Nursing students’ stress and coping strategies during clinical training in KSA. J Taibah Univ Med Sci. 2019;14(2):116–22. https://doi.org/10.1016/j.jtumed.2019.02.002.CrossRefPubMedPubMedCentral

93.

Mohammed Q, Sajit K. Stress and its associated factors among students of the College of Nursing University of Baghdad. Iraqi Natl J Nurs Spec. 2016;29:30–7.

94.

Ajweh AM, Shukri R, Kazem A, Saloom W. Stressors and coping strategies among nursing students at the College Nursing in Sultan Qaboos University. Int J Learn Man Sys. 2015;3:51–69.

95.

Hamaideh SH, Al-Omari H, Al-Modallal H. Nursing students’ perceived stress and coping behaviors in clinical training in Saudi Arabia. J Ment Health. 2017;26(3):197–203. https://doi.org/10.3109/09638237.2016.1139067.CrossRefPubMed

96.

Ismaile S, et al. Open J Nurs. 2017;07(04):10.

97.

Subhi Al-Zayyat A, Al-Gamal E. Perceived stress and coping strategies among Jordanian nursing students during clinical practice in psychiatric/mental health courses. Int J Ment Health Nurs. 2014;23(4):326–35. https://doi.org/10.1111/inm.12054.CrossRef

98.

Shaban IA, Khater WA, Akhu-Zaheya LM. Undergraduate nursing students’ stress sources and coping behaviours during their initial period of clinical training: a Jordanian perspective. Nurse Educ Pract. 2012;12(4):204–9. https://doi.org/10.1016/j.nepr.2012.01.005.CrossRefPubMed

99.

Maged R, El A, Hosny H, Ata A. Conflict management styles, assertiveness and stress among nursing students; 2019. p. 49–59.

100.

Alzayyat A, Al-Gamal E. Correlates of stress and coping among jordanian nursing students during clinical practice in psychiatric/mental health course. Stress Health. 2016;32(4):304–12. https://doi.org/10.1002/smi.2606.CrossRefPubMed

101.

John B, Al-Sawad M. Perceived stress in clinical areas and emotional intelligence among baccalaureate nursing students. J Indian Acad Appl Psychol. 2015;41(3):75–84.

102.

Naqvi A, Alrasheed F, Ahmad R, Ahmad N. Academic stress and prevalence of stress-related self-medication among undergraduate female students of health and non-health cluster colleges of a public sector University in Dammam, Saudi Arabia. J Pharm Bioallied Sci. 2018;9:251–8.

103.

Alghamdi S, Aljabri S, Jafari G, Alzebali R, Alkunaidiri N, Kalantan N. Sources of stress among undergraduate nursing students. Global J Health Sci. 2019;11(9):116. https://doi.org/10.5539/gjhs.v11n9p116.CrossRef

104.

Shalaby S, AlDilh SMS. Exploring the relationship between perceived stress and academic achievement among critical care nursing students. Athens J Health. 2015;2(4):283–96. https://doi.org/10.30958/ajh.2-4-4.CrossRef

105.

Shalaby S, Aljezani A. Exploring the relationship between perceived educational environment and academic achievement among critical care nursing students. Clin Nurs Stud. 2018;7(1):1. https://doi.org/10.5430/cns.v7n1p1.CrossRef

106.

Yehia DBM, Jacoub SM, Eser SM. Predictors of coping strategies among nursing college students at AL-Zaytoonah University of Jordan. J Educ Pract. 2016;7(15):149–54.

107.

Khalil Abdulqawi MS, Brair SL. Coping strategies regarding stress among bachelor nursing students in clinical practice, Khartoum State, 2018. Al Neelain Med J. 2018;(22). ISSN 1858-6155.

108.

Hassanein S, Elshair I, Abdrbo A, Hassan E. Coping strategies as predictors of coursework stress among university nursing students. J Nurs Educ Pract. 2016;7(2):99–106.

109.

Al Masaed AS. Relationships of positive and negative psychological stress coping strategies with locus of control and some variables among a sample of Al-al Bayt University students. 2013;7(3):19. مجلة الدراسات التربویة والنفسیة.

110.

Mahfouz R, Alsahli H. Perceived stress and coping strategies among newly nurse students in clinical practice. J Educ Pract. 2016;7(23):118–28.

111.

al Zamil L. Perceived level of stress, & coping strategies among Saudi nursing student. IOSR J Nurs Health Sci. 2017;06:06–13.CrossRef

112.

Ibrahim SR, Sayed FS. Stress level and coping behaviors of psychiatric nursing students pre and post clinical practice. J Nurs Health Sci. 2018;7(Issue 2 Ver. IV):54–64.

113.

COPE Inventory. Measurement instrument database for the social science. Carver, C.S; 2013. Retrieved from www.midss.ie.

114.

Carver CS. You want to measure coping but your protocol’s too long: consider the brief COPE. Int J Behav Med. 1997;4(1):92–100. https://doi.org/10.1207/s15327558ijbm0401_6.CrossRefPubMed

115.

Robotham D, Julian C. Stress and the higher education student: a critical review of the literature. J Furth High Educ. 2006;30(2):107–17. https://doi.org/10.1080/03098770600617513.CrossRef

116.

Folkman S, Lazarus RS. The relationship between coping and emotion: implications for theory and research. Soc Sci Med. 1988;26(3):309–17. https://doi.org/10.1016/0277-9536(88)90395-4.CrossRefPubMed

117.

Raymond J, Sheppard K. Effects of peer mentoring on nursing students’ perceived stress, sense of belonging, self-efficacy and loneliness. J Nurs Educ Pract. 2017;8(1):16. https://doi.org/10.5430/jnep.v8n1p16.CrossRef

118.

Klainin-Yobas P, Keawkerd O, Pumpuang W, Thunyadee C, Thanoi W, He H-G. The mediating effects of coping on the stress and health relationships among nursing students: a structural equation modelling approach. J Adv Nurs. 2014;70(6):1287–98. https://doi.org/10.1111/jan.12283.CrossRefPubMed

119.

Seyedfatemi N, Tafreshi M, Hagani H. Experienced stressors and coping strategies among Iranian nursing students. BMC Nurs. 2007;6(1):11. https://doi.org/10.1186/1472-6955-6-11.CrossRefPubMedPubMedCentral

120.

Zhao FF, Lei XL, He W, Gu YH, Li DW. The study of perceived stress, coping strategy and self-efficacy of C hinese undergraduate nursing students in clinical practice. Int J Nurs Pract. 2015;21(4):401–9. https://doi.org/10.1111/ijn.12273.CrossRefPubMed

121.

Del Prato D, Bankert E, Grust P, Joseph J. Transforming nursing education: a review of stressors and strategies that support students’ professional socialization. Adv Med Educ Pract. 2011;2:109–16. https://doi.org/10.2147/AMEP.S18359.CrossRefPubMedPubMedCentral

122.

Ghodasara SL, Davidson MA, Reich MS, Savoie CV, Rodgers SM. Assessing student mental health at the Vanderbilt University School of Medicine. Acad Med. 2011;86(1):116–21. https://doi.org/10.1097/ACM.0b013e3181ffb056.CrossRefPubMed

123.

Ibrahim AK, Kelly SJ, Adams CE, Glazebrook C. A systematic review of studies of depression prevalence in university students. J Psychiatr Res. 2013;47(3):391–400. https://doi.org/10.1016/j.jpsychires.2012.11.015.CrossRefPubMed

124.

Puthran R, Zhang MWB, Tam WW, Ho RC. Prevalence of depression amongst medical students: a meta-analysis. Med Educ. 2016;50(4):456–68. https://doi.org/10.1111/medu.12962.CrossRefPubMed

125.

Nelwati N, McKenna L, Plummer V. Indonesian student nurses’ perceptions of stress in clinical learning: a phenomenological study. J Nurs Educ Pract. 2013;ISSN 1925-4040:56–65.

126.

Zupiria Gorostidi X, Huitzi Egilegor X, Jose Alberdi Erice M, Jose Uranga Iturriotz M, Eizmendi Garate I, Barandiaran Lasa M, et al. Stress sources in nursing practice. Evolution during nursing training. Nurse Educ Today. 2007;27(7):777–87. https://doi.org/10.1016/j.nedt.2006.10.017.CrossRefPubMed

127.

Lo R. A longitudinal study of perceived level of stress, coping and self-esteem of undergraduate nursing students: an Australian case study. J Adv Nurs. 2002;39(2):119–26. https://doi.org/10.1046/j.1365-2648.2000.02251.x.CrossRefPubMed

128.

Maalouf FT, Alamiri B, Atweh S, Becker AE, Cheour M, Darwish H, et al. Mental health research in the Arab region: challenges and call for action. Lancet Psychiatry. 2019;6(11):961–6. https://doi.org/10.1016/S2215-0366(19)30124-5.CrossRefPubMed

129.

Pulido-Martos M, Augusto-Landa JM, Lopez-Zafra E. Sources of stress in nursing students: a systematic review of quantitative studies. Int Nurs Rev. 2012;59(1):15–25. https://doi.org/10.1111/j.1466-7657.2011.00939.x.CrossRef

130.

Chan CK, So WK, Fong DY. Hong Kong baccalaureate nursing students’ stress and their coping strategies in clinical practice. J Prof Nurs. 2009;25(5):307–13. https://doi.org/10.1016/j.profnurs.2009.01.018.CrossRefPubMed

131.

Yamashita K, Saito M, Takao T. Stress and coping styles in Japanese nursing students. Int J Nurs Pract. 2012;18(5):489–96. https://doi.org/10.1111/j.1440-172X.2012.02056.x.CrossRefPubMed

132.

Penn TD. Enhancing student comfort in psychiatric clinical settings. Teach Learn Nurs. 2008;3(2):53–5. https://doi.org/10.1016/j.teln.2007.10.001.CrossRef

133.

Zhao FF, Lei XL, He W, Gu YH, Li DW. The study of perceived stress, coping strategy and self-efficacy of Chinese undergraduate nursing students in clinical practice. Int J Nurs Pract. 2015;21(4):401–9. https://doi.org/10.1111/ijn.12273.CrossRefPubMed

134.

Yan ATC. Prediction of perceived stress of Hong Kong nursing students with coping behaviors over clinical practicum: a cross-sectional study. J Biosci Med. 2019;7(5):50–60. https://doi.org/10.4236/jbm.2019.75008.CrossRef

135.

Devkota R, Shrestha S. Stress among bachelor level nursing student. Nepal Med Coll J. 2018;20(1-3):33–40.

136.

Carter A, Elzubeir M, Abdulrazzaq Y, Revel A, Townsend A. Health and lifestyle needs assessment of medical students in the United Arab Emirates. Med Teach. 2003;25(5):492–6. https://doi.org/10.1080/01421590310001605633.CrossRefPubMed

137.

El-Gilany A-H, Amr M, Hammad S. Perceived stress among male medical students in Egypt and Saudi Arabia: effect of sociodemographic factors. Ann Saudi Med. 2008;28(6):442–8. https://doi.org/10.5144/0256-4947.2008.442.CrossRefPubMedPubMedCentral

138.

Saipanish R. Stress among medical students in a Thai medical school. Med Teach. 2003;25(5):502–6. https://doi.org/10.1080/0142159031000136716.CrossRefPubMed

139.

Perceived Stress Scale (PSS). From: Cohen S, Kamarck T, Mermelstein R. A global measure of oerceived stress. J Health Soc Behav. 1983;24(4):385–96.

140.

Jones MC, Johnston DW. The derivation of a brief Student Nurse Stress Index. Work Stress. 1999;13(2):162–81. https://doi.org/10.1080/026783799296129.CrossRef

141.

Lindop E. Individual stress among nurses in training: why some leave while others stay. Nurse Educ Today. 1991;11(2):110–20. https://doi.org/10.1016/0260-6917(91)90146-2.CrossRefPubMed

142.

Ab Latif R, Mat Nor MZ. Stressors and coping strategies during clinical practice among diploma nursing students. Malays J Med Sci. 2019;26(2):88–98. https://doi.org/10.21315/mjms2019.26.2.10.CrossRefPubMedPubMedCentral

143.

Turner K, McCarthy VL. Stress and anxiety among nursing students: a review of intervention strategies in literature between 2009 and 2015. Nurse Educ Pract. 2017;22:21–9. https://doi.org/10.1016/j.nepr.2016.11.002.CrossRefPubMed

144.

Algaralleh A, Altwalbeh D, Alzayyat A. Preliminary psychometric properties of the Arabic version of Sheu and colleagues Perceived Stress Scale among nursing students at Jordanian universities. J Multidiscip Healthc. 2019;12:777–87. https://doi.org/10.2147/JMDH.S214456.CrossRefPubMedPubMedCentral

145.

Watson R, Deary IJ, Thompson DR, Li G. The stress in nursing students scale (SINS): principal components analysis of longitudinal data from Hong Kong. J Clin Nurs. 2010;19(7-8):1170–2. https://doi.org/10.1111/j.1365-2702.2009.03159.x.CrossRefPubMed

146.

Folkman S. Stress: appraisal and coping. In: Gellman MD, Turner JR (eds). Encyclopedia of behavioral medicine. New York; Springer; 2013. https://doi.org/10.1007/978-1-4419-1005-9_215.

Title: Perceived stress, stressors, and coping strategies among nursing students in the Middle East and North Africa: an overview of systematic reviews
Authors: Sonia Chaabane
Karima Chaabna
Sapna Bhagat
Amit Abraham
Sathyanarayanan Doraiswamy
Ravinder Mamtani
Sohaila Cheema
Publication date: 01-12-2021
Publisher: BioMed Central
Keyword: Care
Published in: Systematic Reviews / Issue 1/2021
Electronic ISSN: 2046-4053
DOI: https://doi.org/10.1186/s13643-021-01691-9

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Springer Medicine

Perceived stress, stressors, and coping strategies among nursing students in the Middle East and North Africa: an overview of systematic reviews

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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