The effect of a stress management program on first-year nursing students' clinical stress: A randomized controlled experimental study

Background: Clinical clerkships lie at the core of nursing education and are crucial for developing professional skills. However, nursing students, especially freshmen, often encounter significant stress during their clinical experiences. Objectives: This study investigated the effect of a stress management program on first-year nursing students' clinical stress levels. Design: This randomized controlled experimental study adopted a pretest-posttest-follow-up test research design. Settings and participants: Participants were recruited using simple randomization. The sample consisted of 64 firstyear nursing students (intervention = 32; control = 32) from the nursing department of the faculty of health sciences of a university in Turkiye. Methods: Participants were randomized into intervention and control groups. The intervention group attended a stress management program, one weekly session for five weeks (intervention). The research was conducted between 21.02.2022 and 20.05.2022. Data were collected using a personal information form, the Perceived Stress Scale, the Physio-Psycho-Social Response Scale, and the Coping Behavior Inventory. The data were collected pretest and posttest the intervention and two months follow-up test. The data were analyzed using the two-way repeated measures analysis of variance (ANOVA). Results: The changes in the Perceived Stress Scale mean scores, group*time interaction, were statistically significant (p < 0.05). The results showed that the changes in the Coping Behavior Inventory "problem-solving" subscale mean scores, group*time interaction, were statistically significant (p < 0.05). The multiple comparisons showed a statistically significant difference in posttest Physio-Psycho-Social Response Scale "social behavioral symptoms" and "emotional symptoms" subscale scores between the intervention and control groups (p < 0.05). The multiple comparisons showed a statistically significant difference in posttest Coping Behavior Inventory "problem-solving" and "avoidance" subscale scores between the intervention and control groups (p < 0.05). Conclusion: The stress management program helps first-year nursing students experience less stress and develop problem-solving skills before they perform clinical clerkships. It also allows them to suffer from fewer emotional and social behavioral symptoms and exhibit fewer avoidance behaviors.