Stress is an inevitable issue for the people who make living in this rapidly changing modern era. Although the types and duration of stress and coping are different by one's developmental stage, everyone experiences certain level of stress in one's life (Gong, Jung, & Lee, 2008). College students are in the stage of emerging adulthood, shifting from adolescents to adult stage, where they explore their identity, transit to autonomic and independent life-style and experience various trial-and-errors, which are an unstable but critical period (Arnett, 2007). Therefore, they have developmental tasks of becoming mature adults through overcoming the required competition and pressure of the society and developing the social, cognitive, and psychological skills (Hogarth, 1991), and more students are experiencing difficulty navigating the stress of college life (Alipuria, 2007). Most of the Korean college students, preoccupied with college entrance competition and studying under the directive and protective environment in their Junior and high school, become abruptly exposed to autonomic and liberal environment simultaneously with college entrance (Han & Kim, 2007). They experience quite level of stress in the process of adapting to college life, preparing for the future career, and interpersonal relationships (Alipuria, 2007; Kim, 2003). Especially, college students experience the most stress in academic issues followed by interpersonal relationship, career, financial, and family issues (Moon & Park, 2007).

Excessive stress of college students imposes negative effects on physical and emotional dimension. Preexisting studies about college students' stress found out that the more stress they experienced the more physical complaints they had (Murphy, Denis, Ward, & Tartar, 2010), as well as reporting of negative subjective health status (Oh, 2009). In addition to physical symptoms, psychological symptoms (Choi, 2003; Jimenez, Navia-Osorio, & Diaz, 2010; Jin, Oh, & Kim, 2008), behavioral symptoms including alcohol consumption (Park, Armeli, & Tennen, 2004) and obsessive-compulsive behaviors (Lee, 2004) were also increased.

The individual difference of adaptation, such as whether he or she can adapt well or not, can be understood as the difference of one's coping strategy to impending stress (Gong & Lee, 2006). Lazarus and Folkman (1984) categorized stress coping type into problem-focused and emotion-focused coping. In problem-focused coping, a person tends to manage or change the issues that cause pain. In emotion-focused coping, a person tends to modify emotional response to the stressful issues. Korean studies of college students' coping strategies showed mixed results. Some of them reported that the college students more take problem-focused copings than emotion-focused (Gong & Lee, 2006; Moon & Park, 2007), while others reported the opposite (Min & Chang, 2006; Park, Bae, & Jung, 2002). So far, based on the thorough literature review, the researchers found out that most of the preexisting studies, focusing on the relationships among stress and individual traits or several stress-relating factors, have limitation to explore the influences of stress-relating factors on the stress symptoms and to provide comprehensive understanding of Korean college students' stress in terms of its level, symptoms and ways of coping. A large-scale repetitive investigation of Korean college students' stress was a necessity to get better understanding of the nature of it.

The purpose of this study was to identify perceived stress level, stress symptoms, and ways of coping and to examine the influences of perceived stress and ways of coping on stress symptoms in Korean college students. Specifically, there were three aims: (a) to identify the students' perceived stress level, stress symptoms, and ways of coping; (b) to examine the differences of the variables according to the students' general characteristics; (c) to determine the predictive relationships and the influences on the students' stress symptoms.

There was limitation to discuss this study with comparing it to the other studies, since there was no preexisting research which estimated college students' stress level with BESPI-K. According the Kim et al. (1998) s study, which adapted arithmetically Frank and Zyzanski (1988) s BEPSI score, BEPSI-K score can be categorized into 3 levels: high (over 2.8), moderate (1.8 to 2.6), and low (below 1.6). Based on these BEPSI-K 3 level standards for Korean adults, the students' perceived stress level (M=2.3) falls on the moderate level. It was found that 57.7% of the students were in the moderate stress group and 19% of them were in the high stress group. Comparing these results to Kim et al. (1998)'s study, which reported that the perceived stress level of the adults in their twenties was 1.7 and the rate of high stress level was 6.5%, the students' perceived stress level was quite high and the rate of high stress level seems fairly high. These results show the increase of the college students' stress level for last 10 years and support other research (Gong & Lee, 2006; Kim, 2003; Moon & Park, 2007; Murphy, Denis, Ward, & Tartar, 2010) which reported that college students difficulties in adaptation and interpersonal relationship as well as burden of job seeking and future career due to economic downturn made them experiencing tremendous stress.

The students' total stress symptoms score (M=2.1) in this study was slightly higher than that (M=2.1) of Han et al. (2007) s study which used the same instrument. Besides, the female students' total stress symptoms score was significantly higher than that of the male students, which articulated there was gender difference in stress symptoms. Major stress symptoms were different by gender. In female, depression symptom score was the highest while, in male, the cognitive disorganization. Although the major stress symptoms were different by gender, both male and female college students reported higher stress symptoms in psychological dimension such as depression, cognitive disorganization, and emotional irritability than physical dimension. These results are different from Han et al. (2007)'s results which reported peripheral manifestations, habitual patterns, and cognitive disorganization as college students' common stress symptoms, as well as Han and Kim (2007)'s results identifying emotional irritability, gastrointestinal symptom, and muscle tension as female college students' common stress symptom. In that this study selected research participants from throughout the country, it identified Korean college students' stress symptom in more comprehensive way than other preceding studies which investigated college students in specific regions or department. The results that the female and the students who reported their perceived health status were bad showed significantly high score in both perceived stress and total stress symptom gave us suggestions about differences based on gender and health perception on stress. In addition, the results that the students who exercised more than 3 times a week showed significantly low in total stress symptom and who exercise more frequently showed low in perceived stress level gave us advice to reducing effect of exercise on stress.

Unlikely the perceived stress level and total stress symptoms, the coping types of the students did not show significant difference by their gender. Only having religion, higher economic status and exercise frequency were identified as helpful characteristics to cope with stress in more problem-focused way. There were no significant differences except drinking alcohol frequency in emotion-focused coping. These results are partially consistent with Kim (2003)'s results which reported problem-focused coping was significantly different by religion and exercise frequency. In the study of Folkman & Lazarus (1980), middle aged men use more problem- focused coping than women at work context, but there were no gender differences in emotion-focused coping. Even though there were limits to determine the stress context and appraisal, it was considered that these results partially reflect the cognitive phenomenological perspective on coping in that the more potent factors are context and how the event is appraised than personal characteristics.

In correlation analysis of the relationship among the predicting factors of the students' total stress symptoms positive correlation was identified between perceived stress level and total stress symptoms, and between perceived stress level and each stress coping type. In addition, perceived stress level and total stress symptoms showed higher correlation with emotion-focused coping than with problem-focused coping. These results were consistent with preceding research which found that college students' perceived stress has positive correlation with depression, anxiety, physical symptoms, and emotion-focused coping (Oh, 2009; Wang & Yeh, 2005) and share opinion with Lazarus and Folkman (1984) in that each stress coping has different focus but is mutually facilitating problem-solving process, the emotion-focused coping may be effective to overcome stress temporarily, however, the fundamental causes of the issue remain steadily without managed, which can aggravate the mal-adaptation.

Perceived stress, emotional relieving and wishful thinking, and perceived health status were identified as influencing factors of college students' total stress symptom. In other words, we can assume that, if a person has high perceived stress level, cope to stress with emotion-focused, and perceive one's health negatively, he or she possibly complain more stress symptom. These results gave same voice with other research such as Lee (2004) s study and Ni et al. (2010)'s study on the college students' life stress, which reported emotion-focused coping can increase psychiatric symptom, and Gong and Lee (2006)'s study which found that female college students using emotion-focused coping had increased depression.

Limitations of the study are that the study subjects were collected by quota sampling, which means there are limits to the representative and generalization of the findings to all Korean college students. Some demographic and certain health related data were used to identify the influencing factors to the stress symptoms, which means there are limits to the explanation of the regression results. And non-standardized measurements were used, which means there are limits to the stability of research tools.

Recognition and comprehensive assessment of the perceived stress level, stress symptoms, and ways of coping are required to develop and to apply the stress management. The findings of this study indicated that higher perceived stress level, emotion-focused coping, and negative perceived health status were all associated with higher stress symptoms score. Current findings suggest that nurses should be aware of the common stress symptoms of college students, the differences based on gender, and health perception, and the tendency of emotion-focused coping. Nurses need to have the knowledge assessing the physical and psychological stress symptoms of college students. In particular, nurses could apply the psychological intervention to reduce their major stress symptom: depression, cognitive disorganization, and emotional irritability as counselors. And as educators, nurses could motivate and improve stress management including exercise program and problem-focused coping skill to help college students improve their psychological well-being.

By doing this, the study facilitated the understanding of college students' stress and provided basic data to develop stress management program. More systematic approach and effective stress management program and nursing interventions should be developed for college students' wellbeing. In addition, repetitive and further research should take into consideration the stress context, appraisals to being experienced and the mediating effect of coping.