Factors Affecting Clinical Practicum Stress of Nursing Students: Using the Lazarus and Folkman's Stress-Coping Model

Sung Hae Kim; JuHee Lee; MiRa Jang

doi:10.4040/jkan.2019.49.4.437

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Kim, Lee, and Jang: Factors Affecting Clinical Practicum Stress of Nursing Students: Using the Lazarus and Folkman's Stress-Coping Model

Original Article

Journal of Korean Academy of Nursing 2019; 49(4): 437-448.

Published online: 29 August 2019

DOI: https://doi.org/10.4040/jkan.2019.49.4.437

Factors Affecting Clinical Practicum Stress of Nursing Students: Using the Lazarus and Folkman's Stress-Coping Model

Sung Hae Kim¹

, JuHee Lee²

, MiRa Jang¹

¹College of Nursing, Yonsei University, Seoul, Korea.

²College of Nursing · Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Korea.

Address reprint requests to: Jang, MiRa. College of Nursing, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea. Tel: +82-2-2228-3318, Fax: +82-2-392-5027, silvaplana@naver.com

Received 7 February 2019 Revised 13 May 2019 Accepted 22 May 2019

Korean Society of Nursing Science

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0/) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

Abstract

Purpose

This study was conducted to test a path model for the factors related to undergraduate nursing students' clinical practicum stress, based on Lazarus and Folkman's stress-coping model.

Methods

This study utilized a path analysis design. A total of 235 undergraduate nursing students participated in this study. The variables in the hypothetical path model consisted of clinical practicum, emotional intelligence, self-efficacy, Nun-chi, and nursing professionalism. We tested the fit of the hypothetical path model using SPSS/WIN 23.0 and AMOS 22.0.

Results

The final model fit demonstrated a satisfactory statistical acceptance level: goodness-of-fit-index=.98, adjusted goodness-of-fit-index=.91, comparative fit index=.98, normed fit index=.95, Tucker-Lewis index=.92, and root mean square error of approximation=.06. Self-efficacy (β=−.22, p=.003) and Nun-chi behavior (β=−.17, p=.024) were reported as significant factors affecting clinical practicum stress, explaining 10.2% of the variance. Nursing professionalism (β=.20, p=.006) and self-efficacy (β=.45, p<.001) had direct effects on emotional intelligence, explaining 45.9% of the variance. Self-efficacy had indirect effects on Nun-chi understanding (β=.20, p<.001) and Nun-chi behavior (β=.09, p=.005) through emotional intelligence. Nursing professionalism had indirect effects on Nun-chi understanding (β=.09, p=.005) and Nun-chi behavior (β=.09, p=.005) through emotional intelligence. The variables for self-efficacy and nursing professionalism explained 29.1% of the Nun-chi understanding and 18.2% of the Nun-chi behavior, respectively.

Conclusion

In undergraduate nursing education, it is important to identify and manage factors that affect clinical practicum stress. The findings of this study emphasize the importance of Nun-chi, self-efficacy, emotional intelligence, and nursing professionalism in the development of an educational strategy for undergraduate nursing students.

Keywords: Clinical Practicum, Psychological Stress, Nursing Students

Figures and Tables

Figure 1

Conceptual framework for this study.

Figure 2

Path diagram for the final model.

Table 1

Characteristics of Nursing Students and Clinical Practicum Stress (N=213)

M=Mean; SD=Standard deviation.

^†Multiple response; ^††Post-hoc analysis=Scheffe test.

Table 2

Descriptive Statistic of Variables (N=213)

M=Mean; SD=Standard deviation.

^†Converting each scales into scores ranging from 1 to 4 points or 0 to 4 points or 1 to 5 points.

Table 3

Standardized Estimates Effect of the Final Model (N=213)

CR=Critical ratio; SE=Standard error; SMC=Squared multiple correlations.

Notes

^{CONFLICTS OF INTEREST} The authors declared no conflict of interest.

References

1. Korean Nurses Association. National hospital and nursing education list [Internet]. Seoul: Korean Nurses Association;c2019. cited 2019 Jan 28. Available from: http://www.koreanurse.or.kr/resources/nurse_edu.php.

2. Korean Accreditation Board of Nursing Education (KABONE). KABONE: Accreditation manual with interpretive guidelines for four-year nursing programs [Internet]. Seoul: KABONE;c2017. cited 2019 Jan 28. Available from: http://www.kabone.or.kr/kabon02/index04.php.

3. Whang SJ. The relationship between clinical stress, self-efficacy, and self-esteem of nursing college students. The Journal of Korean Academic Society of Nursing Education. 2006; 12(2):205–213.

4. Lazarus RS, Folkman S. Stress, appraisal, and coping. New York: Springer;1984. p. 1–456.

5. Park HJ, Jang IS. Nursing students' experience in community health center practice. Journal of Korean Academy of Community Health Nursing. 2010; 21(2):188–199. DOI: 10.12799/jkachn.2010.21.2.188.

6. Hyoung HK, Ju YS, Im SI. A concept mapping study on clinical stress for nursing students during clinical practice. Journal of Korean Academy of Nursing Administration. 2014; 20(4):394–404. DOI: 10.11111/jkana.2014.20.4.394.

7. Yoo JS, Chang SJ, Choi EK, Park JW. Development of a stress scale for Korean nursing students. Journal of Korean Academy of Nursing. 2008; 38(3):410–419. DOI: 10.4040/jkan.2008.38.3.410.

8. Yang NY, Moon SY. Relationship of self-leadership, stress and satisfaction in clinical practice of nursing students. Journal of Korean Academy of Nursing Administration. 2011; 17(2):216–225. DOI: 10.11111/jkana.2011.17.2.216.

9. Lee OS, Gu MO. The relationship between emotional intelligence and communication skill, clinical competence & clinical practice stress in nursing students. Journal of the Korea Academia-Industrial cooperation Society. 2013; 14(6):2749–2759. DOI: 10.5762/KAIS.2013.14.6.2749.

10. Jeong GS. Relationship between nursing students' emotional intelligence, self-efficacy, ego-resiliency and the stress on clinical practices. Korean Journal of Care Management. 2013; (10):165–183.

11. Yang SY. The effect of emotional intelligence and self-efficacy on clinical competence of the nursing students. The Journal of the Korea Contents Association. 2015; 15(6):370–378. DOI: 10.5392/JKCA.2015.15.06.370.

12. Bandura A. Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review. 1977; 84(2):191–215. DOI: 10.1037/0033-295X.84.2.191.

13. Kim CM, Kim EM. An evaluation of the fundamental nursing practice in clinical settings by triangulation method. The Journal of Korean Academic Society of Nursing Education. 2011; 17(2):235–245. DOI: 10.5977/JKASNE.2011.17.2.235.

14. 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 Education Today. 2018; 61:197–209. DOI: 10.1016/j.nedt.2017.11.029.

15. Kang HS, Kim YY, Lee HS. Predictive factors influencing clinical competence in nursing students. Journal of the Korea Academia-Industrial cooperation Society. 2018; 19(3):389–398. DOI: 10.5762/KAIS.2018.19.3.389.

16. Lee JE, KIM SL. Relationship among stress, coping strategies, and self-esteem in nursing students taking clinical experience. The Journal of Korean Academic Society of Nursing Education. 2005; 11(1):98–106.

17. Heo JH, Park WJ, Kim SJ. Conceptualization of nunchi. Studies in Humanities. 2012; 33:557–581.

18. Lee JK. The relationships among clinical competence, clinical practice stress, communication skill & nunchi in nursing students [master's thesis]. Jinju: Gyeongsang National University;2015. 1–53.

19. Yeun EJ, Kwon YM, Ahn OH. Development of a nursing professional values scale. Journal of Korean Academy of Nursing. 2005; 35(6):1091–1100. DOI: 10.4040/jkan.2005.35.6.1091.

20. Hallin K, Danielson E. Registered nurses' perceptions of their work and professional development. Journal of Advanced Nursing. 2008; 61(1):62–70. DOI: 10.1111/j.1365-2648.2007.04466.x.

21. Park HJ, Oh JW. The relationships of the clinical practice stress and the major satisfaction with the nursing professionalism of nursing college students. Journal of Digital Convergence. 2014; 12(12):417–426. DOI: 10.14400/JDC.2014.12.12.417.

22. Khine MS. Application of structural equation modeling in educational research and practice. Rotterdam: Sense Publishers;2013. p. 3–21.

23. Wong CS, Law KS. The effects of leader and follower emotional intelligence on performance and attitude: An exploratory study. The Leadership Quarterly. 2002; 13(3):243–274. DOI: 10.1016/S1048-9843(02)00099-1.

24. Yoo TY, Roh HM, Kim EJ. The moderating effects of emotional intelligence on the relationship between personality traits and job attitudes and performance. Korean Psychological Association. 2004 Korean Psychological Association Annual Conference Program & Abstract. In : Proceedings of the 2004 Korean Psychological Association Annual Conference; 2004 Aug 19-21; Korean Psychological Association, Busan, Korea. Seoul: Korean Psychological Association;2004. p. 223–224.

25. Schwarzer R, Born A, Iwawaki S, Lee YM. The assessment of optimistic self-beliefs: Comparison of the Chinese, Indonesian, Japanese, and Korean versions of the General Self-Efficacy scale. Psychologia: An International Journal of Psychology in the Orient. 1997; 40(1):1–13.

26. Heo JH, Park WJ. Development and validation of nunchi scale. Korean Journal of Counseling. 2013; 14(6):3537–3555. DOI: 10.15703/kjc.14.6.201312.3537.

27. Han SS, Kim MH, Yun EK. Factors affecting nursing professionalism. The Journal of Korean Academic Society of Nursing Education. 2008; 14(1):73–79. DOI: 10.5977/JKASNE.2008.14.1.073.

28. Yang BH. Understanding multivariate data analysis. Seoul: Communication Books;2006. p. 1–580.

29. Shin GG. Structural equation modeling (SEM) with Amos 23. Seoul: Chungram Publisher;2013. p. 78–95.

30. Kim AL. The effect of compassion fatigue, ego resilience, clinical practice self efficacy on stress on clinical practice of the nursing students. The Journal of Learner-Centered Curriculum and Instruction. 2017; 17(21):645–663. DOI: 10.22251/jlcci.2017.17.21.645.

31. Yang SY. The study on relationship between characteristics of cultural exchanges, self-efficacy, and cultural competency of nursing students. The Journal of the Korea Contents Association. 2014; 14(7):334–345. DOI: 10.5392/JKCA.2014.14.07.334.

32. Song J, Kim M. Study on clinical education for nursing in hospitals in Korea. The Journal of Korean Academic Society of Nursing Education. 2013; 19(2):251–264. DOI: 10.5977/jkasne.2013.19.2.251.

33. Cho GP, Kwon TW, Kim KW. Development and validation of the sense of wit scale for high school students. Journal of Education and Culture. 2016; 22(1):127–144.

34. Heo JH. The relation between nunchi and the quality of life: In the moderation of affect regulation. Discourse and Policy in Social Science. 2016; 9(1):53–65.

35. Kim HJ, Kim JH. Concept analysis of tacit nursing knowledge. Journal of Korean Academy of Nursing. 2018; 48(6):637–655. DOI: 10.4040/jkan.2018.48.6.637.

36. Kim SG, Seo YS. Affecting factors of clinical competence in the nursing students using a mediation model. Journal of the Korea Academia-Industrial cooperation Society. 2016; 17(3):283–291. DOI: 10.5762/KAIS.2016.17.3.283.

37. Sharon D, Grinberg K. Does the level of emotional intelligence affect the degree of success in nursing studies? Nurse Education Today. 2018; 64:21–26. DOI: 10.1016/j.nedt.2018.01.030.

38. Oh EJ, Kong JH. The relationship among emotional intelligence, career attitude maturity, and nursing students. The Journal of Humanities and Social Sciences. 2017; 8(3):245–259. DOI: 10.22143/HSS21.8.3.14.

39. Jang I. The effects of emotional regulation between clinical practice stress and nursing professionalism in nursing students. Journal of the Korean Data and Information Science Society. 2016; 27(3):749–761. DOI: 10.7465/jkdi.2016.27.3.749.

40. Ham YS, Kim HS, Cho IS, Lim JY. Affecting factors of nursing professionalism perceived by senior nursing students. The Journal of Korean Academic Society of Nursing Education. 2011; 17(3):536–544. DOI: 10.5977/JKASNE.2011.17.3.536.

41. Johnston C, Mash EJ. A measure of parenting satisfaction and efficacy. Journal of Clinical Child Psychology. 1989; 18(2):167–175. DOI: 10.1207/s15374424jccp1802_8.

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ORCID iDs

Sung Hae Kim
https://orcid.org/0000-0001-8252-1317

JuHee Lee
https://orcid.org/0000-0002-2805-1622

MiRa Jang
https://orcid.org/0000-0003-1263-3190

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