Leodoro J. Labrague

A literature review on stress and coping strategies in nursing students

Abstract Background: While stress is gaining attention as an important subject of research in nursing literature, coping strategies, as an important construct, has never been comprehensively reviewed. Aim: The aims of this review were: (1) to identify the level of stress, its sources, and (2) to explore coping methods used by student nurses during nursing education. Methods: This is a systematic review of studies conducted from 2000 to 2015 on stress and coping strategies in nursing students. CINAHL, MEDLINE, PsycINFO and PubMed were the primary databases for the search of literature. Keywords including “stress”, “coping strategy”, “nursing students” and “clinical practice” in 13 studies met the criteria. Findings: Stress levels in nursing students range from moderate to high. Main stressors identified included stress through the caring of patients, assignments and workloads, and negative interactions with staff and faculty. Common coping strategies utilized by nursing students included problem-solving strategies such as developing objectives to resolve problems, adopting various strategies to solve problems, and finding the meaning of stressful events. Conclusion: Nurse educators may consider the use of formulation and implementation of empirically tested interventions to reduce stress while enhancing coping skills.

Influence of Music on Preoperative Anxiety and Physiologic Parameters in Women Undergoing Gynecologic Surgery

The aim of this study was to determine the influence of music on anxiety levels and physiologic parameters in women undergoing gynecologic surgery. This study employed a pre- and posttest experimental design with nonrandom assignment. Ninety-seven women undergoing gynecologic surgery were included in the study, where 49 were allocated to the control group (nonmusic group) and 48 were assigned to the experimental group (music group). Preoperative anxiety was measured using the State Trait Anxiety Inventory (STAI) while noninvasive instruments were used in measuring the patients’ physiologic parameters (blood pressure [BP], pulse [P], and respiration [R]) at two time periods. Women allocated in the experimental group had lower STAI scores (t = 17.41, p < .05), systolic (t = 6.45, p < .05) and diastolic (t = 2.80, p < .006) BP, and P rate (PR; t = 7.32, p < .05) than in the control group. This study provides empirical evidence to support the use of music during the preoperative period in reducing anxiety and unpleasant symptoms in women undergoing gynecologic surgery.

Filipino Nurses’ Spirituality and Provision of Spiritual Nursing Care:

This study was to explore the perceptions of Filipino nurses’ spirituality and the provision of spiritual nursing care. A descriptive, cross-sectional, and quantitative study was adopted for this study. The study was conducted in the Philippines utilizing a convenience sample of 245 nurses. Nurses’ Spirituality and Delivery of Spiritual Care (NSDSC) was used as the main instrument. The items on NSDSC with higher mean scores related to nurses’ perception of spirituality were Item 7, “I believe that God loves me and cares for me,” and Item 8, “Prayer is an important part of my life,” with mean scores of 4.87 (SD = 1.36) and 4.88 (SD = 1.34), respectively. Items on NSDSC with higher mean scores related to the practice of spiritual care were Item 26, “I usually comfort clients spiritually (e.g., reading books, prayers, music, etc.),” and Item 25, “I refer the client to his/her spiritual counselor (e.g., hospital chaplain) if needed,” with mean scores of 3.16 (SD = 1.54) and 2.92 (SD = 1.59). Nurse’s spirituality correlated significantly with their understanding of spiritual nursing care (r = .3376, p ≤ .05) and delivery of spiritual nursing care (r = .3980, p ≤ .05). Positive significant correlations were found between understanding of spiritual nursing care and delivery of spiritual nursing care (r = .3289, p ≤ .05). For nurses to better provide spiritual nursing care, they must care for themselves through self-awareness, self-reflection, and developing a sense of satisfaction and contentment.

Operating Room Nurses Knowledge and Practice of Sterile Technique

Introduction: Nurses play an important role in the prevention and control of surgical site infections or SSI’s because they undertake a high proportion of the treatment and care of surgical patients. Sterile technique plays a vital role in the control and prevention of SSI’s and surgical site contamination. Aim: This investigation aimed to determine the knowledge and extent of practice of sterile technique among operating room nurses in four selected hospitals in Samar, Philippines. Methodology: The investigators utilized the descriptive-correlational method of research. Total enumeration was utilized to recruit respondents from four identified hospitals in Samar, Philippines, namely; Calbayog Sanitarium and Hospital, Our lady of Porziuncola Hospital Inc., St. Camillus Hospital, and Samar Provincial Hospital. Knowledge and extent of practice of sterile technique were measured through an investigators formulated questionnaire and evaluation checklist based on the concepts of sterile technique. Results: Nurses have “Excellent Knowledge” on the concepts/principles of sterile technique and applied it to a “Very Great Extent”. No correlations were found between nurses’ knowledge and extent of practice on sterile technique and their demographic variables such age, gender, length of clinical experience, and number of relevant trainings attended. However, significant relationship was found between knowledge and extent of practice of sterile technique. Conclusion: Findings suggest positive association between knowledge on sterile technique and its application. Thus nurses’ must continue to upgrade its knowledge to keep them abreast with the new trends and innovations on peri-operative nursing.

Disaster Preparedness in Philippine Nurses

PURPOSE This study examined the perceived level of disaster preparedness in Philippine nurses. DESIGN A descriptive, cross-sectional research design was used in this study. METHODS Two hundred nurses were invited to participate in the study, with 170 responses (105 hospital nurses and 65 community nurses) or an 85% response rate, during the months of April 2014 through July 2014. Data collection was based on interviews using a standardized instrument, the Disaster Preparedness Questionnaire. Descriptive statistics such as frequencies, means, percentages, and standard deviations were utilized to quantify the responses. RESULTS Three fourths of the respondents (n = 136, 80%) indicated that they were not fully prepared to respond to disasters, while only 20% (n = 34) acknowledged that they felt they were adequately prepared. Respondents believed that they could function in the primary roles of educator (n = 107, 62.94%), caregiver (n = 104, 61.17%), and counselor (n = 82, 48.24%). More than half of the respondents (n = 98, 57.7%) were not aware of existing protocols of disaster management in the workplace. Courses taken in such areas as first aid (n = 79, 46.4%), field triage (n = 43, 25.29%), and basic cardiac life support (n = 57, 33.53%) were cited as important in preparing for disasters. CONCLUSIONS Nurses in the study revealed that they were not sufficiently prepared for disasters nor were they aware of disaster management protocols in the workplace. CLINICAL RELEVANCE Hospital administrators should consider the development and formulation of disaster management protocols and provide appropriate disaster nursing education and training. Nursing curricula should incorporate basic principles of disaster management into nursing courses as a framework for addressing this critical deficit.

Use of Music Intervention for Reducing Anxiety and Promoting Satisfaction in First-Time Filipino Fathers

Childbirth is an anxiety-provoking event in a man’s life. Therefore, strategies to decrease paternal anxiety during childbirth are necessary. This study determined the effects of music and satisfaction of first-time Filipino fathers during childbirth. In the study, a prospective quasi-experimental design was utilized. Ninety-eight purposive samples of first-time fathers were included in the study, 50 were allocated in the experimental group (music group) and 48 in the control group (nonmusic group) during the months of August to October 2013. Paternal anxiety and satisfaction were measured using the State Trait Anxiety Inventory and the Visual Analogue Scale for Satisfaction, respectively. Results revealed that the first-time fathers in the experimental group had lower State Trait Anxiety Inventory scores (p < .05) and higher Visual Analogue Scale for Satisfaction scores (p < .05) than those in the control group. Findings of the study provide substantial evidence to support the use of music in reducing anxiety and promoting satisfaction among first-time fathers during childbirth.

Stress and coping strategies among nursing students: an international study

Abstract Background: Mounting literature on stress and coping in nursing students are available; however, most of the findings are confined to a single cultural group. Aims: This 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. Methods: Using a descriptive, comparative research design, 547 nursing students (161 Greek nursing students, 153 Filipino nursing students, 233 Nigerian nursing students) participated in the study from August 2015 to April 2016. Two standardized instruments were used, the Perceived Stress Scale (PSS) and the Coping Behavior Inventory (CBI). Results: Findings revealed that the degree of stress and the type of stressors and coping styles utilized by nursing students differ according to the country of origin. The year of study predicted overall stress (β = –0.149, p < 0.001) while advanced age predicted overall coping (β = 0.008, p = 0.037) in the nursing students. Conclusions: Strengthening nursing students’ positive coping skills may be helpful for them to effectively deal with various stressors during their educational experiences while maximizing learning. Implementing empirically tested approaches maybe useful to prevent the recurrence of stress and lessen its impact such as stress management counseling, counseling programs, establishing peer and family support systems, and formulating hospital policies that will support nursing students.