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Exploring strategies to reduce student stress in clinical nursing teaching: a mixed methods study

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Summary:Introduction: Clinical education (CE) is a demanding period in nursing training, exposing students to academic, emotional, and relational stressors that may compromise learning, well-being, and professional development. Identifying personal resources and coping strategies associated with better adjustment is crucial for designing effective educational interventions. Objective: To outline strategies that improve nursing students’ stress management during CE and promote their personal and professional development. Methods: Pilot action-research study with a mixed-methods design, grounded in Betty Neuman’s Systems Model, involving students from a Portuguese nursing school. Five stages were conducted: stress management workshop (n=11); coping assessment (n=245); self-concept and social skills (n=256); lifestyles, self-esteem, and well-being (n=424); and a focus group (n=10) to generate recommendations. Results: The workshop identified stress triggers and learning inhibitors, including low self-concept, social skills deficits, and inadequate coping. Questionnaire data showed lower stress levels associated with social support coping, planned problem solving, and positive reappraisal. Lower stress and higher satisfaction were related to higher self-esteem, well-being, and healthier lifestyles. The focus group further explored stressors and learning inhibitors and proposed interventions to foster personal and professional development. Conclusion: Engaging students in CE enabled a better understanding of stressors, coping, and personal resources, highlighting the contribution of relational and communication competencies to stress management. Proposed strategies include promoting healthy lifestyles, time management, self-esteem enhancement, and improved supervision, using a playful pedagogical approach.
Main Authors:Cruz, Márcia
Other Authors:Brito, Irma; Carvalho, António Luís
Subject:Life and Healthcare Sciences
Year:2026
Country:Portugal
Document type:article
Access type:open access
Associated institution:Instituto Politécnico de Viseu
Language:English
Origin:Millenium
Description
Summary:Introduction: Clinical education (CE) is a demanding period in nursing training, exposing students to academic, emotional, and relational stressors that may compromise learning, well-being, and professional development. Identifying personal resources and coping strategies associated with better adjustment is crucial for designing effective educational interventions. Objective: To outline strategies that improve nursing students’ stress management during CE and promote their personal and professional development. Methods: Pilot action-research study with a mixed-methods design, grounded in Betty Neuman’s Systems Model, involving students from a Portuguese nursing school. Five stages were conducted: stress management workshop (n=11); coping assessment (n=245); self-concept and social skills (n=256); lifestyles, self-esteem, and well-being (n=424); and a focus group (n=10) to generate recommendations. Results: The workshop identified stress triggers and learning inhibitors, including low self-concept, social skills deficits, and inadequate coping. Questionnaire data showed lower stress levels associated with social support coping, planned problem solving, and positive reappraisal. Lower stress and higher satisfaction were related to higher self-esteem, well-being, and healthier lifestyles. The focus group further explored stressors and learning inhibitors and proposed interventions to foster personal and professional development. Conclusion: Engaging students in CE enabled a better understanding of stressors, coping, and personal resources, highlighting the contribution of relational and communication competencies to stress management. Proposed strategies include promoting healthy lifestyles, time management, self-esteem enhancement, and improved supervision, using a playful pedagogical approach.