BACKGROUND: Coronavirus disease (COVID‑19) causes significant psychological distress among nursing students. College‑bound nursing students might have preferred different types of coping strategies to deal with psychological distress. This study aims to measure the psychological distress and role of coping styles to mediate the stress level among the baccalaureate nursing students amid the COVID‑19 pandemic. MATERIAL AND METHODS: A cross‑sectional online survey was conducted in December 2020 at a nursing college attached to a tertiary care teaching hospital, North India. Nearly 251 baccalaureate nursing students completed the Impact of Event Scale‑Revised (IES‑R) and Coping Orientation to Problems Experienced Inventory (Brief‑COPE) scale to report their psychological distress and coping styles, respectively. Chi‑square test, independent sample t‑test followed by binary and multivariable regression were used to identify the factors associated with distress in students during the pandemic. RESULTS: Students’ mean age was 22.22 ± 1.24 years. The mean IES‑R was 19.59 ± 12.45 in nursing students. Psychological distress found a significant association with age (P = 0.022), academic class (P = 0.016), travel history (P = 0.034), and being positive reverse transcription–polymerase chain reaction (RT‑PCR) for COVID‑19 status of self (P = 0.018) and family members in the medical profession (P = 0.013). In binary logistic regression, stress level found a significant association with first‑year academic level (OR: 3.250, 95% CI: 1.429–7.390, P = 0.005) and family members in the medical profession (OR: 4.44, 95% CI: 1.019–19.382, P = 0.047). Adaptive coping styles were more frequently preferred than maladaptive coping styles (54% vs 41%). Adaptive (r = 0.295, P < 0.001) and maladaptive coping (r = 0.403, P < 0.001) shows a significant positive relationship with stress in students, respectively. CONCLUSIONS: Coronavirus pandemic causes significant distress among nursing students. Students were able to manage stress using acceptance and religious/spiritual coping strategies. During the pandemic, stress management to support mental health is highly recommended.
World Health Organization (WHO). Getting your workplace ready for COVID-19. 2020. Available from: https://apps.who. int/iris/handle/10665/331584. [Last accessed on 2021 Jan 25]. 2. Gorbalenya AE, Baker SC, Baric RS, de Groot RJ, Drosten C, Gulyaeva AA, et al. Severe acute respiratory syndrome‑related coronavirus: The species and its viruses – A statement of the Coronavirus Study Group. bioRxiv 2020;1–15. Available from: https://www.biorxiv.org/content/100.1101/2020.02.07.93786 2v1.full.pdf. [Last accessed on 2021 Jan 25]. 3. Kumar R, Singh V, Mohanty A, Bahurupi Y, Gupta P. Corona health‑care warriors in India: Knowledge, attitude, and practices during COVID‑19 outbreak. J Educ Health Promot 2021;10:44. 4. Chan JWM, Ng CK, Chan YH, Mok TYW, Lee S, Chu SYY, et al. Short term outcome and risk factors for adverse clinical outcomes in adults with severe acute respiratory syndrome (SARS). Thorax 2003;58:686–9. 5. Moghimian M, Farzi K, Farzi S, Moladoost A, Safiri S. Exploring the experiences of nurses and physicians infected with COVID‑19. J Edu Health Promot 2022;11:35. 6. Khanal P, Devkota N, Dahal M, Paudel K, Joshi D. Mental health impacts among health workers during COVID‑19 in a low resource setting: A cross‑sectional survey from Nepal. Global Health 2020;16:89. 7. Kumar R, Nancy. Stress and coping strategies among nursing students. Nurs Midwifery Res J 2011;7:141–51. 8. Savitsky B, Findling Y, Ereli A, Hendel T. Anxiety and coping strategies among nursing students during the covid‑19 pandemic. Nurse Educ Pract 2020;46:102809. 9. Eweida RS, Rashwan ZI, Desoky GM, Khonji LM. Mental strain and changes in psychological health hub among intern‑nursing students at pediatric and medical‑surgical units amid ambience of COVID‑19 pandemic: A comprehensive survey. Nurse Educ Pract 2020;49:102915. 10. Abdulghani H, Irshad M, Al Zunitan M , A l Sulihem A, Al Dehaim M, Al Esefir WA, et al. Prevalence of stress in junior doctors during their internship training: Across‑sectional study of three Saudi medical colleges’ hospitals. Neuropsych 2014;10:1879–86. 11. Center of Disease Control and Prevention, 2020. Information for Pediatric Healthcare Providers. 2020. Available from: https:// stacks.cdc.gov/view/cdc/88112/cdc_88112_DS1.pdf?. [Last accessed on 2021 Jan 25]. 12. Schwirtz M. Nurses die, doctors fall sick and panic rises on virus front lines. 2020. Available from: https://www.nytimes. com/2020/03/30/nyregion/ny‑coronavirus‑doctors‑sick. html. [Last accessed on 2021 Jan 25]. 13. Gold J. The Covid‑19 crisis too few are talking about: Health care workers’ mental healt. 2020. Available from: https://www. statnews.com/2020/04/03/the‑covid‑19‑crisis-too‑few‑are‑talki ng‑about‑health‑care‑workers‑mental‑health/. [Last accessed on 2021 Jan 25]. 14. Wong TW, Yau JKY, Chan CLW, Kwong RSY, Ho SMY, Lau CC, et al. The psychological impact of severe acute respiratory syndrome outbreak on healthcare workers in emergency departments and how they cope. Eur J Emerg Med 2005;12:13‑8. 15. Huang L, Lei W, Xu F, Liu H, Yu L. Emotional responses and coping strategies in nurses and nursing students during Covid‑19 outbreak: A comparative study. PLoS One 2020;15:e0237303. 16. Folkman S, Lazarus RS, Pimley S, Novacek J. Age differences in stress and coping processes. Psychol Aging 1987;2:171–84. 17. Folkman S, Lazarus RS. An analysis of coping in a middle‑aged community sample. J Health Soc Behav 1980;21:219–39. 18. Wani RT. Socio‑economic status scales‑modified Kuppuswamy and Udai Pareekh’s scale updated for 2019. J Fam Med Prim Care 2019;8:1846–9. 19. Weiss DS, Marmar CR. The impact of event scale – revised. In: Wilson JP, Keane TM, editors. Assessing Psychological Trauma and PTSD:a practitioner's handbook. The Impact of Events Scale— Revised. New York: Guildford; 1997. p. 399–411. 20. Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open 2020;3:e203976. 21. Tiemensma J, Depaoli S, Winter SD, Felt JM, Rus HM, Arroyo AC. The performance of the IES‑R for Latinos and non‑Latinos: Assessing measurement invariance. PLoS One 2018;13:e0195229. 22. Carver CS. You want to measure coping but your protocol’s too long: Consider the brief COPE. Int J Behav Med 1997;4:92–100. 23. Begam B, Devi K. A study to assess the perceived stress among nursing students during COVID‑19 lockdown. Int J Sci Healthc Res 2020;5:388–93. 24. IBM Corp. IBM SPSS Statistics for Windows: Version 23.0. Armonk, NY, USA: IBM Corp.; 2017. 25. Xiao C. A Novel approach of consultation on 2019 Novel Coronavirus (COVID‑19)‑related psychological and mental problems: Structured letter therapy. Psychiatry Investig 2020;17:175–6. 26. Aslan H, Pekince H. Nursing students’ views on the COVID‑19 pandemic and their percieved stress levels. Perspect Psychiatr Care 2021;57:695‑701. 27. Subba R, Subba HK, Singh JP, Mehta RK. Psychological impact and coping strategies of nursing students during the outbreak of coronavirus disease in Nepal. Asian J Multidiscip Stud 2020;8:23–31. 28. Sheu S, Lin H‑S, Hwang S‑L. Perceived stress and physio‑psycho‑social status of nursing students during their initial period of clinical practice: The effect of coping behaviors. Int J Nurs Stud 2002;39:165–75. 29. Karaca A, Yildirim N, Ankarali H, Açikgöz F, Akkuş D. Nursing students’ perceived levels of clinical stress, stress responses and coping behaviors. J Psychiatry Nurs 2017;8:832–9. 30. Nebhinani M, Kumar A, Parihar A, Rani R. Stress and coping strategies among undergraduate nursing students: A descriptive assessment from Western Rajasthan. Indian J Community Med 2020;45:172–5. 31. Kumar R. Personality traits, academic stress and adjustement styles among nursing students. Nurs J India 2018;CIX: 184–8. 32. Dalal P, Roy D, Choudhary P, Kar S, Tripathi A. Emerging mental health issues during the COVID‑19 pandemic: An Indian perspective. Indian J Psychiatry 2020;62:354–64. 33. Li D, Zou L, Zhang Z, Zhang P, Zhang J, Fu W, et al. The psychological effect of COVID‑19 on home‑quarantined nursing students in China. Front Psychiatry 2021;12:652296. 34. Younas A. Levels of stress and coping strategies used by nursing students in asian countries: An integrated literature review. J Middle East North Africa Sci 2016;2:50–7. 35. Schuler RS. Definition and conceptualization of stress in organizations. Organ Behav Hum Perform 1980;25:184–215. 36. Salman M, Asif N, Mustafa ZU, Khan TM, Shehzadi N, Tahir H, et al. Psychological impairment and coping strategies during the covid‑19 pandemic among students in Pakistan: A cross‑sectional analysis. Disaster Med Public Health Prep 2020;1–7. doi: 10.1017/ dmp. 2020.397.
37. Carver CS, Scheier MF, Weintraub JK. Assessing coping strategies: A theoretically based approach. J Pers Soc Psychol 1989;56:267–83. 38. Sheroun D, Wankhar DD, Devrani A, PV L, Gita S, Chatterjee K. A study to assess the perceived stress and coping strategies among B.Sc. nursing students of selected colleges in Pune during covid‑19 pandemic lockdown. Int J Sci Healthc Res 2020;5:280–8. 39. Huang L, Xu F, Liu H. Emotional responses and coping strategies of nurses and nursing college students during COVID‑19 outbreak. medRxiv 2020;2020.03.05.20031898. Available from: http://medrxiv.org/content/ early/2020/03/08/2020.03.05.20031898.abstract. 40. Rafati F, Nouhi E, Sabzevari S, Dehghan‑Nayeri N. Coping strategies of nursing students for dealing with stress in clinical setting: A qualitative study. Electron Physician 2017;9:6120‑8. 41. Al‑Dubai SAR, Al‑Naggar RA, Alshagga MA, Rampal KG. Stress and coping strategies of students in a medical faculty in Malaysia. Malays J Med Sci 2011;18:57–64. 42. Kalpana K. Stress and coping strategies among first year nursing students in selected nursing colleges of Mumbai city. Indian J Appl Res 2019;9:28–9. 43. Wortmann J. Religious coping. In: Gellman M, Turner J E. Encyclopedia of Behavioral Medicine [Internet]. Encycl Behav Med 2016. Available from: https://link.springer.com/referenc eworkentry/10.1007%2F978‑1‑4614‑6439‑6_665‑2. [Lastaccessed on 2021 Jan 25]. 44. Dharra S, Kumar R. Promoting mental health of nurses during the coronavirus pandemic: Will the rapid deployment of nurses’ training programs during covid‑19 improve self‑efficacy and reduce anxiety? Cureus 2021;13:e15213. 45. Prasad K, McLoughlin C, Stillman M, Poplau S, Goelz E, Taylor S, et al. Prevalence and correlates of stress and burnout among U.S. healthcare workers during the COVID‑19 pandemic: A national cross‑sectional survey study. EClinicalMedicine 2021;35:100879.
Ankita Sharma,.. and Rajesh Kumar,.. (2022). Psychological distress and coping styles among baccalaureate nursing students: Promoting mental health of future nurses in COVID‑19 pandemic. Journal of Education and Health Promotion, 12(9), 1-9.
MLA
Ankita Sharma,.. , and Rajesh Kumar,.. . "Psychological distress and coping styles among baccalaureate nursing students: Promoting mental health of future nurses in COVID‑19 pandemic", Journal of Education and Health Promotion, 12, 9, 2022, 1-9.
HARVARD
Ankita Sharma .., Rajesh Kumar .. (2022). 'Psychological distress and coping styles among baccalaureate nursing students: Promoting mental health of future nurses in COVID‑19 pandemic', Journal of Education and Health Promotion, 12(9), pp. 1-9.
CHICAGO
.. Ankita Sharma and .. Rajesh Kumar, "Psychological distress and coping styles among baccalaureate nursing students: Promoting mental health of future nurses in COVID‑19 pandemic," Journal of Education and Health Promotion, 12 9 (2022): 1-9,
VANCOUVER
Ankita Sharma .., Rajesh Kumar .. Psychological distress and coping styles among baccalaureate nursing students: Promoting mental health of future nurses in COVID‑19 pandemic. J Educ Health Promot, 2022; 12(9): 1-9.
