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Abstract
Background and objective: Nursing students face challenges in nursing education. Prior research has identified depression and fatigue as prevalent issues among nursing students, attributing these concerns to inadequate support from faculty and disorganised coursework, which contribute significantly to student exhaustion. Consequently, this study aimed to explore the relationship between stress and educational fatigue among final-semester nursing students to provide evidence that can help prevent stress and its negative health impacts, ultimately enhancing the well-being of nursing students.
Methods: This cross-sectional study investigated 56 final-semester nursing students using self-administered questionnaires: the Karolinska Exhaustion Disorder Scale (KEDS) and the Higher Education Stress Inventory (HSEI). Data were analysed using descriptive statistics and bivariate analysis using Spearman correlation coefficient.
Results: The study found that final-semester nursing students experienced high stress (Mean 21.84, SD = 7.065) due to workload (Mean 8.00, SD = 1.68), insufficient feedback (Mean 5.16, SD = 1.35), and faculty shortcomings (Mean 16.04, SD = 2.90). Significant positive correlations were noted between concentration and insufficient feedback (r =.29, p =.30) and low commitment (r =.27, p =.39). Physical stamina correlated significantly with workload (r =.41, p =.001) and low commitment (r =.36, p =.007). Memory and sleep showed no association with education-related stress.
Conclusions: The study found that final-semester nursing students reported workload and insufficient feedback as the factors related to education-related stress. There was no link between education-related stress and variables such as memory and sleep. These findings highlight the need to address a supportive learning environment and facilitate overall student health.
Keywords
Cross-sectional study
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Correlation
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Exhaustion
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Nursing students
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Self-administered questionnaire
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Emina Hadziabdic, Jalal Safipour, Carina Schmidt, Gunilla Lindquist.
Stress and exhaustion among nursing students during their final year: A cross-sectional study.
Journal of Nursing Education and Practice, 2025, 15(7): 21-27 DOI:10.63564/jnep.v15n7p21
| [1] |
Alharoubi SAS, Alasmary AMA, Alkhaledi WJM, et al. Comprehensive Review of Nursing Education and Clinical Practice. Journal of Ecohumanism. 2024; 3(8): 4239-47. https://doi.org/10.62754/joe.v3i8.5078
|
| [2] |
Labrague LJ, McEnroe-Petitte DM, De Los Santos JAA, et al. Examining stress perceptions and coping strategies among Saudi nursing students: A systematic review. Nurse Education Today. 2018; 65: 192-200. PMid:29602137 https://doi.org/10.1016/j.nedt.2018.03.012
|
| [3] |
Arian M, Jamshidbeigi A, Kamali A, et al. The prevalence of burnout syndrome in nursing students: A systematic review and meta-analysis. Teaching and Learning in Nursing. 2023; 18(4): 512-20. https://doi.org/10.1016/j.teln.2023.04.015
|
| [4] |
Bakker EJ, Kox JH, Miedema HS, et al. Physical and mental determinants of dropout and retention among nursing students: protocol of the SPRiNG cohort study. BMC Nursing. 2018; 17: 1-9. PMid:29977155 https://doi.org/10.1186/s12912-018-0296-9
|
| [5] |
Bakker EJ, Verhaegh KJ, Kox JH, et al. Late dropout from nursing education: An interview study of nursing students’ experiences and reasons. Nurse Education in Practice. 2019; 39: 17-25. PMid:31352089 https://doi.org/10.1016/j.nepr.2019.07.005
|
| [6] |
Van Hoek G, Portzky M, Franck E. The influence of sociodemographic factors, resilience and stress reducing activities on academic outcomes of undergraduate nursing students: A cross-sectional research study. Nurse Education Today. 2019; 72: 90-6. PMid:30463034 https://doi.org/10.1016/j.nedt.2018.10.013
|
| [7] |
Anaman-Torgbor JA, Tarkang E, Adedia D, et al. Academic-related stress among ghanaian nursing students. Florence Nightingale Journal of Nursing. 2021; 29(3): 263. PMid:35110166 https://doi.org/10.5152/FNJN.2021.21030
|
| [8] |
Dancot J, Pétré B, Dardenne N, et al. Exploring the relationship between first-year nursing student self-esteem and dropout: A cohort study. Journal of Advanced Nursing. 2021; 77(6): 2748-60. PMid:33656178 https://doi.org/10.1111/jan.14806
|
| [9] |
Park JW, Sun HN. Nursing students’ Clinical Experiences. J Korean Acad Psychiatr Ment Health Nurs. 2003; 12(1): 27-35. https://doi.org/10.12934/jkpmhn.2003.12.1.27
|
| [10] |
Tung YJ, Lo KK, Ho RC, et al. Prevalence of depression among nursing students: A systematic review and meta-analysis. Nurse Education Today. 2018; 63: 119-29. PMid:29432998 https://doi.org/10.1016/j.nedt.2018.01.009
|
| [11] |
Yüksel A, Bahadir-Yilmaz E. Relationship between depression, anxiety, cognitive distortions, and psychological well-being among nursing students. Perspectives in Psychiatric Care. 2019; 55(4): 690-6. PMid:31140627 https://doi.org/10.1111/ppc.12404
|
| [12] |
CSN CSSCCs. Studerandes hälsa (Students health). 2020.
|
| [13] |
Mazzotta R, Durante A, Bressan V, et al. Perceptions of nursing staff andstudentsregarding attrition: a qualitativestudy. InternationalJournal of Nursing Education Scholarship. 2024; 21(1). PMid:38354280 https://doi.org/10.1515/ijnes-2023-0081
|
| [14] |
The Swedish National Audit Office. Higher education institutions’ efforts to counter dropping out of shortage occupation programmes. 2025: 3.
|
| [15] |
Pulido-Martos M, Augusto-Landa JM, Lopez-Zafra E. Sources of stress in nursing students: a systematic review of quantitative studies. International Nursing Review. 2012; 59(1): 15-25. https://doi.org/10.1111/j.1466-7657.2011.00939.x
|
| [16] |
Lisnyj KT, Gillani N, Pearl DL, et al. Factors associated with stress impacting academic success among post-secondary students: A systematic review. Journal of American College Health. 2023; 71(3): 851-61. PMid:34242132 https://doi.org/10.1080/07448481.2021.1909037
|
| [17] |
Lundell Rudberg S, Sormunen T, Scheja M, et al. Nursing students experienced academic emotions during education-a longi-tudinal descriptive study from a nursing bachelor’s program in Sweden. BMC Nursing. 2024; 23(1): 52. PMid:38238730 https://doi.org/10.1186/s12912-024-01729-y
|
| [18] |
Woods C, West C, Mills J, et al. Undergraduate student nurses’ selfreported preparedness for practice. Collegian. 2015; 22(4): 359-68.PMid:26775522 https://doi.org/10.1016/j.colegn.2014.05.003
|
| [19] |
Sundberg K. Perspectives on nursing education within the Swedish higher education system. Thematic evaluation of nursing education. 2023.
|
| [20] |
Besèr A, Sorjonen K, Wahlberg K, et al. Construction and evaluation of a self rating scale for stress-induced Exhaustion Disorder, the Karolinska Exhaustion Disorder Scale. Scandinavian Journal of Psychology. 2014; 55(1): 72-82. PMid:24236500 https://doi.org/10.1111/sjop.12088
|
| [21] |
Adamsson A, Bernhardsson S. Symptoms that may be stress-related and lead to exhaustion disorder: a retrospective medical chart review in Swedish primary care. BMC Family Practice. 2018; 19(1): 172. PMid:30376811 https://doi.org/10.1186/s12875-018-0858-7
|
| [22] |
Kristiansen J, Friborg MK, Brandt L, et al. The Danish version of the Karolinska Exhaustion Disorder Scale (KEDS). EPICOH 2016 Epidemiology in Occupational Health Conference-Occupational Health, Think Globally, Act Locally; 2016.
|
| [23] |
Persson R, Österberg K, Viborg N, et al. Two Swedish screening instruments for exhaustion disorder: cross-sectional associations with burnout, work stress, private life stress, and personality traits. Scandinavian Journal of Public Health. 2017; 45(4): 381-8. PMid:28367741 https://doi.org/10.1177/1403494817696182
|
| [24] |
Shim EJ, Jeon HJ, Kim H, et al. Measuring stress in medical education: validation of the Korean version of the higher education stress inventory with medical students. BMC Medical Education. 2016; 16: 1-8. PMid:27881178 https://doi.org/10.1186/s12909-016-0824-9
|
| [25] |
Pacheco JPG, Hoffmann MS, Braun LE, et al. Translation, cultural adaptation, and validation of the Brazilian Portuguese version of the Higher Education Stress Inventory (HESI-Br). Trends in Psychiatry and Psychotherapy. 2023; 45: e20210445.
|
| [26] |
Masha’al D, Hayajneh AA, Tawalbeh LI. Psychometric evaluation of the Arabic version of the higher education inventory scale for nursing students. BMC Psychiatry. 2021; 21: 1-13. PMid:33549080 https://doi.org/10.1186/s12888-021-03082-9
|
| [27] |
Dahlin M, Joneborg N, Runeson B. Stress and depression among medical students: A cross-sectional study. Medical Education. 2005; 39(6): 594-604. PMid:15910436 https://doi.org/10.1111/j.1365-2929.2005.02176.x
|
| [28] |
World Medical Association.Declaration of Helsiniki-Ethical Principles for Medical Research Involving Human Subjects 2024. Available from: https://www.wma.net/policies-post/wma-declaration-of-helsinki/
|
| [29] |
Labrague LJ. Umbrella review: Stress levels, sources of stress, and coping mechanisms among student nurses. Nursing Reports. 2024; 14(1): 362-75. PMid:38391073 https://doi.org/10.3390/nursrep14010028
|
| [30] |
Onieva-Zafra MD, Fernández-Muñoz JJ, Fernández-Martínez E, et al. Anxiety, perceived stress and coping strategies in nursing students: a cross-sectional, correlational, descriptive study. BMC Medical Education. 2020;20: 1-9. PMid:33081751 https://doi.org/10.1186/s12909-020-02294-z
|
| [31] |
Kong LN, Yao Y, Chen SZ, et al. Prevalence and associated factors of burnout among nursing students: A systematic review and meta-analysis. Nurse Education Today. 2023; 121: 105706. PMid:36577286 https://doi.org/10.1016/j.nedt.2022.105706
|
| [32] |
Riva E, Freeman R, Schrock L, et al. Student wellbeing in the teaching and learning environment: A study exploring student and staff perspectives. Higher Education Studies. 2020; 10(4): 103. https://doi.org/10.5539/hes.v10n4p103
|
| [33] |
Rayan A. Mindfulness, self-efficacy, and stress among final-year nursing students. Journal of Psychosocial Nursing and Mental Health Services. 2019; 57(4): 49-55. PMid:30508462 https://doi.org/10.3928/02793695-20181031-01
|
| [34] |
Alatawi AO, Morsy NM, Sharif LS. Relation between Resilience and Stress as Perceived by Nursing Students: A Scoping Review. Evidence-Based Nursing Research. 2021.
|
| [35] |
Cheung T, Wong SY, Wong KY, et al. Depression, anxiety and symptoms of stress among baccalaureate nursing students in Hong Kong: a cross-sectional study. International Journal of Environmental Research and Public Health. 2016; 13(8): 779. PMid:27527192 https://doi.org/10.3390/ijerph13080779
|
| [36] |
SFS.Hälso-och sjukvårdslag (Health and Medical Services Act). 2017; 30.
|
| [37] |
Choi MY, Park S, Noh GO. Social support for nursing students: A concept analysis study. Nurse Education Today. 2024; 132: 106038. PMid:37976883 https://doi.org/10.1016/j.nedt.2023.106038
|
| [38] |
Silva M, Chaves C, Duarte J, et al. Sleep Quality Determinants among Nursing Students. Procedia-Social and Behavioral Sciences. 2016; 217: 999-1007. https://doi.org/10.1016/j.sbspro.2016.02.090
|
| [39] |
Gallego-Gómez JI, González-Moro MTR, González-Moro JMR, et al. Relationship between sleep habits and academic performance in university Nursing students. BMC Nursing. 2021; 20(1): 100. PMid:34140029 https://doi.org/10.1186/s12912-021-00635-x
|