American Journal of Nursing Research
ISSN (Print): 2378-5594 ISSN (Online): 2378-5586 Website: Editor-in-chief: Apply for this position
Open Access
Journal Browser
American Journal of Nursing Research. 2019, 7(6), 995-999
DOI: 10.12691/ajnr-7-6-13
Open AccessArticle

Stress and Anxiety among Junior Nursing Students during the Initial Clinical Training: A Descriptive Study at College of Health Sciences, University of Bahrain

Hala Mohamed Sanad1,

1Fellow HEA, Nursing Department-WHO Collaborating Center for Nursing Development, College of Health Sciences, University of Bahrain, P.O. Box: 32038, Salmanya, Kingdom of Bahrain

Pub. Date: October 16, 2019

Cite this paper:
Hala Mohamed Sanad. Stress and Anxiety among Junior Nursing Students during the Initial Clinical Training: A Descriptive Study at College of Health Sciences, University of Bahrain. American Journal of Nursing Research. 2019; 7(6):995-999. doi: 10.12691/ajnr-7-6-13


Background: Anxiety and stress among nursing students are challenge for academic education and a need exists to explore the factors that contribute to such phenomena among Arab culture. Objective: To assess the anxiety and stress levels among junior nursing students at College of Health Sciences (CHS), University of Bahrain (UoB) during their initial clinical exposure. Material and Methods: A self-administered questionnaire was employed to gather data on perceived stress (5 points likert scale), perceived anxiety (4 points likert scale) and socio-demographic characteristics from 93 second year nursing students at CHS (a response rate of 77.5%). The total scores for each item were summed and average scores were calculated accordingly. Both univariate and multivariate analyses were undertaken in order to identify significant factors that influence anxiety and /or stress levels among students. The p-value of less than 0.05 was considered statistically significant. Results: About four-fifth of the respondents were female students. Most students had normal levels of anxiety while two-third reported moderate stress level. Female gender was the only significant factor that is related to stress in univariate as well as multivariate analyses. Conclusion: Nursing students at CHS had moderate stress level which would have a negative effect on the quality of their education and clinical practice. Further studies are needed to explore effective strategies to deal with anxiety and stress among junior and senior students.

anxiety clinical training nursing student stress

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit


[1]  Chen, C. J., Chen, Y. C., Sung, H. C., Hsieh, T. C., Lee, M. S., & Chang, C. Y. (2015). The prevalence and related factors of depressive symptoms among junior college nursing students: a cross‐sectional study. Journal of psychiatric and mental health nursing, 22(8), 590-598.
[2]  Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer.
[3]  Chernomas, W. M., & Shapiro, C. (2013). Stress, depression, and anxiety among undergraduate nursing students. International journal of nursing education scholarship, 10(1), 255-266.
[4]  Duffy, A. (2009). Guiding students through reflective practice-The preceptors experiences. A qualitative descriptive study. Nurse Education in Practice, 9(3), 166-175.
[5]  Tully, A. (2004). Stress, sources of stress and ways of coping among psychiatric nursing students. Journal of Psychiatric and Mental Health Nursing, 11(1), 43-47.
[6]  Alzayyat, A., & Al‐Gamal, E. (2014). A review of the literature regarding stress among nursing students during their clinical education. International Nursing Review, 61(3), 406-415.
[7]  Robotham, D., & Julian, C. (2006). Stress and the higher education student: a critical review of the literature. Journal of further and higher education, 30(02), 107-117.
[8]  Zung, W. W. (1971). A rating instrument for anxiety disorders. Psychosomatics, 12(6), 371-379.
[9]  Cohen, S., Kamarck, T., & Mermelstein, R. (1994). Perceived stress scale. Measuring stress: A guide for health and social scientists.
[10]  Bayoumi, M. M. M., & Elbasuny, M. M. M. (2012). Evaluating Nursing Students' Anxiety and Depression during Initial Clinical Experience. International Journal of Psychology and Behavioral Sciences, 2(6), 277-281.
[11]  Seyedfatemi, N., Tafreshi, M., & Hagani, H. (2007). Experienced stressors and coping strategies among Iranian nursing students. BMC nursing, 6(1), 11.
[12]  Pulido‐Martos, M., Augusto‐Landa, J. M., & Lopez‐Zafra, E. (2012). Sources of stress in nursing students: a systematic review of quantitative studies. International Nursing Review, 59(1), 15-25.
[13]  Sheu, S., Lin, H. S., & Hwang, S. L. (2002). Perceived stress and physio-psycho-social status of nursing students during their initial period of clinical practice: the effect of coping behaviors. International journal of nursing studies, 39(2), 165-175.
[14]  Chang, E. M., Bidewell, J. W., Huntington, A. D., Daly, J., Johnson, A., Wilson, H., ... & Lambert, C. E. (2007). A survey of role stress, coping and health in Australian and New Zealand hospital nurses. International journal of nursing studies, 44(8), 1354-1362.
[15]  Chan, C. K., So, W. K., & Fong, D. Y. (2009). Hong Kong baccalaureate nursing students' stress and their coping strategies in clinical practice. Journal of professional Nursing, 25(5), 307-313.
[16]  Burnard, P., Edwards, D., Bennett, K., Tothova, V., Baldacchino, D., Bara, P., & Mytevelli, J. (2008). A comparative, longitudinal study of stress in student nurses in five countries: Albania, Brunei, the Czech Republic, Malta and Wales. Nurse Education Today, 28(2), 134-145.
[17]  Timmins, F., & Kaliszer, M. (2002). Aspects of nurse education programmes that frequently cause stress to nursing students-fact-finding sample survey. Nurse Education Today, 22(3), 203-211.