METHODS TO

REDUCE
ANXIETY IN
NURSING
STUDENTS
 Introduction:
Nursing is stressful, and
nursing students also have
the additional pressures
particularly for young
students having no prior
healthcare experience,
and uncertainties shared
with all academic
students.
Objective:

qDiscuss some
methods to reduce
anxiety in nursing
students.
ar 2008-2009, our requirement for the course was to find e
on nurse students, so we suggest several skills for stress m
 Wxhieyty?
e an n ursin
hav g is
d en t a st r
g s tu essfu
rs in l job
Nu ?
Analyzing the question

P: student nurses with anxiety.

I: stress management skills.
C: No stress man. skills
O: reduce anxiety.

Question Sentence:
In student nurse with anxiety,
do stress management skills
reduce anxiety?
 Search
Strategy
1.Analyzing the question.
2.Generating the word list.
3.Linking word lists( AND, OR, NOT).
4.Search databases:
ØGoogle scholar.
ØCochrane library.
ØPub Med.
 Generating the word list
P:Student nurse with Anxious, worry, student anxiety,
nurse anxiety.
anxiety.

Cognitive, feedback, supportive,

I: Stress management environment, Personnel support.
skills.
Same as intervention
C:Same as intervention
Anxiety reduction.
O:Reduce anxiety.
 Linking word lists( AND, OR, NOT)

p i c .H o
th i s t o
l a t ed to
nce re
v i de
a n y ( 0) e
t m
w ords , w e go
link ing
 The effectiveness of current approaches to workplace
stress management in the nursing profession: an evidence
based literature review

 The effectiveness of current approaches to

workplace stress management for nurses was
assessed through a systematic review. Seven
randomised controlled trials and three
prospective cohort studies assessing the
effectiveness of a stress management
programmes were identified and reviewed.


 There is more evidence for the effectiveness

of programmes based on:
A. providing personal support
B. environmental management to reduce
stressors.
 METHODS
A systematic review was conducted.
 The following inclusion criteria were used:-
1.The subjects are nurses.

2.Two stress management interventions are

compared to each other, or a stress
management intervention is compared to
a placebo or no intervention control in a
prospective way.

 METHODS
3.The stress management intervention is
clearly described.
4.The outcome is change in individual levels of
stress and/or of symptoms or squeal of
stress measured by an instrument with
evidence of validity.

 RESULTS
A- Personnel support interventions:-


1- An exercise and a music programme was



examined using two treatment groups and a

no intervention control which was waiting
for the active intervention to be available.


 the exercise and music programmes are

potentially effective, but this should be
viewed with caution.

 RESULTS

A- Personnel support interventions:-



2- A relaxation training programme was
examined. The programme is considered to
focus on personnel support. A placebo
intervention consisted of an equal number
of lectures on theory analysis.


 the treatment group showed a greater

decrease in stress than the placebo group.
 RESULTS

A- Personnel support interventions:-



3- This study investigated a cognitive,
behavioural, and physiological programme.
It was compared to a placebo, self
awareness programme involving self writing
and identification of stressors, and a no
intervention control.


 Therefore, it would be impossible to

conclude whether the programme is
effective or not.

 RESULTS

B- Environmental management interventions:-



1- This study examined the effect of providing
structured training and a regular support
programme.


 Stress was increased on all subscales post-

intervention in both the treatment and
control groups.



 RESULTS

B- Environmental management interventions:-



2- This study examined the effect of
introducing individualised nursing care.


 The positive effect should be viewed with

caution.

 Summary of results
 Among the response support interventions,
one approach focusing on cognitive
techniques was determined to be effective,
although evidence was weak; three
approaches on exercise, music, and
relaxation training were potentially
effective; one approach of social support
education is questioned but possibly
effective; and two are impossible to draw
conclusions after the critical appraisals.
 Summary of results
 One study focusing on environmental change
(introducing different nursing method), the
study is classified as possibly effective.
 there is more evidence for the effectiveness of
personal support than environmental
management for reducing workplace stress in
the nursing profession. However, it is not
possible at this stage to determine what kind of
approach is more effective, because the number
of studies is too small to compare different
approaches
 Recommendation
 It is not possible to recommend any particular
approach for practical implementation because the
number of studies is too small to determine it.
However, there is more evidence for the
effectiveness of personnel support than
environmental management. Moreover all
programmes reviewed here appeared at least not
harmful. This review strongly suggests the need for
experimental research on stress management
programmes.



C Mimura and P Griffiths
Florence Nightingale School of Nursing and Midwifery, King’s College London, UK

Correspondence to:
Dr P Griffiths, Primary and Intermedicate Care Section, Florence Nightingale School of
Nursing and Midwifery, King’s College London, Waterloo Road, London SE1 8WA, UK;
Accepted 19 June 2002