الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
One of the many challenges that college students face is stress. Short-term stress can help students improve their grades, polish their essays, or pursue a desired career opportunity. Long-term stress, on the other hand, can have negative consequences if not addressed. According to the American Institute of Stress, four out of every five college students are stressed on a regular basis. Unmanaged stress can cause physical symptoms such as difficulty concentrating, irritability, a lack of energy, appetite changes, a weakened immune system, and difficulty sleeping , as a result, it is critical to assist participants in balancing their daily stressors with activities and attitudes that replenish the physical, mental, and emotional energy depleted by stress.
The aim of the present study was to assess the effect of a stress management intervention program on stress level and coping responses of Technical Health Institute students. Specific objectives included: to assess the level of stress among Technical Health Institute students, identify the current stress coping strategies of Technical Health Institute students, design and implement a stress management intervention program, and finally assess the impact of the intervention program on improving the students coping responses and decreasing the stress level.
The present study targeted 200 students, 100 for intervention group who had mild and moderate degree of stress and 100 for control group, the intervention group was students of the main Technical Health Institutes, while the control group was taken from the other Technical Health Institutes in Alexandria. 100 students from the main institute who participate in the pre intervention phase and was chosen randomly, using table of random numbers.For conduction of this study the following tools were used: Phase I: A pre intervention phase:A pre designed self-administrated questionnaire was used to collect the following data:- Socio-demographic data e.g.: age, sex, place of residence, number of siblings, occupation of the father and mother and their income (Fahmy et al., 2015)- Educational achievement.- Stress level: was measured using Perceived Stress Scale (PSS) (Cohen, Kamarck & Mermelstein, 1983) and Depression Anxiety Stress Scales (DASS) scale (Lovibond & Lovibond, 1995).Phase II: Intervention Program: Program objectives:- To enable students to think objectively about stressful situations through cognitive restructuring.- To enhance students communication skills.- To teach students problem solving skills.
- To teach them some relaxation techniques. Description of the program:The intervention program was conducted in 5 sessions; each session will last for 45-60 minutes. The sample students were divided into 5 groups, about 20 students for each group. Each group received one session per week until reaching a total of 5 sessions. The educational methods included problem based learning, role play, group discussion, case study. Audiovisual aids such as Power Point presentation, pictures and posters were used to facilitate the learning process.
Evaluation of the educational program was carried out twice; immediately after intervention program completion and three months later, for the 2 groups.The results of the present study can be summarized as follows: The Intervention group included 100 students, their age ranged from 19 up to 22 years with a mean age of 19.27±0.26 years. The intervention group was from the Main Technical Health Institute in Alexandria. The percent of female were more than male students in both groups.
The high proportion of students pre intervention (73.0%) had moderate stress while only (27.0%) of students had mild stress. However, after termination of the program, about half of students (51.0%) turned into mild stress whereas number of students with moderate stress decreased to reach (49.0%), with slight improvement (5.7%) immediately after the intervention which decrease to (5.1%) three months after the intervention while in control group there was no improvement.
About three quarters (74.0%) of students from middle socioeconomic class had moderate stress whereas about more than one third of the intervention group (33.3%) form high socio-economic standard had mild stress.
The most common coping methods used by students with both mild and moderate stress were planning, acceptance, self-distraction and religion before the intervention.
Before initiation of the program, students from high socio-economic standard (7.0±0.89) were using self-distractions as a method of coping with stress more than the students form middle and low socio-economic standard (5.16 ± 1.53), (4.88 ± 1.36) respectively and this difference was statistically significant (F = 4.867), (p = 0.010). While immediately after the intervention the students with low socio economic score were using denial, humor and self-blame as a method of coping mechanism more than students from middle and high socio-economic standard (3.82±1.63), (4.59 ± 1.37), (6.59 ± 1.50) respectively and these differences were statistically significant (p = 0.020, 0.002, 0.019) respectively.
Before initiation of the program, it was found that there were very weak negative correlations between planning, acceptance, religion and perceived stress (r = -0.215, p = 0.031), (r = -0.214, p = 0.033), (r = -0.225, p =0.025), respectively. However, after program termination it was found that there were a negative significance weak correlation between stress and venting (r = -0.238, p = 0.017), and there were a positive moderate correlation between stress and behavioral disengagement (r = 0.212, p = 0.034).
Before initiation of the program, it was noticed that female students used behavioral disengagement more than male students and this was statistically significant (p = 0.025), while after termination of the program the female students used active coping and planning as a methods of coping with stress more than male students and the difference were statistically significant (p = 0.046, 0.034) respectively.Before initiation of the program, the older students (21-) were using behavioral disengagement as a method of coping more than the younger students and this was statistically significant (p = 0.043), while after termination of the program the older students were using instrumental support and venting as methods of coping and the differences were statistically significant (p = 0.017, 0.040) respectively.
6.2 Conclusion
Stress is an unavoidable part of life that many college students face. It frequently results from a combination of academic, social, environmental, physical, and psychological factors. To deal with stress, university students employ a variety of positive and negative coping techniques. Yet, when stress exceeds the student’s ability to cope with stress, personal management skills or professional support are required immediately. Evaluation of the intervention program showed a significant improvement in stress reduction by 5.7% immediately and 5.1% three months after the intervention.
It was concluded that about 70% of students had moderate stress, their age ranged from 19-20 years, mostly females students. There was a significant reduction in moderately stressed students from 73.0% to reach 49.0% three months following the intervention and an increase in the number of mild stressed students from 27.0% reaching 51.0% three months after the intervention. The score of active coping, planning and acceptance was higher in females students than male students after the intervention, the mean score of denial, humor, and self-blame was significantly higher among students from low socio-economic class, with a significant increase in some adaptive coping strategies used by students after the program as active coping and acceptance; and a significant decrease in some maladaptive coping strategies.3.6 Recommendation For health educators:-
1. Health educators should encourage college students to use adaptive coping strategies to manage stress.2. Identifying what causes stress in college students can help to reduce its impact.
3. It is necessary to provide counseling services to nursing students who are really struggling with their stress issues.4. It is important to note that the academic community has a responsibility to promote coping and well-being in nursing students.
5. Develop an online programme throughout the semester to provide students with education, self-assessments tools, and stress-management strategies.
6. Regular workshops on stress, coping strategies, and healthy lifestyle should be organized for students, especially first-year college students, where they can be learn how to manage their stressors through the use of stress-reducing strategies such as time management and some relaxation techniques.7. It is important to teach a future professional nurse to become more aware about the use of assertive techniques in their workplaces to manage the challenges they face when dealing with human resources. So it is important to develop some assertive training program in order to improve assertive behavior.
8. A collaborative environment among students, faculty, and clinical staff is another suggestion for faculty to help students cope with the stress of clinical training.9. Stress, coping strategies, and healthy lifestyle workshops should be held on a regular basis for students, particularly first-year college students and their parents, so that they can learn how to manage their stressors through the use of stress-reducing strategies such as time management and breathing exercises.For parents:1. Community awareness programs should be conducted for the partners and future parents about how to deal with stress.
2. It is essential for parents to give time, support, affection, nurturance and acceptance to their adolescents and young adults which will had a great effect in manage their stress.
For Community:1. There is a greater need to focus on expanding mental health services and awareness, particularly in underserved areas with limited access to services and treatment for mental issues.2. Emphasizing the importance of integrating diverse activities and sports into the daily routine of people especially university students, which can significantly lead to a reduction of stress.