Assessment of Psychological Distress Among Nursing Students in University of Kufa

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Assessment of psychological distress among nursing students in University of Kufa

Assessment of psychological distress among nursing students in University of Kufa

Ali Kareem Khudhair

Mental Health Nursing , College of Nursing, University of Kerbala.

E:mail:

ABSTRACT

The aim of this study is to assess the psychological distress among nursing students. A descriptive-analytic study was carried out at University of Kufa at college of nursing from Nov. 1st , 2012 to Mar. 15th , 213. A proportional stratified sample of 130 nursing collegians were included in the present study. The data were collected through the use of self administered questionnaire which consists of two parts; the first part includes socio-demographic data form and contains 9-items; the second part contains the Psychological distress instrument which includes General Health Questionnaire (GHQ-28). The results of the present study showed that the common students were mild psychological distress distributed differently among the general health questionnaire domains as 50% for mild level in depression domain in 1st class, 59% for mild level in depression domain in 2nd class, 51% for mild level in anxiety domain in 3rd class, 60.8% for mild level in social dysfunction in 4th class.

In conclusion this study indicated that most of the nursing collegians have mild level of psychological distress, the majority of the nursing collegians were female, the majority of the students are attended from urban residential areas and the majority of the nursing student's highest percentages of the study sample (50%) are within the sufficient family income. The all nursing student suffering from mild psychological distress. It was recommended that there is an urgent need for a university based mental health advocacy and other youth oriented mental health programs to provide awareness on anxiety and depression and its effects, and make a provision for appropriate supportive facilities. Future research should also focus on ways of increasing students’ ability to cope with the stressors of nursing education. Give psychological counseling and educational guidance are of great significance in the college to promote mental health.

Key words: Psychological distress, mental health, Psychological well-being, anxiety, depression .

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Assessment of psychological distress among nursing students in University of Kufa

INTRODCTION

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Assessment of psychological distress among nursing students in University of Kufa

Mental health is one of the important aspects of health and related to the mental well-being component include in WHO’s definition of health “a state of physical, mental and social well-being and not merely absence of disease"(1). Psychological distress is largely defined as a state of emotional suffering characterized by symptoms of depression (e.g., lost interest; sadness; hopelessness) and anxiety (e.g., restlessness; feeling tense). These symptoms may be tied in with somatic symptoms (e.g., insomnia; headaches; lack of energy)(2). Transition of students from school environment to university environment could cause a psychological, academic and social shock to them, since this educational system has huge differences: the student will face new methods of teaching, new academic requirements, new type of relations between students and faculties and even new relations among students themselves(3,4). Regardless of the desired outcome, the process of education can be a very stressful experience. Nursing students are valuable human resources. Detection of these symptoms are anxiety; depression and social dysfunction can lead to low productivity, minimized quality of life and suicidal thoughts. Psychological health distress is related to a wide-ranging of experiences that influence on thinking, feeling and behaving and results in a less than effective capacity to manage with and cope the live, mostly faced change in daily life and a new environment(5). Evidence of psychological health distress may include, among other factors, low-level anxiety or depression, reduced concentration and performance, withdrawal from peer group, and changes in behavior and appearance, suicidal ideas, obsessive attitude to work/pre-occupation with failure. The condition must be note that psychological distress may be expert by any person in any period and the World Health Organization maintains that one in four individuals will experience psychological distress at certain point in their lives(6). Several authors have observed that the prevalence of psychological distress (PD) is higher among students than among working nonstudent populations the prevalence of psychological distress among year 1 students ranged from 17.6% to 50% and it was among year 2 ranged from 36.5% to 47.9%, in year 3 ranged from 29.8% to 40.5%, the prevalence of psychological distress among year 4 students ranged from 28.3% to 48.7%. This information showed that psychological distress was different depending on the stages of college training(7) . Nursing students are the future professional staff in health care system who play an important role in providing care, treatment and support patients physically and psychologically. Nursing is an important career which requires very good mental health. Nursing students face mental problems factors in their educational experiences including hospital atmosphere, working with dying patients, special clinical skills, interpersonal relationship with nurses, other stuff and patients, examinations and academic workload and lack of free time High level of psychological distress can cause physical and mental health problems and my affect students’ academic performance(1,8). It is observed that nursing students undergo tremendous stress during various stages of their course. Occupational mental health and affective well-being among student health professionals has been the focus of increased study in recent years(5).

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Assessment of psychological distress among nursing students in University of Kufa

MATERIALS AND METHODS

Materials:

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Assessment of psychological distress among nursing students in University of Kufa

A descriptive analytic study was carried out to identify the Psychological distress among nursing students in University of Kufa. The study is conducted from November 1st , 2012 to March 15th, 2013. Proportional stratified sampling: The sample of study (N=130), 1st class (46), 2nd class (32), 3rd class (29), and 4th class (23) (Table 1).

Table (1). Distribution of the Sample according the class:

No / All Class of nursing branch / Total / select sample
1 / 1st class / 199 / 46
2 / 2nd class / 136 / 32
3 / 3th class / 124 / 29
4 / 4th class / 93 / 23
Total / 552 / 130

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Assessment of psychological distress among nursing students in University of Kufa

INSTRUMENTS:

The General Health questionnaire (GHQ-28) is comprised of 28 items include somatic symptoms domains (7 items); anxiety domain (7 items); social dysfunction domains (7 items) & depression domain (7 items), the general health questionnaire is a self-administered screening instrument used to measure the psychological distress and general mental health in non-psychiatric persons. The scale was used previously in other study conducted by Goldberge and Hillier (1979)(9) and the investigator translated the scales (GHQ-28) from English to Arabic. Translation validity was achieved through the process of forward and backward translation, then forward to the experts to review the translation. The investigator obtained both copies in English and Arabic and uses it directly after simple modification. the final study instrument consist two parts : Part I : the first section was socio demographic characteristics sheet consist of 9 items , which included , residence, gender, age, marital status, father education level , mother education level , father occupation , and finally family income. Part II: The investigator used instrument to assess the Psychological distress among nursing students in University of Kufa.

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Assessment of psychological distress among nursing students in University of Kufa

Data Collection:

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Assessment of psychological distress among nursing students in University of Kufa

The data are collected through the utilization of the developed questionnaire (Arabic version) and by means of self-administered questionnaire (self-report) with the subjects' who were included in the present study before data collection, the investigator met the nursing collegians at the classroom to clarify the student and get their agreement to participation in the study, then a copy of the questionnaire was distributed for each student to complete they receded by the investigator, this process was applied at the data collected process has been performed from March. 17th 2013 until April.4th 2013. .

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Assessment of psychological distress among nursing students in University of Kufa

Data analysis:

In order to achieve the early stated objectives, the data of the study were analyzed through the use of statistical package of social sciences (SPSS) version 16 through descriptive and inferential statistical analyses.

Rating and Scoring :

The items have been rated and scores according to the following patterns. Four point liker scales is used for rating the GHQ-28 scales items scored as (1) for not at all, (2) for no more than usual, (3) for rather more than usual, (4) for much more than usual). Finally the rating cut off point used to this scale (normal- Less than =8; Mild- 9-12; Moderate- 13-17 & Sever Hight.17+).

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Assessment of psychological distress among nursing students in University of Kufa

RESULTS

Table (2) shows that the majority of the study sample is living in urban residential area (70.76%) of the completely sample. More than half of the study subjects are females (56.92%). Concerning to ages ranged from (18 to 22) more common are (71.53%). In addition, this table shows that the majority of the study sample (88.46%) is single. Regarding to fathers level of education, the results show that the major group of the study sample are college graduated (23.84%). while regarding to the mothers level of education, the study results indicate that the highest percentage of mothers were secondary school (33.84%). Concerning to occupation of father, the results show that the major group of the study sample are officer (40.76 %), while the majority of their mothers are housewife (67%). Finally, the study result shows that the majority of study sample (50%) is within the sufficient family income.

Table (2). Socio-Demographic Profile of the study population (n=130).

Variable / Items / N. / Percent
Residence / Urban / 92 / 70.76
Rural / 38 / 29.23
Gender / Male / 56 / 43.07
Female / 74 / 56.92
Age / 18-22 / 93 / 71.53
23-27 / 28 / 21.53
28-32 / 7 / 6.38
Marital status / Single / 115 / 88.46
Married / 15 / 11.53
Father Education Level / can't read and write / 4 / 3.076
Primary School Graduated / 27 / 20.76
Secondary School / 28 / 21.53
Junior High School / 15 / 11.53
Institute Graduated / 24 / 18.46
College Graduated / 32 / 23.84
Mother Education Level / can't read and write / 11 / 8.46
Primary School Graduated / 32 / 24.61
Secondary School / 44 / 33.84
Junior High School / 17 / 13.07
Institute Graduated / 20 / 15.38
College Graduated / 6 / 3.07
Father Occupation / Officer / 53 / 40.76
Retired / 31 / 23.84
Unemployed / 4 / 3.076
Freelancers / 42 / 32.30
Mother Occupation / Officer / 23 / 17.69
Retired / 18 / 13
Family income / Housewife / 88 / 67
Freelancers / 1 / 0.76
Sufficient / 65 / 50
Barely sufficient / 54 / 41
Insufficient / 11 / 8.46

Table (3).Distribution of the first class nursing students by their response to GHQ-28 domains (somatic symptoms; anxiety; social dysfunction and depression).

Psychological distress 1st year class nursing collegians /
GHQ-28 Scores / Somatic Symptoms domain / Anxiety domain / Social dysfunction domain / Depression domain /
Level / Rang
Cut off point / No / % / No / % / No / % / No / % /
Normal / Less than =8 / 3 / 6.52 / 16 / 34.7 / 3 / 6.52 / 10 / 21.73
Mild / 9-12 / 19 / 41 / 14 / 30.4 / 15 / 32.6 / 23 / 50
Moderate / 13-17 / 12 / 26 / 4 / 8.69 / 22 / 47.82 / 7 / 15.21
Sever / Hight.17+ / 12 / 26 / 12 / 26. / 6 / 13.04 / 6 / 13.04
Total / 46 / 100 / 46 / 100 / 46 / 100 / 46 / 100
Mean ± SD / 2.72±0935 / 2.2609±1.2006 / 2.6739±0.79 / 2.1957±0.9338

Table (3) shows that the common of the 1st year students responses to general health questionnaire domains are within the mild psychological distress level, this results distributed differently among the general health questionnaire domains as (41%) for mild level in somatic symptoms domain, (34.7%) for normal level in anxiety domain, (47.8%) for moderate level in social dysfunction, and (50%) for mild level in depression domain.

Table (4). Distribution of the second class nursing students by their response to GHQ-28 domains (somatic symptoms; anxiety; social dysfunction and depression )

Psychological distress 2nd year class nursing collegians /
GHQ-28 Scores / Somatic Symptoms domain / Anxiety domain / Social dysfunction domain / Depression domain /
Level / R / No / % / No / % / No / % / No / % /
Normal / Less than =7 / 3 / 9.375 / 1 / 3.125 / 7 / 21.875 / 7 / 21.875
Mild / 8-14 / 11 / 34.375 / 11 / 34.375 / 19 / 56.25 / 19 / 59.375
Moderate / 15-12 / 10 / 31.25 / 14 / 43.75 / 2 / 6.25 / 2 / 6.25
Sever / Hight.22+ / 8 / 25 / 6 / 18.75 / 5 / 15.625 / 4 / 12.5
Total / 32 / 100 / 32 / 100 / 32 / 100 / 32 / 100
Mean ± SD / 2.72±0958 / 27812±0.792 / 2.1562±0.959 / 2.0938±0.896

Table (4) indicates that the common of 2nd year students responses to general health questionnaire domains are within the mild psychological distress level, this results distributed differently among the general health questionnaire domains as (34.37%) for mild level in somatic symptoms domain, (43.75 %) for moderate level in anxiety domain, (56.25%) for mild level in social dysfunction, and (59.37%) for mild level in depression domain.