Thesis:

Adaptation of stress management model for students studying in selected schools of nursing in Rwanda

Stress among students is mainly caused by balancing school schedules, preparing for and taking exams. Individual life with the requirements of school are all possible stressors in a student’s life. Nursing students are not exceptional; they also have similar demands that lead to rigorous course load and clinical competency requirements. The main objective of this study is to adapt a model of stress management for students attending selected nursing schools in Rwanda, while specific objectives are: 1) to determine the socio demographic characteristics of students studying in selected schools of nursing in Rwanda, 2) to assess the level of stress of students studying in selected schools of nursing in Rwanda, 3) to identify the stressors of students studying in selected schools of nursing in Rwanda, 4) to determine the coping mechanisms of students studying in selected schools of nursing in Rwanda, 5) to explore the knowledge of students studying in selected nursing schools in Rwanda about stress, 6) to adapt a model of stress management for students studying in selected nursing schools in Rwanda. A cross- sectional descriptive study design using mixed method (both quantitative and qualitative approaches) has been used in this study. The stratified sampling technique was used to choose 384 nursing students who completed the questionnaires, 59 students’ members of 6 focused groups’ interview were selected using convenience sampling technique, and purposive sampling technique was used to choose two key informants from each institution. Analysis of quantitative data was done using software of SPSS version 23. For inferential statistics, we have used Chi Square Test, correlation, and linear regression. Results indicate that nursing students experience stress while at schools: only 63.2% of respondents scored a low level of stress while, 23.9% of participants scored moderate level of stress, and 12.7% scored a high to very high levels of stress. About coping mechanisms, 44% of respondents do not always use the positive coping mechanisms, but use them sometimes, compared to 25% who uses them often, and 30.9% who never use positive coping mechanisms. In relation to stressors, 22% of respondents ranked exams as the first stressor, followed by financial issues (21%), and academic workload (18%). The above data are supported by the qualitative data from FGDs and KIIs. The Stress Management Model for nursing students in Rwanda was successfully adapted based on the existing theory stated as” Transactional Model” of Dr Richard Lazarus and Dr Suzan Folkman (1984) and it has 4 major concepts namely stress, appraisal, coping and reinforcement. The adapted model for stress management among nursing students studying in some selected nursing schools was validated by a team of experts in nursing profession and then tested among 39 nursing students of UR- Huye Campus (representing 10% of participants in the main study). Nursing students who participated in the model testing showed a high level of enthusiasm about the model of stress management. This study will benefit many people since it will be a tool showing how to manage stress among students at nursing schools of Rwanda.