CHAPTER ONE

1.0 INTRODUCTION

Stress is a feeling of emotional or physical tension. It can come from any event or thought that

makes an individual feel frustrated, angry, or nervous. Stress is an inevitable condition which is

widespread and occurs in various aspects of every human endeavor. Stress and its effects are

common phenomena which affect all manner of persons regardless of age, sex, socio-economic

status, political orientation, ethnicity, faith and career. Nowadays, students in tertiary educational

institutions are saddled with stress which can affect their academic performance (Akanpaadgi,

Binpimbu and Kuuyelleh, 2023).

1.1 BACKGROUND OF THE STUDY

The term “stress” describes external demands, either physical or psychological, on an

individual‟s physical and mental health. Stress is not just a stimulus or a response; rather, it is a

process of perceiving and coping with environmental events. Perceived and potential stress affect

students relatively often, making them vulnerable to psychological problems and impacts on

their physical well-being (Lin et al, 2020).

Stress is a negative construct that may be linked to many life-threatening situations. It may be

considered as an individual‟s reaction to demands made on the body or response to disturbing

events in the environment. Stress is an element of daily life an individual may feel pressured

when expectations are extremely high and cannot be achieved readily. Some levels of stress may

be motivating and helping in achieving a productive life. However excessive level of stressed

experienced over a long period of time may induce significant physical and psychological

problems (Abdullahi, Shah and Idris, 2020). Stress is a mental or physical feeling of tension. A

variety of accidents occur in the life of a person which leads to negative emotions such as anger,
 frustration and nervousness. Stress is the body's response to demand or threat. It could be

positive at times; however chronic stress can lead to severe health and academic challenge.

Stress levels can vary depending on how an individual react to a certain situation. Certain

citizens do not care and do not worry; they consider stress to be meaningless knock and live on.

In reality, some worry more than they should and affect their health (Vijayashree & Srinivasa,

2022).

Stress is the process by which an individual or a person reacts when opened to external or

internal problems and challenges. “the organism processes numerous systems to coordinate such

adaptive responses both at systematic and cellular levels “by this, stress has direct effect on the

brain and the whole anatomy of the body as such failure to adapt to a stressful condition can

result in brain malfunction, physiological problem and also many areas of psychological

challenge‟s in the form of depression, anxiety, pain and burnout (Richard, 2019).

1.2 STATEMENT OF THE PROBLEM

In the contemporary educational landscape, students encounter a multitude of challenges that can

significantly impact their academic performance. Among these challenges, stress emerges as a

prominent and pervasive factor that influences students' ability to succeed in their studies. The

relationship between stress and academic performance is complex and multifaceted. Students

face a wide range of stressors, including academic demands, social pressures, financial

constraints, and personal issues, all of which can contribute to heightened stress levels.

The deleterious effects of stress on various aspects of individuals' well-being have been well-

documented, but its specific impact on academic performance remains an area of ongoing

research and investigation. However, it has been established by previous studies that as stress

accumulates, it may lead to a variety of detrimental outcomes, such as decreased concentration,

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 impaired memory, reduced motivation, and compromised problem-solving abilities – all of

which can ultimately hinder academic achievement and increase school dropout rates (Pascoe,

Hetrick & Parker, 2019).

The Post Basic Nursing students of Jos University Teaching Hospital had experienced physical,

mental and social trauma as a result of their eviction from the hostels in August, 2023. The

researcher observed that the performance of the November, 2023 Nursing and Midwifery

Council examinations dropped in the four schools who previously recorded 100% each.

The researcher was motivated to write on the effects of stress on the academic performance of

Post Basic Nursing Students of JUTH because no one had written on this subject and it is a

problem that requires careful solution.

1.3 OBJECTIVE OF THE STUDY

The objectives of the study are:

1. To assess the factors responsible for stress among Post Basic Nursing Students in Jos University

Teaching Hospital

2. To determine the perceived effects of stress on academic performance among Post Basic Nursing

Students in Jos University Teaching Hospital.

3. To identify the strategies in coping with stress by the students of Post Basic Nursing Schools in

Jos University Teaching Hospital.

1.4 RESEARCH QUESTIONS

1. What are the factors responsible for stress among Post Basic Nursing Students in Jos University

Teaching Hospital?

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 2. What are the perceived effects of stress on academic performance of Post Basic Nursing Students

in Jos University Teaching Hospital?

3. What are the strategies adopted by the students in coping with stress at Post Basic Nursing

Schools of Jos University Teaching Hospital?

1.5 SIGNIFICANCE OF THE STUDY

This research is on the effect of stress on academic performance of Post Basic Nursing students,

Jos University Teaching Hospital. In today's fast-paced and competitive educational

environment, students face numerous stressors that may significantly impact their ability to

perform well academically.

To the students: Despite the prevalence of stress among students, there is a lack of

comprehensive understanding regarding the specific stressors that affect academic performance

and the mechanisms through which stress influences students' ability to succeed in their studies.

This study aims to enlighten students and improve their understanding on this issue.

To Health workers: Understanding the mechanisms through which stress affects academic

performance is crucial for educators, administrators, and policymakers seeking to create

supportive and conducive learning environments for students especially in the Post Basic

Nursing Schools. By identifying the specific stressors that impact students and exploring the

underlying psychological, physiological, and behavioral pathways through which stress

influences academic performance, interventions, and strategies can be developed to mitigate the

negative effects of stress and foster optimal academic outcomes. This would undoubtedly be

beneficial to nursing education in Nigeria and beyond. This study also seeks to contribute to the

existing body of knowledge on student well-being and academic-success.

To the society: The findings of this research have the potential to inform educational practices

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 and interventions in our country, that prioritize students' mental health and well-being, fostering

an environment that supports their academic growth and overall flourishing.

1.6 SCOPE OF THE STUDY

The study is on assessment of the effects of stress on academic performance among students of

Post Basic Nursing Schools in Jos University Teaching Hospital.

1.7 OPERATIONAL DEFINITION OF TERMS

Academic Performance: Connected with education, especially studying in schools and

universities.

Assessments: This is the state of measuring students‟ educational performance

Effect: This is the consequences of any or group of stressors on the student academic

performance.

Post Basic Nursing: it is a program designed to inculcate an in-depth understanding of advanced

level nursing.

Stress: Pressure put on something that can damage it or lose its shape.

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 CHAPTER TWO

LITERATURE REVIEW

2.1 INTRODUCTION

With the increasing demand for education at all levels, stress is widespread. It is well known that

students can be negatively impacted by stress, the effects include their performance on tests,

class participation, and overall well-being. Existing research shows that the prevalence of stress

is increasing among students receiving higher education.

This chapter deals with literature review; in which relevant literatures about the topic, journals

and Internet will be searched for and will be discussed under the following sub heading:

Conceptual framework, theoretical framework and empirical studies.

2.2 CONCEPTUAL EVIEW

Stress refers to any changes that cause physiological or psychological strain. Stress is

conceptualized as three components: stressors, stress response, and transaction. Stressors are

stimuli or changes in the environment, and they can be major life events or daily hassles. Stress

response refers to a person‟s physical or psychological response to stressors. A transaction or a

process involves constant interaction and modification between a person and their environment,

where each influences the other. Stimuli or reaction does not solely determine stress effects.

Instead, the individual can directly affect the magnitude of the stressor‟s impact by utilizing

behavioural, cognitive, and emotional strategies. It has been shown that how students cope with

academic-related stress may influence their ability to succeed academically during the study

period. It is important to note that the strategies that students choose to cope with stressful

situations impact their experience of stress, and if these strategies are ineffective, stress will

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 persist. Therefore, developing an effective stress control strategy is essential for all students

(Jiayu, 2023).

2.2.1 CONCEPT OF STRESS

According to Abdullahi, et al. (2020), Stress is one of the basic principles that were implemented

in the education line recently which affects both individuals ' physical and psychological well-

being. Stress emerges when the blend of inside and outer weights surpasses the person's ability to

adapt to their circumstances.

According to the World Health Organization (2020), stress is a vital concern of our times, which

affects both individuals ' physical and psychological well-being.

Stress is the most undermined syndrome in our society that is ignored as it is linked with the

component of mental health. Relationships with friends and significant others can also be

stressful. The relationship between students and lecturers can also be a source of stress where

this relationship has a strain. In addition, many students are experiencing financial stress in

school which had developed into lowered attainment, lowered sense of belonging, increased risk

of non-continuation and poor mental health. It entails the struggle to find enough money to pay

for tuition and to obtain the funds needed to cover the cost of living while in school. Academic

stress presents a lot of challenges for society as it hinders students from gaining full intellectual

knowledge that is needed to advance development and growth in society, so academic stress is a

problem for both students and society (Abdullahi, et al, 2020).

Brobbey (2021), in his literature posits that "people claim they are stressed when taking an exam,

when facing a stressful job situation or when experiencing problems in relationships". Stressful

situations can be regarded as harmful, dangerous or difficult. It is difficult, with so many factors

contributing to stress. The definition of stress is difficult to describe.

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Hachintu and Kasisi (2022) were of the opinion that the word stress brings about the thoughts of

depression, anxiety and other potentially life-threatening conditions in the mind of an individual.

Every person is exposed to stress at some point in their lives, and it is an inevitable part of a

student‟s life as it takes a toll on their emotional well-being, academic performance as well as

their physical health.

Stress is a state of an individual that results from the communication of the individual with the

environment which seems intimidating or a threat to their well-being. Although some degree of

stress is vital to inspire and motivate individuals to achieve their goals, stress can be a barrier for

focusing, problem solving, decision making and other essential capacities for students‟ learning

(Hachintu and Kasisi, 2022).

Abdullahi et al (2020), is of the opinion that stress is an inevitable and natural component of

college students‟ daily life that face the difficulties of campus life. The school transition has

always been another stressor, which requires adaptation to a new social and academic

environment. College life is a major transition because the students are free to decide what to do

without the undue influence of their parents. If stress is not dealt effectively, feelings of

loneliness and nervousness, as well as sleeplessness and excessive worrying may result.

Furthermore, the major sources of stress includes; change in sleeping habits, vacation and breaks,

change in eating habits, increased workload, and new responsibilities. Based on the finding, if

the stress levels among students is higher, the performance of the student will have lessened in

terms of academic accomplishments and can affect both the physical and mental health of

students.

Stress has become an important subject in research studies in academia as well as in our society.

Academic stress in students has long been the subject of research and researchers have

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 recognized various important stressors including missions, unhealthy competition among

students in the class, fear of failure in academic success, inadequate finances, poor interpersonal

relationships with teachers and family issues (Brobbey, 2021).

CAUSES OF STRESS

According to Baluwa, Lazaro, Mhango, and Msiska (2021), nursing students are also stressed by

external factors such as accommodation and financial problems, as well as relationships with

their peers and relatives.

2.2.2 STUDENTS’ ACADEMIC PERFORMANCE

Students‟ academic performance is a key characteristic of education. It is considered to be the

center around which the entire education system evolves. Some factors influencing high

academic achievement include daily hours of study, parents' economic status and good learning

facilities. Students face challenges in their studies due to the ineffective use of these factors to

improve academic performance (Brobbey, 2021).

Abdullahi et al (2020) citing a definition of academic performance according to the Cambridge

University Reporter 2003, which was defined in terms of examination performance. In the study

academic performance was characterized by the overall performance in each year which

culminates in a Grade Point Average (GPA). The GPA score would consider students‟

performance in tests, course work and examinations. Additionally, academic performance is

generally used to determine how well an individual student is able to assimilate, retain,

reproduce, recall and communicate his/her knowledge of what has been learnt which usually is

measured by examination or continuous assessment.

According to Brobbey (2021), academic stress occurs when the academic demands exceed the

resources available to a person whom he or she adapts and this stress should not be ignored

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 because it negatively affects the general adjustment of students. Stress can negatively affect a

student's academic performance, so it is important for students to manage stress in order to

overcome the negative effect of stress.

2.2.3 FACTORS RESPONSIBLE FOR STRESS

Stress may occur in the daily life of a person in different ways. It is a prevalent issue that at some

stage it affects a student‟s life. A College student is subjected to many problems from family,

financial, peers and campus life. Different stressors and a high level of stress could impact the

performance of the students. Therefore, stress is the body‟s nonspecific response mechanism

towards demands or strains made on itself of the environment. It is a process by which a person

reacts and adjusts to environmental threats and new conditions challenges (Abdullahi et al 2020).

Academic stress occurs when the academic demands exceed the resources available to a person

whom he or she adapts and this stress should not be ignored because it negatively affects the

general adjustment of students. Stress can negatively affect a student's academic performance,

so it is important for students to manage stress in order to overcome the negative effect of stress

(Brobbey, 2021).

According to Sampson (2023), people react differently to stressful situations. What is stressful

for one person may not be stressful for another, and almost any event can potentially cause

stress. For some people, just thinking about a trigger or several smaller triggers can cause stress.

There is no identifiable reason why one person may feel less stressed than another when facing

the same stressor. Mental health conditions, such as depression, or a building sense of frustration,

injustice, and anxiety can make some people feel stressed more easily than others. Previous

experiences may affect how a person reacts to stressors. Common major life events that can

trigger stress include:

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 job issues or retirement

 lack of time or money

 bereavement

 family problems

 illness

 moving home

 relationships, marriage, and divorce

 Other commonly reported causes of stress are:

 abortion or pregnancy loss

 driving in heavy traffic or fear of an accident

 fear of crime or problems with neighbors

 pregnancy

 excessive noise, overcrowding, and pollution

 uncertainty or waiting for an important outcome

Students experience stress due to various factors including time management issues, financial

issues, interaction with teachers, personal subjective goals, social behavior and adjustment in

lack of cultural support. Admission process, curriculum with complex concepts, unsuitable

school hours, unbalanced student-teacher relationship, physical classroom environment,

unhealthy student-teacher interaction, strict and fast discipline rules, too many tasks or complex,

teaching methodology, the careless attitude of the teacher and the emphasis on weaknesses rather

than recognizing strengths (Brobbey, 2021).

Brobbey (2021), further classified factors that contributes to stress to include; health, social and

academic factors. The health factors include; sleep pattern, exercise and nutrition. Social factors

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 according to Brobbey include; finance, family and social support, and problem with roommate.

The academic factors in-turn involves management of time, finance, and course overload.

2.2.4 EFFECTS OF STRESS ON STUDENTS’ ACADEMIC PERFORMANCE

Stress may affect student achievement either negatively or positively. First, if the students cannot

cope with these stresses and overcome them, they may negatively affect their academic

performance, leading to a failure to complete tasks and achieve high grades. High pressure can

lead to a decrease in academic performance and then a decline in degrees.

According to Brobbey (2021), stress is an explosion of energy that basically advises you on what

to do. Stress has many benefits in small doses. For example, stress can help an individual

overcome daily challenges and motivate that individual to reach his/her goals. In fact, stress can

help them do things more effectively. It can even increase memory. Stress is also a vital alert

system, which produces the fight or flight response. When the brain detects a certain type of

stress, it begins to flood the body with chemicals such as epinephrine, norepinephrine and

cortisol. This creates a variety of reactions, such as an increase in blood pressure and heart rate.

In addition, the senses suddenly have a laser-like focus so that you can avoid situations of

physical stress, such as jumping out of a moving car and being safe. In addition, there are several

health benefits with a little stress. Researchers believe that some stress can help strengthen the

immune system. For example, stress can improve the functioning of your heart and protect your

body from infection. Brobbey (2021) also noted that stress can have a plethora of negative

effects. According to him stress worsens grades; when a student is stressed and worried, it takes

charge of his ability to concentrate during lessons or studies. Stress can even cause students to

drop out of school or stop school. The National Health Assessment 2010 of the American

University Health Association reported that more than twenty-five percent of students say that

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stress has reduced their grades or the ability to complete a course. For students experiencing

stress at home, attending school homework may not be a priority. As the research shows, the

stress exhibited by instructors directly increases the stress level of students in the classroom.

Stressors can appear at any time to interrupt learning and concentration. It is vital for educators

to recognize the significant impact of stress on adolescents and young adults and to work to

create a calm and supportive educational environment. School administrators who want their

students to be academically successful should regularly check on students and refer students to

mental health counselors and programs if necessary, and inform families of the negative impact

of stress on students. Stress decreases the quality of sleep: there is a link between stress levels

and lack of sleep. According to the Anxiety and Depression Association of America, 70% of

those who report persistent stress have trouble sleeping. The National Sleep Foundation reports

that teens need at least eight hours of sleep to function at peak performance, but only about 15%

of teens get enough. Lack of sleep makes stress management difficult, while negatively affecting

concentration, learning, listening, memory and problem solving. Additionally, stress can be to

blame for students who are likely to intimidate others. The Mayo Clinic reports that stress

increases feelings of irritability and anger, increasing the likelihood of outbursts and social

withdrawal. In addition to directing anger at fellow students, stressed students may be reluctant

to follow school guidelines and engage respectfully with the instructors.

Persistent stress from various sources often affects health of students and could lead to

psychological distress and psychosomatic illness. The perception of stress and ability to handle

stress is largely determined by the coping styles used by the students. The students who perceive

their stress levels as very high and are not able to cope effectively with the situation may often

become prey to many physical and psychological health issues (Nebhinani, Kumar, Parihar and

Rani, 2020).

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Pompilus and Pompilus (2021), academic-related stress clearly reduces academic performance as

well as decreasing motivation to complete school assignments. Also, lack of motivation caused

by stress is one of the factors related to the increasing dropout of student dropout of classes and

schools. In addition, unmanageable stress is significantly affecting academic performance as well

as one of the leading causes of students drop out of classes and school. As indicated throughout

this paper, research studies have shown that stress from a variety of venues strongly affects

student academic performance as well as showing stress exhibited by student family social

economic conditions and instructors‟ academic expectations also increases the stress levels of

students on and off campus. When stress is unbearable on students, it can negatively affect

cognitive functioning and academic performance including sleep and social activities; however,

it is primarily found among students from low socioeconomic status backgrounds. For those

reasons, the impact of stress on academic performance varies among ethnic groups as one of the

contributing factors to racial-ethnic and socioeconomic achievement gaps among both developed

and under-developed nations.

Pompilus et al (2021), opines that at late adolescence and emerging adulthood are transitional

periods marked by major physiological and psychological changes, including elevated stress.

This pattern is particularly true for college students. According to a 2015 American College

Health Association-National College Health Assessment survey, three in four college students

self-reported feeling stressed, while one in five college students reported stress-related suicidal

ideation; American Psychological Association, 2020). Studies show that a stressor experienced

in college may serve as a predictor of mental health diagnoses. Indeed, many mental health

disorders, including depression, anxiety, and substance abuse disorder, begin during this period.

Stress experienced by college students is multi-factorial and can be attributed to a variety of

contributing factors. A growing body of evidence suggests that academic-related stress plays a

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significant role in college. For instance, as many as 87% of college students surveyed across the

United States cited education as their primary source of stress (American Psychological

Association, 2020). College students are exposed to novel academic stressors, such as an

extensive academic course load, substantial studying, time management, classroom competition,

financial concerns, familial pressures, and adapting to a new environment. Academic stress can

reduce motivation, hinder academic achievement, and lead to increased college dropout rates.

Academic stress has also been shown to negatively impact mental health in students (Pompilus et

al, 2021). Mental, or psychological, well-being is one of the components of positive mental

health, and it includes happiness, life satisfaction, stress management, and psychological

functioning. Positive mental health is an understudied but important area that helps paint a more

comprehensive picture of overall mental health. Moreover, positive mental health has been

shown to be predictive of both negative and positive mental health indicators over time. Further

exploring the relationship between academic stress and mental well-being is important because

poor mental well-being has been shown to affect academic performance in college. Perception

of academic stress varies among different groups of college students. For instance, female

college students report experiencing increased stress than their male counterparts. Male and

female students also respond differently to stressors. Moreover, compared to their cisgender

peers, non-binary students report increased stressors and mental health issues. The academic year

of study of the college students has also been shown to impact academic stress levels. While

several studies indicate that racial/ethnic minority groups of students, including Black/African

American, Hispanic/Latino, and Asian American students, are more likely to experience anxiety,

depression, and suicidal tendencies than their white peers, these studies are limited and often

report mixed or inconclusive findings. Therefore, more studies should be conducted to address

this gap in research to help identify subgroups that may be disproportionately impacted by

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academic stress and lower wellbeing. The coronavirus disease 19 (COVID-19) pandemic is a

major stressor that has led to a mental health crisis (American Psychological Association, 2020).

For college students, the COVID-19 pandemic has resulted in significant changes and

disruptions to daily life, elevated stress levels, and mental and physical health deterioration

(American Psychological Association, 2020). While any college student is vulnerable to these

stressors, these concerns are amplified for members of minority groups. Identifying students at

greatest risk provides opportunities to offer support, resources, and mental health services to

specific subgroups. The overall aim of this study was to assess academic stress and mental well-

being in a sample of college students. Within this umbrella, we had several goals. First, to

determine whether a relationship exists between the two constructs of perceived academic stress,

measured by the Perception of Academic Stress Scale (PAS), and mental well-being, measured

by the Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS), in college students.

Second, to identify groups that could experience differential levels of academic stress and mental

health. Third, to explore how the perception of the ongoing COVID-19 pandemic affected stress

levels. We hypothesized that students who experienced more academic stress would have worse

psychological well-being and that certain groups of students would be more impacted by

academic- and COVID-19- related stress.

According to Akanpaadgi, Binpimbu and Kuuyelleh (2023), Stress among students of higher

educational institutions appear to be more prevalent now than ever with some of the causes being

poverty, information overload, unrealistic expectations, poor time management and lack of

infrastructure for recreation. Students of tertiary institutions may be looking forward to an

opportunity to have some excitement since they are no longer under the strict supervision of

parents and school authorities because they are considered as adolescents; however, life in

tertiary educational institutions can be very stressful due to high cost of living, difficult

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 relationships, lack of guidance and over indulgence. Besides, there is so much to be done within

a short period leaving very little time for extracurricular activities which further exacerbates

stress. Stress can be a catalyst to good academic performance if properly managed; but can also

be a waterloo to students when not properly handled as some students have suffered depression,

high blood pressure, migraine and stroke. Students‟ ability to manage stress determines their

academic performance. Those who are able to effectively manage stress tend to perform better

than those who are not. Stress has generated a lot of interest in recent times especially among

members of academia. As a result, some studies have been done on the impact of stress on

students‟ academic performance.

2.2.5 STRATEGIES USED IN DEALING WITH STRESS

Fewer number of research studies have been conducted worldwide to address this important

issue. Further, the decreasing resilience and increasing referrals of nursing students for

psychiatric consultation indicate that this group of population experience considerable stress.

According to Jiayu (2023), stress management requires the ability of coping. Coping can be

viewed as a critical process in managing stress. Individuals use cognitive and behavioural

strategies to manage internal and external stressors. It has been established that there are two

types of coping strategies: approach coping and avoidance coping. Approach coping involves

focusing on the problem and controlling or eliminating stressors through cognitive and

behavioural strategies. By practicing avoidance coping, people tend to avoid thinking about the

source and effects of stress and focus on their emotions instead. Coping is a critical factor in

reducing, minimizing, or tolerating stress. In addition, it is critical to prevent negative academic

results due to stress. Avoidance coping may sometimes be beneficial in the short term. However,

long time, it can lead to increased stress, more intense negative emotions, and impairments in

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academic performance. According to research, cognitive avoidance may adversely affect

academic achievement. Evidence shows that students who refuse to address their emotional or

psychological problems are more likely to respond to stress mal-adaptively. There are several

ways in which these responses can be manifested, including drug use and diets that are harmful

to health. Therefore, knowing both coping strategies and considering which is most effective in a

given situation is worthwhile. Self-efficacy is generally increased when stress is dealt with

positively. As a result, the person may feel more motivated and succeed tremendously, resulting

in improved quality of life and greater mental and physical well-being. A high level of self-

efficacy is significant among college students since self-efficacy is more motivational and is

known to increase the achievement of goals. Promoting academic self-efficacy makes students

more likely to read textbooks, ask questions in class, and conduct independent study.

According to Baluwa, et al, (2021) in terms of coping, problem solving and staying optimistic

have been revealed to be common strategies in alleviating stress and helping students cope with

demands of the nursing program.

Baluwa et al (2021) mentioned that common coping strategies used among nursing students were

active coping and planning. Active coping strategies such as problem-solving skills have also

been reported. The use of active coping strategies among these students signifies positive attitude

and adaptation to stress despite learning in resource constrained clinical environments. The

literature recommends that teachers should encourage the use of proven interventions to

effectively cope with stress. The use of active strategies such as development of professional

competency, correcting mistakes, confronting stressful situations and reflecting on stressful

issues have been found to be helpful. Faculty members should reinforce the use of these

strategies to overcome stressful situations in this context.

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Scott (2023) deduced ten (10) strategies of dealing with stress as follows;

Get Enough Sleep: Students, with their packed schedules, are notorious for missing sleep.

Unfortunately, operating in a sleep-deprived state puts an individual at a distinct disadvantage.

They are less productive, may find it more difficult to learn, and may even be a hazard behind

the wheel. Research suggests that sleep deprivation and daytime sleepiness are also linked to

impaired mood, higher risk for car accidents, lower grade point averages, worse learning, and a

higher risk of academic failure.

Use Guided Imagery: Guided imagery is a useful and effective tool to help stressed students

cope with academic, social, and other stressors. Visualizations can help you calm down, detach

from what‟s stressing you, and reduce your body‟s stress response.

Exercise Regularly: One of the healthiest ways to blow off steam is to get regular exercise.

Research has found that students who participate in regular physical activity report lower levels

of perceived stress. While these students still grapple with the same social, academic, and life

pressures as their less-active peers, these challenges feel less stressful and are easier to manage.

Take Calming Breath: Because they are fast-acting, breathing exercises are a great way to cope

with moments of acute stress, such as right before an exam or presentation. But they can also

help manage longer-lasting stress such as dealing with relationships, work, or financial problems.

Practice Progressive Muscle Relaxation (PMR): This technique involves tensing and relaxing

all muscles until the body is completely relaxed. With practice, you can learn to release stress

from your body in seconds.

Listen to Music: Research has found that playing upbeat music can improve processing speed

and memory. Stressed students may find that listening to relaxing music can help calm the body

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and mind. One study found that students who listened to the sounds of relaxing music were able

to recover more quickly after a stressful situation.

Build your Support Network: One way to combat feelings of loneliness and make sure that you

have people to lean on in times of need is to expand your support network and nurture your

relationships.

Eat a Healthy Diet: A healthy diet can help combat stress in several ways. Improving your diet

can keep you from experiencing diet-related mood swings, light-headedness, and more.

Unfortunately, students are often prone to poor dietary habits. Feelings of stress can make it

harder to stick to a consistently healthy diet, but other concerns such as finances, access to

cooking facilities, and time to prepare healthy meals can make it more challenging for students.

Find ways to Minimize Stress: This might mean cutting some extracurricular activities out of

your schedule. It might mean limiting your use of social media. Or it might mean learning to say

no to requests for your time, energy, and resources. While it might be challenging at first,

learning how to prioritize yourself and your mental well-being is an important step toward

reducing your stress.

Try Mindfulness: mindfulness involves becoming more aware of the present moment. Rather

than judging, reacting, or avoiding problems, the goal is to focus on the present, become more

aware of how you are feeling, observe your reactions, and accept these feelings without passing

judgment on them (Scott, 2023).

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2.3 THEORETICAL FRAMEWORK

Lazarus Stress theory (1984)

Lazarus states that stress is experienced when a person perceives that the “demands exceed the

personal and social resources the individual is able to mobilise.” This is called the 'transactional

model of stress and coping. Lazarus‟s transactional theory of stress and coping is an appraisal

theory rooted in the assumption that individuals assign subjective meaning to an event, and

subjective meaning, influenced by macro- and micro-level factors, elicits specific response

patterns and emotions. Major theoretical propositions include the interactive nature of person-

environment-outcome evaluation and the role of cognition in engaging in effective coping to

mediate those transactions. The transactional theory of stress and coping emphasizes the role of

constant evaluation in a dynamic person-environment relationship.

Neither the environmental event nor the person‟s response defines stress, rather the individual‟s

perception of the psychological situation is the critical factor. According to Lazarus, the effect

that stress has on a person is based more on that person‟s feelings of threat, vulnerability and

ability to cope than on the stressful event itself. He defines psychological stress as a "particular

relationship between the person and environment that is appraised by the person as taxing or

exceeding his or her resources and endangering his or her wellbeing."

Primary Appraisal - When we decide if a situation is threatening or positive, relevant or

irrelevant to our situation. There are three things needing to be evaluated:

 Is the threat significant to that person?

 Is it a positive encounter?

 Is it threatening/harmful/challenging.

21
 If an individual decides that the situation is threatening the following may occur: injury, illness,

angry, disgust, disappointment, worry, anxiety, a fear response, a challenge or anticipation.

Secondary Appraisal - When we assess what resources are available to us to help combat or

cope with the stressor. An individual may choose to use:

 Internal Options: will-power, inner strength, or

 External Options: peers, professional help.

Problem-Based Coping - Used when we feel we have control over the situation, thus can

manage the source of the problem. There are four steps to manage this stress:

 Define the problem,

 Generate alternative solutions

 Learn new skills to dealing with stressors

 Reappraise and find new standards of behaviour.

 Emotional-Based Coping - Is used when an individual feels as if they cannot manage the

source of the problem. Involves gaining strategies for regulating stress.

2.3.1 APPLICATION OF THE THEORY TO THE STUDY

We experience stress when the demands of a situation exceed our capacity to deal with. The fact

that there is a great deal of stress among Nursing students. This theory describes how stress is

appraised by the Nursing students; it shows ways in which it can assist in identifying internal and

external sources associated with Nurses‟ performances on academic excellence. It also shows

how we think about them and the emotions that arise from those thoughts determine whether a

situation results in harmful stress to the individual.

22
2.4 EMPIRICAL REVIEW

Brobbey (2021) conducted a study on “the impact of stress in the academic performance of

students in the university of Cape-coast using a quantitative descriptive cross-sectional research

design”. The data collected and analyzed were driven from the three (3) research questions

posed. A sample size of 100 from a population of over one-thousand (1,000) was used due to the

COVID-19 pandemic. From the findings, it was discovered that academic stress could be

controlled to enhance students‟ performance. The study discovered that by educating students on

how to manage stress, staying focus, having enough rest, exercising a lot and effective time

management can help to manage stress in order to enhance students‟ academic performance.

Study conducted by Akanpaadgi, Binpimbu and Kuuyelleh (2023), on the impact of stress on

students‟ academic performance”. This study assessed the impact of stress on the academic

performance of students in the Bolgatanga Technical University. It investigated the causes of

stress, the symptoms of stress, the effects of stress and how students can overcome stress. The

quantitative research strategy was used for the study. The research data collection was preceded

by a literature review to provide an in-depth understanding of the research topic. A structured

questionnaire designed in the form of a Likert Scale was administered to One Hundred and Forty

(140) students who were the participants of the study. The data was analyzed using the Statistical

Package for Social Sciences (SPSS) and the results were presented in the form of descriptive

statistics using the Relative Importance Index (RII). The study revealed that several factors

namely high cost of living, poor time management, limited facilities, difficult relations and the

workload caused stress among students of the Bolgatanga Technical University. It was

concluded that stress has a negative impact on the academic performance of students. The study

recommends that the guidance and counseling department of the university should be

strengthened to make it more effective in supporting students to overcome stress. In addition,

23
guidance programmes such as seminars and public lectures on stress awareness should be

organized periodically for students so that they can be adequately equipped with the needed

skills to handle issues related to academic stress better. Finally, provision should be made in the

curriculum for adequate time for students to rest by not allowing lectures to extend to weekends.

Kamal and Amardeep (2019) on “Factors of Stress Amongst Students of Professional Institutes”.

The study was conducted to identify factors of stress amongst (n = 428) students of the age group

of 18 years - 23 years studying in various professional institutes in the state of Punjab. There

were 243 (56.77 %) boys, while 185 (43.22%) were girls. Data were collected by using a self-

administered questionnaire through convenience sampling method from Gurdaspur, Amritsar,

Jalandhar, Ludhiana, and Chandigarh ; 58% of the students (248) belonged to the graduate

courses such as [Link], B. Tech, BBA, BCA, LLB and 42% (180) of the students belonged to the

post graduate courses such as MBA, M. Tech, MCA, and [Link]. The time period of the study

was January - May 2018. Eight factors were extracted through factor analysis. The total variance

explained was 68.13%. The first factor extracted was Daily Grind (13.308%) followed by

Academic Pressure (11.653%), Peer Pressure (11.269 %), Family Pressure (7.746%), Personal

Complexes (6.971%), and Financial Pressure (4.747%). There were three factors which seemed

different relatively in terms of previous literature such as Daily Grind (13.308%), Procrastination

(6.666%), and Materialism (5.780%). This indicated that the daily activities and chores amongst

students were also a cause for huge stress due to time constraints. Further, the students who kept

on delaying or postponing things for later got stressed out when work piled up. It was also

observed that the increasing association of good living with materialistic things or money also

gave rise to stress and depression amongst students.

Nebhinani et al (2020) carried out a study on stress and coping strategies among undergraduate

nursing students in western Rajasthan. Two hundred and twenty-one (221) undergraduate

24
nursing students were recruited for the study through total enumeration. Standardized Student

Nurse Stress Index and brief cope scale were used to assess stress and coping strategies. Result

revealed nearly 82.4% of the students reported moderate level of stress. Interface worries (mean

score 17.88 ± 4.9) and academic load (mean score 17.6 ± 4.78) were the major source of

perceived stress. Students considered attitude of other professionals toward nursing, lack of free

time, and fear of examination as most likely reasons of their distress. Active coping was the most

commonly used coping strategies. Level of stress was found to have significant association with

the interest of students in nursing.

25
 CHAPTER THREE

3.0 METHODOLOGY

This chapter contains the study design, research setting, study population, sampling procedure,

sample size, data collection procedures, inclusion and exclusion criteria, instruments for data

collection, validity, reliability, method of data analysis and the ethical considerations.

3.1 DESIGN

The researcher adopted a descriptive cross sectional design to assess the effect of stress on

academic performance among students of Post Basic Nursing Schools in Jos University Teaching

Hospital. A descriptive cross-sectional study inspects the prevalence of a disease or condition in

a defined population at a specific point or period in time without attempting to draw any

inferences or offer any causes for prevalence (Glasziou, 2024).

3.2 RESEARCH SETTING

The Jos University Teaching Hospital was established by an act of parliament in 1981 by the

then Alhaji Shehu Shagari administration. The Hospital was first established as a General

Hospital, it moves to its permanent site in Lamingo, the present location in December, 2009.

The study will be conducted at Jos University Teaching Hospital Plateau State. The setting is a

Tertiary Health Institution, which is located in Lamingo village of Jos North Local Government

Area of Plateau State, Bounded in the North by Zarazon and to the west by Lamingo town,

particularly the Palace of Adagwon of Izere and Lamingo Primary Health Care Centre (PHC).

The hospital has various units and department of surgery operation services for post-surgical

patient; Surgical Out Patient Department (SOPD) with their different clinic days in

26
 Orthopaedics, Neurological Clinics, Ophthalmic, Plastic Unit, Ear, Nose and Throat (ENT)

Clinic, Obstetrics and Gynaecology out patient‟s department (O&G) respectively.

The hospital has four (4) accredited schools of Post Basic Nursing Schools registered to its name.

The schools conduct its class activities at the old site of the teaching hospital located at

Terminus, Jos and clinical experiences are spread out between Bingham University Teaching

Hospital (BhUTH), Jos University Teaching Hospital (JUTH), Plateau State Specialist Hospital

(PSSH) and other secondary health facilities.

3.3 TARGET POPULATION

NAME OF SCHOOL NUMBER OF STUDENTS

POST BASIC NURSING ANAESTHESIA 42

POST BASIC NEPHROLOGY NURSING 19

POST BASIC PERIOPERATIVE NURSING 26

POST BASIC CRITICAL CARE NURSING 27

TOTAL 114

3.4 SAMPLING TECHNIQUE

The researcher adopted the census sampling technique as the researcher used the total population

for the study.

3.5 SAMPLE SIZE

The researcher used the entire population for the study. This is according to the First Rule of

Thumb which states that, „in extreme scenario, a researcher would include the whole population

27
 of interest in the study sample. In this case, the sample is the population and is therefore the best

representation of the population‟ (J-PAL, 2017).

3.6 INSTRUMENT FOR DATA COLLECTION

A self-structured questionnaire was used to gather data from the respondents. The questionnaire

was structured to provide answers to the research questions.

The instruments was divided into four sections; A, B, C and D.

Section A: Bio data of the respondents

Section B: Factors responsible for stress

Section C: Perceived effects of stress on academic performance among Post Basic Nursing

Students in JUTH,

Section D: Strategies use by Post Basic Nursing Student, JUTH in dealing with stress.

.3.7 INCLUSION CRITERIA

Data is collected from all Post Basic Nursing students of Jos University Teaching Hospital

graduating in November, 2024.

3.8 EXCLUSION CRITERIA

All those who did not fall into the category of the study as well as those who do not volunteer to

participate or were absent.

3.9 VALIDITY OF THE INSTRUMENT

The developed questionnaire was scrutinized by the Project Supervisor for face and content

validation and final corrections were made.

28
3.10 RELIABILITY OF THE INSTRUMENT

A pilot study was done by administering 12 i.e., 10% of the questionnaire on selected students of

Post Basic Midwifery Jos campus within one week and a return of the researcher to the same

population to give them the questionnaire. This is to ensure consistency of the questionnaire.

3.11 METHOD OF DATA COLLECTION

A self-structured questionnaire was administered to the respondents through electronic link. The

data were collected within one week.

3.12 METHOD OF DATA ANALYSIS AND PRESENTATION

The Micro-Soft Excel software was used in the data analysis. Quantitative data were coded,

sorted and entered into the computer. The data was then subjected to descriptive statistical

analysis and results obtained were presented on frequency tables and charts.

3.13 ETHICAL CONSIDERATIONS

An introductory letter was collected from the Coordinator, School of Post Basic Nursing

Anaesthesia, Jos University Teaching Hospital and presented to the ethical committee of Jos

University Teaching Hospital for ethical clearance.

Participation in the study was voluntary and informed consent was obtained from the

respondents by explaining every detailed information to the respondents.

29
 CHAPTER FOUR

DATA PRESENTATION AND ANALYSIS

4.0 INTRODUCTION

A total of 114 respondents received the link to the questionnaires. 109 questionnaires were

accurately completed, retrieved and analyzed. The respondents were Post Basic Nursing students

of Jos University Teaching Hospital, Plateau State.

(Instrument return rate=96%).

SECTION 'A': SOCIO-DEMOGRAPHIC DATA

Table 1: Showing distribution of respondents’ socio-demographic information. n=109

GENERAL FREQUENCY PERCENTAGE

CHARACTERISTICS (N) (%)

Gender Male 39 35.8%

Female 70 64.2%
TOTAL 109 100%

Age of respondents Less than 25 years 15 13.8%

25 - 30 years 31 28.4%

31 – 35 years 20 18.3%

36 – 40 years 15 13.8%

41 – 45 years 15 13.8%

46 years and above 13 11.9%

30
TOTAL 109 100%

Designation of respondents School of Post 41 37.6 %

Basic Nursing

Anaesthesia

School of Post
25 22.9%
Basic

Perioperative

Nursing

School of Post 26 23.9%

Nursing

School of Post
17 15.6%
Basic Nephrology

Nursing

TOTAL 109 100%

Source: Field survey (2024).

Table 1 above shows the socio-demographic distribution of the respondents. Results deduced

shows that the respondents 70 (64.2%) are females, while 39 (35.8%) are males. The age

distribution shows that the respondents who are less than 25 years are 15 (13.8%), 25 – 30 years

31 (28.4%), 31 – 35 years 20 (18.3%), 36 – 40 years 15 (13.8%), 41 – 45 years 15 (13.8%), 46

years and above 13 (11.9%). School of Post Basic Nursing Anaesthesia 41 (37.6 %), School of

31
Post Basic Perioperative Nursing 25 (22.9%), School of Post Basic Critical Care Nursing 26

(23.9%) and School of Post Basic Nephrology Nursing 17 (15.6%).

SECTION B: COMMON FACTORS RESPONSIBLE FOR STRESS AMONG POST

BASIC NURSING STUDENTS

Table 2: What are the factors responsible for stress?

VARIABLE FREQUENCY PERRCENTAGE (%)

Out of control debts 4 3.7%

Poor time management 6 5.5%

Examination 13 11.9%

Difficulty in organizing work 9 8.3%

Pressure of combining paid work and study 11 10.1%

Academic workload 25 22.9%

Peer pressure 17 15.6%

Family pressure 11 10.1%

Financial issues 13 11.9%

TOTAL 109 100 %

Source: Field survey (2024).

Table 2 above shows the common factors responsible for stress among Post Basic Nursing

Students in JUTH; out of control debts 4 (3.7%), poor time management 6 (5.5%), examination

13 (11.9%), difficulty in organizing work 9 (8.3%), pressure of combining paid work and study

32
 11 (10.1%), academic workload 25 (22.9%), peer pressure 17 (15.6%), family pressure 11

(10.1%) and financial issues 13 (11.9%).

Figure 1: Is the school environment conducive for learning?

YES
19
(17.4%)

NO
90
(82.6%)

Source: Field survey (2024).

Figure 1 shows 90 (82.6%) are not finding the School environment conducive for learning, while

only 19 (17.4%) are enjoying the environment.

Figure 2: Do you have hostel accommodation?

YES
18
(16.5%)

NO
91
(83.5%)

Source: Field survey (2024).

33
Figure 2 above shows that 91 (83.5%) are not having accommodation, while 18 (16.5%) are

having accommodation within the school premises.

Figure 3: If you have accommodation, is it comfortable?

15
16 (83.3%)

14

12

10

6
3
4 (16.7%)

0
YES NO

Source: Field survey (2024).

Figure 3 above shows 15 (83.3%) students are unsatisfied with the accommodation given to

them, while 3 (16.7%) students are comfortable with the accommodation.

34
Figure 4: Is daily routine responsible for stress among the students?

NO
11
(10.1%)

YES
98
Source: Field survey (2024). (89.9%)

Figure 4 above shows that 98 (89.9%) of the respondents agreed that daily routine is responsible

for stress among Post Basic student Nurses, while 11 (10.1%) disagreed.

Figure 5: Personal complexes are factors responsible for stress among students?

YES
97
(89%)

100

80

60 NO
12
40 (11%)
20

YES

NO
Source: Field survey (2024).

35
Figure 5: Showing 97 (89%) agreed that personal complexes are responsible for stress among

post basic student Nurses, while 12 (11%) disagreed that personal complexes are responsible

factors for stress among post basic student Nurses.

Figure 6: Previous experience affects person's reaction to stress?

NO
10 (9.2%)

YES
99
(90.8%)

Source: Field survey (2024).

Figure 6 above shows that 99 (90.8%) of the respondents agreed that previous experiences

affects how a person reacts to stress, while 10 (9.2%) disagreed.

36
SECTION C: PERCEIVED EFFECTS OF STRESS ON ACADEMIC PERFORMANCE

AMONG POST BASIC STUDENT NURSES IN JOS UNIVERSITY TEACHING

HOSPITAL

TABLE 3: What are the perceived effects of stress on the academic performance of Post

Basic Nursing Students?

S/N ITEMS SA A D SD

1 Reduces my work rate 61(56%) 34 (31%) 9 (8%) 5(5%)

95(87.2%) 14(12.8%)

2 Reduces my grade and ability to 49(45%) 55(50%) 4(4%) 1(1%)

3 Reduces my ability to read and 51(47%) 43(39%) 10(9%) 5 (5%)

4 Lack of concentration in class 70 (64%) 27 (25%) 8 (7%) 4(4%)

97(89%) 12(11%)

5 Decreases the quality of sleep 59 (54%) 41(38%) 3 (3%) 6 (6%)

100(91.7%) 9(8.3%)

6 Drop out of school 26(24%) 33 (30%) 47(43%) 3 (3%)

59(54.1%) 50(45.9%)

7 Increase in absenteeism from school 56(51%) 37(34%) 10(9%) 6(6%)

93(85.3%) 16(14.7%)

Source: Field survey (2024).

Table 3 above shows the various effects of stress on the academic performance of Post Basic

Nursing Students; 95(87.2%)of the respondents agreed that stress reduces their work rate but

37
14(12.8%) disagreed, 104(95.4%) agreed that it reduces theirgrade and ability to complete course

work, while 5(4.6%) disagreed, 94(86.2%) agreed that stress reduces their ability to read and

understand but 15(13.8%) disagreed, 97(89%) agreed that stress leads to lack of concentration in

class, while 12(11%) disagreed, 100(91.7%) agreed that it decreases their quality of sleep but

9(8.3%) disagreed, 59(54.1%) agreed that it could result in droping out of school while

50(45.9%) disagreedand 93(85.3%) agreed that it increases in absenteeism from school but

16(14.7%) disagreed.

SECTION D: STRATEGIES USED BY POST BASIC STUDENT NURSES IN DEALING

WITH STRESS

TABLE 4: What are the strategies used by Post Basic Student Nurses in dealing with

stress?

ITEMS SA A D SD

Fixing time daily for exercise 71(65%) 25(23%) 7(6%) 6(6%)

96(88.1%) 13(11.9%)

Starting academic tasks from simple to 69(63%) 25(23%) 9(8%) 6(6%)

Avoiding reading only when exams 72(66%) 28(26%) 6(6%) 3(3%)

Build your support network 88(81%) 12(11%) 7(6%) 2(2%)

100(91.7%) 9(8.3%)

Excursions, so as to enhance students 80(73%) 25(23%) 3(3%) 1(1%)

38
Get enough sleep 52(48%) 50(46%) 7(6%) 0

102(93.6%) 7(6.4%)

Take calming breath 54(50%) 39(36%) 9(8%) 7(6%)

93(85.3%) 16(14.7%)

Practice progressive muscle relaxation 38(35%) 51(47%) 12(11%) 8(7%)

89(81.7%) 20(18.3%)

Listen to music 42(39%) 60(55%) 5(5%) 2(2%)

102(93.6%) 7(6.4%)

Eat a healthy diet 41(38%) 49(45%) 12(11%) 7(6%)

90(82.6%) 19(17.4%)

Find ways to minimize stress 68(62%) 26(24%) 9(8%) 6(6%)

94(86.2%) 15(13.8%)

Try mindfulness 55(50%) 40(37%) 10(9%) 4($%)

95(87.2%) 14(12.8%)

Source: Field survey (2024).

Table 4 above shows the various strategies adopted by Post Basic Nursing students in dealing

with stress in JUTH; 96(88.1%) agreed that fixing time daily for exercise, 94(86.2%) starting

academic tasks from simple to complex, 100(91.7%) agreed that avoiding reading only when

exams comes close, 100(91.7%) agreed that building their support network, 105(96.3%) supports

the idea that excursions will enhance students brain cognitively, 102(93.6%) agreed that getting

enough sleep, 93(85.3%) taking calming breath, 89(81.7%) practicing progressive muscle

relaxation 102(93.6%) listening to music, 90(82.6%) eating healthy diets, 94(86.2%) finding

ways to minimize stress and 95(87.2%) try mindfulness respectively.

39
4.2 ANSWERING RESEARCH QUESTIONS

Research Question One: What are the factors responsible for stress among Post Basic

Nursing Students in Jos University Teaching Hospital?

The results obtained and presented on table 2, shows the common factors responsible for stress

among Post Basic Nursing Students in JUTH; 25 (22.9%) complaint of academic workload as a

major factor, while 4 (3.7%) responded that out of control debts being the least.

From figure 1, 90 (82.6%) are not finding the School environment conducive for learning, while

only 19 (17.4%) are enjoying the environment.

Figure 2 indicates that 91 (83.5%) are not having accommodation, while 18 (16.5%) are having

accommodation within the school premises.

Figure 3 shows 15(83.3%) of the students who are having accommodation within the school

premises are unsatisfied with it.

Figure 4 shows that 98 (89.9%) of the respondents agreed that daily routine is responsible for

stress among Post Basic student Nurses while 11 (10.1%) disagreed.

Figure 5 indicates that majority of the respondents, 97 (89%) agreed that personal complexes

were responsible for stress among post basic student Nurses, while 12 (11%) disagreed that

personal complexes were responsible factors for stress among post basic student Nurses.

Figure 6 shows that 99 (90.8%) of the respondents agreed that previous experiences affects how

students reacts to stress, while 10 (9.2%) disagreed.

Research Question Two: What are the perceived effects of stress on the academic performance of

Post Basic Nursing Students in Jos University Teaching Hospital?

From table 3; majority of the respondents agreed that stress reduces their work rate 87.2%,

95.4% agreed that it reduces their grade and ability to complete course work, 86.2% agreed

40
 strongly that stress reduces their ability to read and understand, 89% agreed that stress leads to

lack of concentration in class, 91.7% agreed that it decreases their quality of sleep, 54.1% agreed

that it could result in droping out of school and 85.3% agreed that it increases in absenteeism

from school.

Research Question Three: What are the strategies adopted by the students in coping with stress at

Post Basic Nursing Schools of Jos University Teaching Hospital?

It could be deduced from table 4 that there are various strategies adopted by Post Basic Nursing

students in dealing with stress in JUTH; 88.1% agreed that fixing time daily for exercise, 86.2%

starting academic tasks from simple to complex, 91.7% agreed that avoiding reading only when

exams comes close, 91.7% agreed that building their support network, 96.3% supports the idea

that excursions, will enhance students brain cognitively, 93.6% getting enough sleep, 85.3%

taking calming breath, 81.7% practice progressive muscle relaxation, 93.6% listening to music,

82.6% eating a healthy diet 86.2%, finding ways to minimize stress, while 87.2% trying

mindfulness.

41
 CHAPTER FIVE

DISCUSSION OF FINDINGS

5.0 INTRODUCTION

This chapter discussed the respondents view as it relates to stress. It also highlights the

implications of the study to nursing, limitations of the study were stated, recommendations and

suggestions for further studies were made.

5.1 KEY FINDINGS.

5.1.1 Socio-demographic Characteristics of Respondents

Findings from this study revealed that majority of the students of Post Basic Nursing Schools,

Jos University Teaching Hospital; 70 (64.2%) were females while 39 (35.8%) were males. This

implies that the females were more dominant.

The study also revealed that majority of the respondents (28.4%) were between ages 25-30 years,

with (11.9%) been the least among ages 45 years and above. Furthermore, it was deduced from

the study that majority of the respondents 41 (37.6%) were students of School Of Post Basic

Nursing Anesthesia with the least represented 17 (15.6%) being students of School Of Post Basic

Nephrology. This could be a result of more student intake into school of Post Basic Nursing

Anaesthesia as opposed to other Post Basic Schools within the purview of JUTH.

5.1.2 Research Objective 1: To assess the factors responsible for stress among Post Basic

Nursing Students in Jos University Teaching Hospital

The study results showed that the following as factors responsible for stress among students of

Post Basic Nursing Schools, Jos University Teaching Hospital; out of control debts 4 (3.7%),

poor time management 6 (5.5%), examination 13 (11.9%), difficulty in organizing work 9

42
 (8.3%), pressure of combining paid work and study 11 (10.1%), academic workload 25 (22.9%),

peer pressure 17 (15.6%), family pressure 11 (10.1%) and financial issues 13 (11.9%).

Additionally, it revealed that 90(82.6%) feels the school environment is not conducive for

learning, 18 (16.5%) are accommodated within the school premises, but 15(83.3%) of them are

uncomfortable, 98(89.9%) feels that daily routine is responsible for stress, 97(89%) indicate

personal complexes and 99(90.8%) previous experience affects how an individual reacts to

stress.

5.1.3 Research Objective 2: To determine the perceived effects of stress on academic

performance among Post Basic Nursing Students in Jos University Teaching Hospital.

Reactions to the effect of stress on students‟ academic performance revealed that majority of the

students of Post Basic Nursing Schools, Jos University Teaching Hospital; 95(87.2%) reduces

their work rate, 104(95.4%) it reduces grade and ability to complete their course, 94(86.2%)

reduces their ability to read and understand, 97(89%) it causes lack of concentration in class,

100(91.7%) decrease their quality of sleep, 59(54.1%) causes drop out in school and 93(85.3%)

increase absenteeism in school.

5.1.4 Research Objective 3: To identify the strategies in coping with stress by the students

of Post Basic Nursing Schools in Jos University Teaching Hospital.

Findings on strategies used by students of Post Basic Nursing Schools, Jos University Teaching

Hospital in dealing with stress revealed that majority of the respondents 96(88.1%) fixing time

daily for exercise, 94(86.2%) starting academic tasks from simple to complex, 100(91.7%)

avoiding reading only when exams comes close, 100(91.7%) building one‟s support network,

105(96.3%) going for excursions, so as to enhance students brain cognitively, 102(93.6%)

getting enough sleep can help them deal with stress, 93(85.3%) calming breath helps, 89(81.7%)

43
 practice progressive muscle relaxation, 102(93.6%) listening to music, 90(82.6%) eating healthy

diet and 94(86.2%) finding ways to minimize stress.

5.2 IMPLICATIONS OF FINDINGS WITH LITERATURE SUPPORT

From the findings, results shows that the following are the factors responsible for stress among

students of Post Basic Nursing Schools, Jos University Teaching Hospital; 25 (22.9%) complaint

of academic workload as a major factor, 90 (82.6%) are not finding the School environment

conducive for learning, 91 (83.5%) are not having accommodation, 98 (89.9%) daily routine is

responsible for stress, 97 (89%) personal complexes and 99 (90.8%) previous experiences affects

how students reacts to stress. Abdullahi et al (2020); Brobbey, (2021); Baluwa, et al (2021) and

Sampson (2023); who documented the factors responsible for stress among students to include;

accommodation, daily routine, lack of time, family problems (personal complexes), financial

issues, interaction with teachers, personal subjective goals, social behavior and adjustment in

lack of cultural support.

It equally revealed from this study that the perceived effect of stress include; 95(87.2%) reduces

their work rate, 104(95.4%) it reduces grade and ability to complete their course, 94(86.2%)

reduces their ability to read and understand, 97(89%) it causes lack of concentration in class,

100(91.7%) decrease their quality of sleep, 59(54.1%) causes drop out in school and 93(85.3%)

increase absenteeism in school. Pompilus et al (2021), recorded that academic stress can reduce

motivation, hinder academic achievement, and lead to increased college dropout rates. Academic

stress has also been shown to negatively impact mental health in students.

The findings of this study also reveals that students of Post Basic Nursing Schools of Jos

University Teaching Hospital used the following strategies in coping with stress; 96(88.1%)

fixing time daily for exercise, 94(86.2%) starting academic tasks from simple to complex,

44
 100(91.7%) avoiding reading only when exams comes close, 100(91.7%) building one‟s support

network, 105(96.3%) going for excursions, so as to enhance students brain cognitively,

102(93.6%) getting enough sleep can help them deal with stress, 93(85.3%) calming breath

helps, 89(81.7%) practice progressive muscle relaxation, 102(93.6%) listening to music,

90(82.6%) eating healthy diet and 94(86.2%) finding ways to minimize stress. This agrees with

the study by Scott (2023) who deduced ten (10) strategies of dealing with stress as follows; get

enough sleep, use guided imagery, exercise regularly, take calming breath, listen to music, build

your support network, eat a healthy diet, find ways to minimize stress and try mindfulness.

5.3 ALIGNING FINDINGS WITH FINDINGS FROM OTHER STUDIES

Regarding factors responsible for stress among students of Post Basic Nursing Schools, Jos

University Teaching Hospital; academic workload, 25 (22.9%) complaint of academic workload

as a major factor, 90 (82.6%) are not finding the School environment conducive for learning, 91

(83.5%) are not having accommodation, 98 (89.9%) daily routine is responsible for stress, 97

(89%) personal complexes and 99 (90.8%) previous experiences affects how students reacts to

stress. It is similar to the study conducted by Kamal et al (2019) who mentioned Academic

Pressure (11.653%), Peer Pressure (11.269 %), Family Pressure (7.746%), Personal Complexes

(6.971%), and Financial Pressure (4.747%). This indicated that the daily activities and chores

amongst students were also a listing effect with cause for huge stress due to time constraints.

Perceived effect of stress among students of Post Basic Nursing Schools, Jos University

Teaching Hospital recorded in the study is as follows; 95(87.2%) reduces their work rate,

104(95.4%) it reduces grade and ability to complete their course, 94(86.2%) reduces their ability

to read and understand, 97(89%) it causes lack of concentration in class, 100(91.7%) decrease

their quality of sleep, 59(54.1%) causes drop out in school and 93(85.3%) increase absenteeism

45
 in school. This supported the study conducted by Akanpaadgi, et al (2023), who indicated that

the daily activities and chores amongst students were also a cause for huge stress due to time

constraints.

Finally, to cope with stress and stressors, the following; 96(88.1%) fixing time daily for exercise,

94(86.2%) starting academic tasks from simple to complex, 100(91.7%) avoiding reading only

when exams comes close, 100(91.7%) building one‟s support network, 105(96.3%) going for

excursions, so as to enhance students brain cognitively, 102(93.6%) getting enough sleep can

help them deal with stress, 93(85.3%) calming breath helps, 89(81.7%) practice progressive

muscle relaxation, 102(93.6%) listening to music, 90(82.6%) eating healthy diet and 94(86.2%)

finding ways to minimize stress. It is similar to the studies by Nebhinani et al (2020) who wrote

that active coping was the most commonly used coping strategies.

5.4 IMPLICATIONS OF FINDINGS TO NURSING

Findings from this study revealed various effects of stress to student. Different literatures

documented different bodily effect of stress which include but not limited to inability to sleep

adequately, inability to concentrate and a varying degree of emotional as well as psychological

effects. Strategies suggested to curb stress include music therapy, regular exercise, adequate and

effective support network among others. It is pertinent for Nurses as well as nursing students

control stress as much as they can in the interest of their health.

5.5 LIMITATIONS OF THE STUDY

This study is limited to Schools of Post Basic Nursing schools of Jos University Teaching

Hospital, Jos Plateau State and findings cannot be generalized to other similar institutions. This

is because a convenient sampling method was used for this study, limiting the ability of the study

46
 to accurately describe the perceptions of other people with similar characteristics. The study is

also limited by financial constraints, time factor, and lack of sponsorship.

5.6 SUMMARY OF THE STUDY

This study is carried out to elicit the effect of stress on academic performance among post basic

nursing students of Jos University Teaching Hospital, Plateau State. The objective of the study

was to assess the factors responsible for stress, determine the effects of stress, and identify the

strategies use by Post Basic Nursing Student in dealing with stress. Relevant literatures were

consulted for this study. A non-experimental descriptive cross-sectional research design was

used for the study, with a sample size of 114. A structured electronic questionnaire was

developed and sent to the 114 respondents, with 109 students answered it. The questionnaires

were analyzed and presented on tables and charts. Result showed that majority of the

respondents were recognizes the factors contributing to stress of worthy of mention, is the lack of

accommodation, cognizant of the effect of stress, which were failure of examination, reduction in

hours of sleep, reduction in work rate, reduction in number of hours of study among others. The

strategies employed to curb stress according to respondents were enough sleep, regular exercise,

listening to music among others. It was concluded that stress is an important medical issue and

should be curtailed with immediate effect.

5.7 CONCLUSION

The findings from this study revealed that majority of the respondents identified stress to be a

problem which affects an individual both physically and psychologically. Varying effects of

stress have been identified by respondents which include majorly lack of accommodation,

reduction in work out put, decrease in sleep hours, reduction in academic performance among

others. Strategies employed to curb the menace of stress according to respondents were, regular

47
 exercise, early period of examination preparation to avoid the “rush hour”, getting enough sleep,

creating a good support group among other healthy habits.

5.8 RECOMMENDATIONS

The following recommendations were made at the end of the study;

 Habitable accommodations should be raised to accommodate all the students in the school.

 Stress should be noted by educators and school administrators as an important health challenge

with untoward consequences if it is not properly addressed

 More literatures and flyers should be made readily available to students to equip them with the

right information regarding stress and stressors

 Support groups should be created for individuals who feel like discussing their stresses or

problem.

 Gymnastic and exercise centers should be made available within the school periphery to enable

students have uninterrupted access to them.

5.9 SUGGESTIONS FOR FURTHER STUDY

At the end of this study, the researcher was of the opinion that more studies can be done in the

following area;

 Strategies to address the effect of stress

 Effect of stress on the performance of nursing staffs

 Identify source of stress within the school environment.

48
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[Link]

Akanpaadgi E., Binpimbu F. & Kuuyelleh E.N. (2023). The impact of stress on students’ academic

performance. Retrieved on 10th March, 2024. ISSN 2962-5548

[Link] Eureka: Journal of Educational Research, 2(1), 60-67

Baluwa M.A., Lazaro M., Mhango L. and Msiska G (2021). Stress and coping Strategies among

Malawian undergraduate nursing students. Accessed 30th January 2024,

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Brobbey E. (2021).The impact of stress on the academic performance of students in the University of

Cape Coast School of Business. Accessed on 24th February, 2024,

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Mental Well-Being in College Students: Correlations, Affected Groups, and COVID-19.

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Jiayu He (2023). A Literature Review on Stress and Coping Strategies in Higher Education Their

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51
 APPENDIX 1

QUESTIONNAIRE

Dear Respondent,

I am a student of School of Post Basic Nursing Anaesthesia, Jos University Teaching Hospital

(JUTH), carrying out a research on “ASSESSMENT OF THE EFFECTS OF STRESS ON

ACADEMIC PERFORMANCE AMONG STUDENTS OF POST BASIC NURSING

SCHOOLS IN JOS UNIVERSITY TEACHING HOSPITAL PLATEAU STATE”.

Kindly provide the necessary information as your responses will be treated with utmost

confidentiality.

Thanks for your anticipated co-operation.

Yours Faithfully

Nyam, Faith Nuhu

INSTRUCTION:

Please tick () in the appropriate boxes beside response of your choice and give appropriate

comments when necessary.

SECTION A: DEMOGRAPHIC VARIABLES OF RESPONDENTS

Gender:

a. Male [ ]

b. Female [ ]

52
Age

Below 25 [ ]

25-30 years [ ]

31-35 years [ ]

36-40 years [ ]

41-45 years [ ]

46 and above [ ]

Designation:

SCHOOL OF POST BASIC NURSE ANAESTHESIA [ ]

SCHOOL OF POST BASIC PERIOPERATIVE NURSING [ ]

SCHOOL OF POST BASIC CRITICAL CARE NURSING [ ]

SCHOOL OF POST BASIC NEPHROLOGY NURSING [ ]

SECTION B: Factors responsible for stress (You can tick one as it applies to you)

1. What are the causes of stress

Out of control debt [ ]

Poor time management [ ]

Examinations [ ]

Difficulty in organising work [ ]

Pressure of combining paid work and study [ ]

53
2. What are the common factors responsible for stress among Post Basic Nursing Students

Academic workload [ ]

Peer group Influence [ ]

Family pressure [ ]

Financial Issues [ ]

3. Is your school environment conducive for learning

Yes [ ]

No [ ]

4. Do you have Hostel accommodation

Yes [ ]

No [ ]

5. If yes, is it convenient for learning?

Yes [ ]

No [ ]

6. Daily routine are responsible for stress among Post Basic Students Nursing

Yes [ ]

No [ ]

7. Personal complexes are responsible for stress among Post Basic Nursing Students

Yes [ ]

54
No [ ]

8. Does previous experience affect how a person reacts to stressors?

Yes [ ]

No [ ]

Instruction: Tick (√) the responses that are appropriate to you and fill where necessary.

Key:

SA = Strongly Agree

A = Agree

D = Disagree

SD = Strongly Disagree

SECTION C, Table 1: Effects of stress on academic performance among Post Basic

Nursing Students in JUTH

S/N Variables SA A D SD

9 Reduce my work rate

10 Reduce my grade and ability to complete my

course work

11 Reduce my ability to read and understand

12 Lack of concentration in class

13 Decreases the quality of sleep

55
 14 Drop out of school

15 Increase in absenteeism in school

SECTION D, Table 2: Strategies used by Post Basic Nursing Student in dealing with stress.

S/N Variables SA A D SD

16 Fixing time daily for exercise

17 Starting academic tasks from simple to complex

18 Avoiding reading only when exams comes close

19 Build your support network

20 Excursions, so as to enhance students brain

cognitively

21 Get enough sleep

22 Take calming breath

23 Practice progressive muscle relaxation

24 Listen to music

25 Eat a healthy diet

26 Find ways to minimize stress

27 Try mindfulness

56