EXPLORING MULTIDIMENSIONAL SOURCES OF STRESS AMONG NURSING STUDENTS IN ACADEMIC AND CLINICAL SETTINGS IN PRIVATE COLLEGES LAHORE

Abstract

Background: Nursing students experience considerable stress arising from academic demands, clinical responsibilities, personal circumstances, and environmental conditions. Persistent stress may negatively affect students’ psychological well-being, academic engagement, and clinical learning. Understanding the multidimensional sources of stress is therefore important for developing appropriate institutional support strategies. Objective: To assess the association of academic, clinical, personal, and environmental factors with stress among nursing students enrolled in private nursing colleges in Lahore, Pakistan. Methods: A quantitative correlational research design was used. The study was conducted among 150 third- and fourth-year Bachelor of Science in Nursing students from Bahria Town School of Nursing and Akhter Saeed College of Nursing, Lahore. Participants were selected through purposive sampling. Data were collected through a structured questionnaire assessing four major domains of stress: academic, clinical, personal, and environmental. Data were collected through a face-to-face approach after obtaining informed consent. Results: The Academic Stress subscale comprises six items measuring stress arising from academic demands. Fear of future and career uncertainty (M = 3.97) and concern about lower grades than anticipated (M = 3.98) were the strongest academic stressors. The inability to balance study and leisure time (M = 3.47) and frequent graded activities (M = 3.45) were comparatively lower, though still above the neutral midpoint. Clinical stressors related to physician behavior (M = 4.13) and the gap between theoretical learning and real healthcare practice (M = 4.09) were rated highest within this domain. Maintaining a balance between clinical work and studying (M = 3.08) was rated lowest, with 36% of students either disagreeing or strongly disagreeing with this item. Personal stressors recorded the highest mean domain score (M = 4.005). Financial problems (M = 4.13) and decline in personal health (M = 4.09) were the leading personal stressors. Over 83% of students agreed or strongly agreed that financial difficulties contribute to their stress. Environmental stress scores were relatively consistent across all five items (range: 3.72–3.79), suggesting that environmental factors impose a broadly similar and moderate-to-high level of stress. Absence of a calm classroom environment (M = 3.79) and lack of recreational facilities (M = 3.76) were the most frequently endorsed environmental stressors. Conclusion: Nursing students in private colleges in Lahore experience substantial stress across academic, clinical, personal, and environmental domains, with personal and clinical factors being particularly prominent. The findings highlight the need for comprehensive institutional strategies, including workload management, supportive clinical supervision, career counselling, financial guidance, and improvements in the learning environment, to reduce stress and promote students’ academic and clinical well-being.