Depression affects the ability of the students to perform their duties, their relationship with patients and subsequently their attitude towards the nursing profession. Such students spend more time in school and the quality of their nursing reduces significantly. (Ratanasiripong et al. 2012) Ratanasiripong et al (2012) (Gibbons et al . 2008) Gibbons et al (2008) in their study stress and eustress in nursing students, views stress from both the negative and positive aspect as opposed to other researchers. They therefore bring out the positive aspects of stress. For instance stressful clinical examinations according to them were a source of empowerment as the students felt that such activities were important in preparing them for future practice. As much as dealing with patients was really breath-taking, they felt rewarded after that especially when a patient commented positively on their performance. They therefore conclude that talking about 7
distress alone when exploring stress in nursing students does not give a complete picture of the students’ experience. 2.5 : COPING MECHANISMS The coping mechanisms are broadly classified into two which are the problem focused and emotion focused courtesy of (Lazarus & Folkman 1984) Lazarus and Folkman (1984) . The problem focused are considered the healthy coping mechanisms that are associated with better mental health and entail strategies such as seeking social support, accepting responsibility and planful problem solving. Emotion focused coping strategies are considered the unhealthy/negative mechanisms as they are associated with worse mental health and include strategies such as confrontive coping, escape-avoidance and distancing. (Dlamini 2012) (Dlamini, 2012.) Singh et al . (2011) conducted a cross-sectional study, level of stress and coping strategies used by nursing interns. They found out that the strategy used depended on the situational and individual factors therefore the differences noted among different students. In their study, the third year students used adaptive strategies while the moderately experienced second years were noted to use more of the avoidance strategy to cope with clinical practice. According to another research conducted by Lin (2006) Lin (2006) in Hong Kong, the nursing students used transference, stay optimistic, problem solving and avoidance in that order. He claims that the effectiveness of the coping strategy used depended on the level of the students. Students at higher levels used problem focused coping strategies which are the most effective in relieving stress. Kumar and Nancy in their study majority of the students used the healthy coping mechanisms as compared to the unhealthy negative ones. The most commonly used strategies were solving family problems, developing social support, self-reliance and ventilating feelings.