Relation between Time Management Skills and Stress Level among Fourth Year Students at Faculty of Nursing

Introduction

In an era of increasing competition in nursing field, nursing education is considered as one of the most crucial element for improving the quality of professional identity for the future nurses (1). Today's nursing students are the nucleus of the professional nurses of tomorrow, who will interact with their colleagues and other health care professionals on a daily basis and provide the care for patients, their families and society in the area of health and education in the future. Therefore, nursing students are faced with a lot of academic responsibilities that let them feel that 24 hours in day is too short time due to the nature of their study in nursing such as: assignments, and hospital and laboratory practice as well as the continuous practical and theory exams (2).

Stress is a crucial and likely response of daily living, and is unavoidable because it related to any external incident, whether it is satisfying or worries producing. A person reaction towards stress found on whether an event is judged as a challenge or a warning. Challenging stimulus can bring constructive outcome for instance improved task performance and increase motivation. In other way threatening ones can lead social discomfort, depression, anxiety, and even develop suicidal intention (3).

Stress in nursing education is acknowledged as one of the most important issues in the modern world (4). Stress refers to a forceful interaction between the individual and the environment. In this interaction and boundaries related to work may be apparent as threatening to exceed the person's resources and skills (5, 6).

Furthermore, nursing students are prone to the incidence of stress compared to other students, because they are often faced with a situation that requires them to take many responsibilities such as; care for the life and death of others; aware of new social spheres; adjust to the academic expectations that may be difficult; mastering all learning outcomes in a specific duration of the study; master many theories that must be learned; and learn with people of different cultures and beliefs (7).

Moreover, if students are not able to adapt to the stress experienced, this stress will affect their academic performance and overall health condition. Nursing students in general, may share general concerns and stressors which may possibly be internal or external. However, cultural beliefs and situational factors could also affect their levels of stress (8).

Thus, time management has a greater buffering effect on academic stress and poor time management has been found to be a predictor of academic stress. More than that, academics and time management were often mentioned together as factors causing stress (9). Time management can be defined as the act or process of exercising conscious control over the amount of time spent on specific activities, especially to increase efficiency or productivity. Time management may be aided by a range of skills, tools, and techniques used to manage time when accomplishing specific tasks, projects and goals (10).

Nursing student may need to prioritize all their activities to provide more time for other activities that are important as well. Time management may be the best tool for student nurses. Also, time management is one of the most important techniques that everyone needs to learn (11). Therefore, learning how to manage time effectively will help students feel more relaxed, focused and in control (12). In addition, good time management such as setting goals and priorities as well as monitoring the use of time can facilitate productivity and minimize stress, contributing to work effectiveness (13).

Significance of the study

Time management is a major issue among nursing faculty students which can affects how they view and use the time available to them, and how they adjust to their academic responsibilities. Some of nursing faculty students are very stressful by: busy schedules, midterms, final examinations, research papers, other assignments, and clinical experiences at hospitals. Students often feel stressed by the many requirements of nursing curricula.

In addition, nursing faculty students experience a clinical component, which is highly stressful. Also, all these elements combined with outside responsibilities such as family and hanging out with friends that can lead to unnecessary stress. So the researcher introducing this study to assess the relation between time management skills and stress level among nursing students.

Aim of the study:

The aim of current study was to assess the relation between time management skills and stress level among fourth year students at Faculty of Nursing.

Research Questions

1)       What are the time management skills among fourth year students at Faculty of Nursing?

2)       What is the stress level among fourth year students at Faculty of Nursing?

3)       Is there a relation between time management skills and stress level among fourth year students at Faculty of Nursing?

Subjects and Methods

Study design:                                                                                                               

Descriptive correlational research design was used to achieve the aim of the current study.

Setting: 

The study was conducted at Faculty of Nursing, Minia University.

Subjects:

The subjects of study sample included all fourth year nursing students who enrolled in Faculty of Nursing at Minia University for the academic year 2017-2018. Total number was 265 participants but 30 of them refused to participate in the study sample, and only 235 were used in statistical analysis.

Tools for data collection:

Data collected through the utilization of two tools as follow:     

Tool (1): Time management skills questionnaire; It consisted of two parts:

Part I: personal data:

It used to collect data about nursing students. It included five items related to age, sex, residence, number of family members, and monthly household income.

Part II: Time management skills questionnaire:

This tool developed by (Alay and Kocak, 2002) ⁽¹⁴⁾ and translated into Arabic by the researcher to assess the time management skills among nursing students. It consisted of 27 items; and divided to 3 dimensions as follow: time planning (16 items), time attitude (7 items), and time wasters (4 items) with 5 point likert scale ranged as: (never=1, infrequently= 2, sometimes =3 frequently =4, always =5). The scores were reversed in the negative statements.

The scoring system ranged from [27 to135]. If the total scores were less than 50% considered as low time management skills. If the total scores ranged from 50% less than 75% considered as moderate time management skills, and if the total scores were 75% or more considered as high time management skills.

Tool (2): student nurse stress index (S.N.S.I)

This tool developed by (Jones and Johnston, 1999) ⁽¹⁵⁾ and translated into Arabic by the researcher to assess the stress level among nursing students. It consisted of 22 items; and divided into 4 dimensions as follow: academic load (7items), clinical concerns (7 items), personal problems (4 items), and interface worries (7items) with 5-point Likert scale ranged as: (1=not stressful, 2= low stress, 3=moderate stress, 4= stressful, 5=extremely stressful).

The scoring system ranged from [22 to 110]. If the total scores were less than 50% considered as low stress level. If the total scores ranged from 50% less than 75% considered as moderate stress level, and if the total scores were 75% or more considered as high stress level.

Validity of the tool:

The first tool “time management skills” was developed by Alay and kocak (2002) and the second tool “nursing student stress index ” was developed by Jones and Johnston (1999).

Reliability of tools:

The tools were tested and demonstrated good internal reliability with cronbach' alpha test. The alpha coefficient for time management skills tool was (α= 0.726), and for nursing student stress index tool was (α=0.801).

Pilot study:

A pilot study was conducted on 10% (27) of participants who selected randomly from the total participated students prior to data collection; in order to facilitate the execution of the study. Results indicated that; the tools were applicable and don’t need any changes.

Study procedure       

An official letter was granted from the Nursing Faculty Dean; vice dean for education and student affairs; and heads of all academic department in Faculty of Nursing at Minia University. This letter included a brief explanation of the objectives of the study. 

A group interview was done by the researcher to explain the nature and purpose of the study. Data collection tools were introduced to students to be filled. Data was collected two days per week during the second semester of the academic year 2017-2018, and each interview consisted of ten to fifteen students and lasted for thirty minutes. The time required for filling the questionnaire was estimated after making of the pilot study, it was approximately 25 minutes.

Ethical consideration

 A written initial approval was obtained from the research ethics committee of the Faculty of Nursing, Minia University. Approval to conduct the study obtained from the Dean of faculty, as well from the Vice dean for education and students affairs in Faculty of Nursing at Minia University. The participants were informed that their participation in the study will be completely voluntary and there will be no harm if they not participate in the study. Informed consent was obtained from participating students after explaining the nature and benefits of the study. Each assessment sheet was coded and student names were not appearing on the sheets for the purpose of anonymity and confidentiality.

Statistical analysis:

The collected data were coded, categorized, tabulated and analyzed using the statistical package for the social science (SPSS 20.0). Data was presented using descriptive statistics in the form of percentages, frequency, mean, and standard deviation. Inferential statistical tests of significance such as Friedman's man ANOVA, Pearson correlation, and independent t-test were used to identify group differences and the relations among the study variables. Level of significance at p

Results

Table (1): percentage distribution of the fourth year nursing students according to personal data characteristics

Table (1) showed that about three quarter of the fourth year nursing students (74.9%) had age ranged from 22-24 years, more than half (59.1%) of them were female, and near three quarter (74.5%) of them come from rural areas. In addition more than half of them (51.1%) had 4-6 family members, and (47.4%) of them were moderate house hold income.

Figure (1): levels of time management skills among fourth year nursing students

Figure (1) presented that the time management skills level among the fourth year nursing students were moderate level (75.3 %), whereas (14%) of them possessed low level time management skills, and (10.6%) of them had high level time management skills. 

Figure 2: Levels of stress among fourth year nursing students

Figure (2) presented that the stress level among the fourth year nursing students were moderate level (54.5%) while (25.5%) of them possessed low stress level, and (20%) of them had high stress level.

Table (2): Correlation between time management skills and stress level among the fourth year nursing students

Table (2) reported that there was a fair negative correlation (0.364-) between time management skills and stress level among fourth year nursing students.