Year 2020, Volume 6 , Issue 5, Pages 429 - 437 2020-09-04

Evaluation of sleep quality and perceived stress of nursing students who are engaged in clinical practice based on their sleeping habits

Makbule TOKUR KESGİN [1] , Songül ÇAĞLAR [2]

Objectives: Sleep quality and perceived stress of nursing students affects both their personal health and nursing care. The aim of this study is to identify nursing students' sleep quality and perceived stress and the sleeping habits affecting them.

Methods: This descriptive cross-sectional study was carried out with 446 nursing students. The data were collected through a questionnaire involving some questions aiming to identify sleeping habits and perceived stress, Pittsburgh Sleep Quality Index (PSQI) and Perceived Stress Scale for Nursing Students (PSSNS).

Results: The average score of PSQI was 7.71 ± 3.27 while scale of PSSNS was 63.50 ± 26.65. According to PSSNS, female students perceived stress level more than males (p = 0.005). However, there was no statistically significant difference between female students and male students in terms of total PSQI scores (p = 0.113). Students with poor sleeping quality showed some signs of sleep deprivation during the day. There was a weak relationship between sleeping quality and perceived stress (p = 0.01). Nevertheless, delaying sleep due to academic workload affects students' perceived stress.

Conclusions: Nursing students should be encouraged to develop healthy sleeping habits and skills to deal with stress. 

nursing student, perceived, sleep quality, stress
  • 1. Continente X, Pérez A, Espelt A, López MJ. Media devices, family relationships and sleep patterns among adolescents in an urban area. Sleep Med 2017;32:28-35.
  • 2. Pıçak R, İsmailoğulları S, Mazıcıoğlu MM, Üstünbaş HB, Aksu M. [Approach to sleep disorders and recommendations in primary care]. TJFMPC 2010;4:12-22. [Article in Turkish]
  • 3. Demir G. Daytime sleepiness and related factors in nursing students. Nurse Educ Today 2017;59:21-5.
  • 4. Yazdi Z, Loukzadeh Z, Moghaddam P, Jalilolghadr S. Sleep hygiene practices and their relation to sleep quality in medical students of Qazvin University of Medical Sciences. J Caring Sci 2016;5:153-60.
  • 5. Silva M, Chaves C, Duarte J. Sleep quality determinants among nursing students. Soc Behav Sci 2016;217:999-1007.
  • 6. Gunes Z, Arslantas H. Insomnia in nursing students and related factors: a cross-sectional study. Int J Nurs Pract 2017;23:e12578.
  • 7. Stecker T. Well-being in an academic environment. Med Educ 2004;38:465-478.
  • 8. Thamby Sam A, Muttusamy B, Mun Yee S, Ayapanaido T, Parasuraman S. Investigation of stressors affecting a sample of pharmacy students and the coping strategies employed using modified academic stressors scale and brief cope scale: a prospective study. J Young Pharm 2016;8:122-7.
  • 9. Waqas A, Kahn S, Sharif W, Khalid U, Ali A. Association of academic stress with sleeping difficulties in medical students of a Pakistani medical school: a cross sectional survey. Peer J 2015;12:e840.
  • 10. Ahrberg K, Dresler M, Niedermaier S, Steiger A, Genzel L. The interaction between sleep quality and academic performance. J Psychiatr Res 2012;46:1618-22.
  • 11. Zhang Y, Peters A, Bradstreet J. Relationships among sleep quality, coping styles, and depressive symptoms among college nursing students: a multiple mediator model. J Prof Nurs 2018;34:320-5.
  • 12. Ye Y, Hu R, Ni Z, Jiang N, Jiang X. Effects of perceived stress and professional values on clinical performance in practice nursing students: a structural equation modeling approach. Nurse Educ Today 2018;71:157-62.
  • 13. Yamashita K, Saito M, Takao T. Stress and coping styles in Japanese nursing students. Int J Nurs Pract 2012;18:489-96.
  • 14. Khalil A. Sleep pattern disturbance among undergraduate nursing students and the association with their academic performance. Int J Health Wellness Soc 2017;7:1-17.
  • 15. Yılmaz M, Yaman Z, Erdoğan S. [Stressful situation in nursing students and the methods of coping with stress]. Mersin Univ Saglık Bilim Derg 2017;10:88-99. [Article in Turkish]
  • 16. Adriansen RC, Childers A, Tessa Y, Abraham S. Sleeping habits and perception of its health effects among college students. Int J Studies Nurs 2017;2:28.
  • 17. Buysse DJ, Reynolds DC 3rd, Monk TH, Berman SR,Kupfer DJ. The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res 1989;28:193-213.
  • 18. Ağargün, MY, Kara H, Anlar Ö. [The validity and reliability of the Pittsburgh sleep quality index]. Türk Psikiyatri Arşivi 1996:7(2). [Article in Turkish]
  • 19. Sheu S, Lin HS, Hwang SL. Perceived stress and physio-psycho-social status of nursing students during their initial period of clinical practice: the effect of coping behaviors. Int J Nurs Studies 2002;39:165-75.
  • 20. Karaca A, Yıldırım N, Ankaralı H, Açıkgöz F, Akkuş D. [Turkish adaptation of perceived stress scale, bio-psycho-social response, and coping behaviours of stress scales for nursing students]. Psikiyatri Hemşireliği Dergisi 2015;6(1):15-25. [Article in Turkish]
  • 21. Alkaya SA, Okuyan CB. [The exercise behaviors and sleep quality of nursing students]. Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi 2017;10:236-41. [Article in Turkish]
  • 22. Menon B, Karishma HP, Mamatha IV. Sleep quality and health complaints among nursing students. Ann Indian Acad Neurol 2015;18:363-4.
  • 23. Najafi Kalyani M, Jamshidi N, Salami J, Pourjam E. Investigation of the relationship between psychological variables and sleep quality in students of medical sciences. Depress Res Treat 2017:7143547.
  • 24. Sadoughi M, Mohammad-Salehi Z. The relationship between problematic mobile use and sleep quality among nursing students: the mediating role of perceived stress. Adv Nurs Midwifery 2017;27:15-20.
  • 25. Karatay G, Gürarslan Baş N, Aldemir H, Akay M. [Examining the sleep habits of nursing department students and the affective factors]. HSP 2016;3:16-22. [Article in Turkish]
  • 26. Santos TCMM, Martino MMFD, Sonati JG, Faria ALD, Nascimento EFA. Sleep quality and chronotype of nursing students. Acta Paul Enferm 2016;29:658-63.
  • 27. Silva M, Chaves C, Duarte J, Amaral O, Ferreira M. Sleep quality determinants among nursing students Procedia Soc Behav Sci 2016;217:999-1007.
  • 28. Tada A. The associations among psychological distress, coping style, and health habits in Japanese nursing students: a cross-sectional study. Int J Environ Res Public Health 2017;14:1434.
  • 29. Suarez-Garcia JM, Maestro-Gonzalez A, Zuazua-Rico D, Sanchez-Zaballos M, Moesteiro-Diaz MP. Stressors for Spanish nursing students in clinical practice. Nurse Educ Today 2018;64:16-20.
  • 30. He FX, Turnbull B, Kirshbaum MN, Philips B, Klainin-Yobas P. Assessing stress, protective factors and psychological well-being among undergraduate nursing students. Nurse Educ Today 2018;68:4-12.
  • 31. Gurkova E, Zelenikova R. Nursing students' perceived stress, coping strategies, health and supervisory approaches in clinical practice: a Slovak and Czech perspective. Nurse Educ Today 2018;65:4-10.
  • 32. Labrague LJ, McEnroe-Peitte DM, Papathanasiou IV, Edet OB, Tsaras K, LEocadio MC, et al. Stress and coping strategies among nursing students: an international study. J Ment Health 2018;27:402-8.
  • 33. Dugue M, Garncarzyk C, Dosseville F. [Psychological characteristics of stress in nursing student]. Rev Epidemiol Sante Publique 2018;66:347-54. [Article in French]
  • 34. Labrague LJ. Stress, stressors, and stress responses of student nurses in a government nursing school. Health Sci J 2013;7:424-35.
  • 35. Al-Gamal E, Alhosain A, Alsunaye K. Stress and coping strategies among Saudi nursing students during clinical education. Perspect Psychiatr Care 2018;54:198-205.
  • 36. Ergin E, Çevik K, Pakiş-Çetin S. [Investigation of nursing students’ perception of stress and coping behaviours of stress regarding education]. HEAD 2018;15:16-22. [Article in Turkish]
  • 37. O'Mara L, McDonald J, Gillespie M, Brown H, Miles L. Challenging clinical learning environments: experiences of undergraduate nursing students. Nurse Educ Pract 2014;14:208-13.
  • 38. Kesgin MT, Bilgin NÇ, Ayhan F. [Opinions of nursing students about clinical practıce: general practice course]. Soc Sci Studies J 2018;4:3805-16. [Article in Turkish]
  • 39. Bahçecioğlu Turan G, Tan M, Dayapoğlu N. [Determining the opinions of clinic nurses and nursing students about internship]. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi 2017;20:170-9. [Article in Turkish]
  • 40. Benavente SB, Silva RM, Hİqashi AB, Guido Lde A, Costa A. Influence of stress factors and socio-demographic characteristics on the sleep quality of nursing students. Rev Esc Enferm USP 2014;48:514-20.
  • 41. Labrague LJ, McEnroe-Petitte DM, De Los Santos JAA, Edet OB. Examining stress perceptions and coping strategies among Saudi nursing students: A systematic review. Nurse Educ Today 2018;65:192-200.
  • 42. Karaca A, Yıldırım N, Ankaralı H, Açıkgöz F, Akkuş D. [Nursing studebnts’ perceived levels of clinical stress, stress responses and coping ehaviors]. Psikiyatri Hemşireliği Dergisi 2017;8:32-9. [Article in Turkish]
  • 43. Soares de Souza V, Costa MAR, Rodrigues AC, Bevilaqua JF, Inoue KC, Oliveria JLC, et al. Stress among nursing undergraduate students of a Brazilian public university. Invest Educ Enferm 2016;34:518-27.
  • 44. Bazrafkan L, Kalyani MN. Nursing students’ experiences of clinical education: a qualitative study. Invest Educ Enferm 2018;36:e04.
  • 45. Bartlett ML, Taylor H, Nelson JD. Comparison of mental health characteristics and stress between baccalaureate nursing students and non-nursing students. J Nurs Educ 2016;55:87-90.
  • 46. Doolin J, Vilches JE, Cooper C, Gipson C, Sorensen W. Perceived stress and worldview influence sleep quality in Bolivian and United States university students. Sleep Health 2018;4:565-71.
Primary Language en
Subjects Health Care Sciences and Services
Journal Section Original Articles

Orcid: 0000-0003-2729-8612
Author: Makbule TOKUR KESGİN
Institution: Department of Nursing, Public Health Nursing, Bolu Abant İzzet Baysal University, Faculty of Health Sciences, Bolu, Turkey
Country: Turkey

Orcid: 0000-0002-5412-0708
Author: Songül ÇAĞLAR (Primary Author)
Institution: Department of Nursing, Public Health Nursing, Bolu Abant İzzet Baysal University, Faculty of Health Sciences, Bolu, Turkey
Country: Turkey


Application Date : January 4, 2019
Acceptance Date : October 6, 2019
Publication Date : September 4, 2020

EndNote %0 The European Research Journal Evaluation of sleep quality and perceived stress of nursing students who are engaged in clinical practice based on their sleeping habits %A Makbule Tokur Kesgi̇n , Songül Çağlar %T Evaluation of sleep quality and perceived stress of nursing students who are engaged in clinical practice based on their sleeping habits %D 2020 %J The European Research Journal %P -2149-3189 %V 6 %N 5 %R doi: 10.18621/eurj.508165 %U 10.18621/eurj.508165