Investigation Of Stress Source Of Nursing Students In Operating Room And Effectiveness Of ESPCS Intervention Method

Objective To investigate the stress source and anxiety of nursing students in operating room during internship, to explore the effectiveness and feasibility of Explain-Simulate-Practice-Communication-Support (ESPCS) intervention method used in the operating room clinical teaching.Methods Qualitative research: The 15 nursing students practicing in operating room in The Third People's Hospital of HeFei from September to November, 2009 were selected as subjects by using purposive sampling method in accordance with inclusion and exlcusion criteria and then interviewed using semi-structured deep interviews and site investigation by professionals. The orginal doucuments are classified and analyzed by using content analysis.Cross section survey: According to the results of qualiatiative study, literature analysis, expert consulting and designed surgery stress source scale, 218 nursing student practicing in operating room in the Third people's hospital of HeFei city from January 2010 to December 2010 were selected as study objects to study and evaluate the stress source and anxiety. The obtained data is statictically analyzed using SPSS13.0 software package, the main stress source of surgery nursing student is described by applying percentage, the difference of anxiety state between male and female nursing students and national youth normal model is tested and analyzed by dependent sample t, and the difference of anxiety state of nursing student with different demographic characteristics is compared by using t and variance analysis. The correlation between the anixety state and stress source of nursing students was analyzed with Pearson correlation.Experiment research: selecting the nursing student practicing in operating room in the Third people's hospital of HeFei city from December 2010 to July 2011 as subjects, totally 168 persons including 26 male and 142 female students. They were divided into intervention group with 84 persons (14 male, and 70 female) and control group with 84 students (12 male, 72 female) according random experiment method. There is no obvious difference (P> 0.05) in age, sex, education, home address and interesting between two groups determined by statistics, they are comparble. The intervention group was taught by ESPCS method and the control group use traditional method, and then the questionnaire survey and effectiveness evaluation were done for both two group, respectively before and after intervention. We use paired t to check and compare the anxiety, coping self-efficacy scores of the intervention and control groups as well as the change of coping scores and comparison; use dependent sample t to test and compare the difference of anxiety, general self-efficacy, coping and score of theory and operating examination between two group after intervention.Results The results of qualitative interview indicated that the stress source of nursing student in operating room can be summarized as: special environment in operating room, study and work stress in operating room, emotion pressure, social bias pressures and stress of occupational hazards.Cross-sectional survey shows that: (1) the stress source of surgery nursing student is pretty much, the top ten followed by sorting: the first hands on the operating table, lack of specialty knowledge of the operating room, fast-paced, high concentration of attention, fears of mistakes and accident, increase of probability of being infected due to contacting with patient blood, secretions, etc, acrimony of teacher, unfamiliar environment in operating room, intense work and irregular office time due to the cooperation with multi-department doctors (without eating and sleep on time) and the misunderstand of patients and their families. (2) The analysis results of anxiety status for surgery nursing student in different groups indicate that:①the score of general state anxiety scale (S-AI) is higher than the normal model (P<0.01) for the same age②the difference of the S-AI score between only child and siblings was not statistically significant (P>0.05); the S-AI score of nursing student from countryside is higher than that of one from city (P<0.01); the S-AI score of secondary group is higher than that of college and university group (P<0.01, P<0.01); the S-AI score of the transfers is higher that of voluntary care and the one influenced by others (P<0.01, P<0.05).Experiment results indicate that the score of the anxiety state and negative coping score of the intervention group in the assessment survey is much less than that of the control group (P<0.01), but the general self-efficacy and positive coping score is much higher that of control group (P<0.01). The score of the anxiety state of the intervention group before and after intervention is 44.24±3.36 and 40.04±3.53 (P<0.01), respectively; the score of the general self-efficacy is 2.42±0.24 and 2.57±0.34 (P<0.01), respectively; the positive coping score is 1.83±0.27and 1.92±0.19 (P<0.05), respectively; the negative coping score is 1.63±0.24 and 1.52±0.16 (P<0.01), respectively. However, for the control group: the score of the anxiety state before and after intervention is 44.93±2.11 and 44.89±2.12 (P>0.05), respectively; the score of the general self-efficacy is 2.41±0.30 and 2.40±0.18 (P>0.05), respectively. The positive coping score is 1.82±0.30 and 1.84±0.20 (P>0.05), respectively; the negative coping score is 1.62±0.22 and 1.61±0.18 (P>0.05), respectively.Conclusion Operating room nursing students are more sources of stress experienced, the S-AI score of both male and female nursing students is higher than that of normal model. They have more serious anxiety. The ESPCS intervention method can effectively alleviate the anxiety, promoting health, improving the quality of practice of nursing students.