Stress is a particular experience that can be defined1 as “a condition or feeling experienced when a person realizes that the demands placed on them exceed the resources the individual has available” and is accompanied by predictable biochemical, physiological, emotional, cognitive, and behavioral accommodations2. In medical education, nursing students’ levels of stress were found to be higher than those among non-nursing students3.4, and nursing and medical students deal with many more types of challenging stressors than most students with other majors, including curricular aspects, learning environments, intense academic demands and workloads, personal life events, and psychological pressures that are difficult to cope with5,6. Thus, nursing and medical students’ academic and emotional demands are more prominent than those of any other profession7. Research has shown that stress is a double-edged sword for nursing and medical students that can either increase their chances of success or prevent them from enhancing their performance8.
While stress provides motivation that, to some extent, can be considered an academic stimulation, prolonged stress can lower performance and lead to health problems9. A study in China indicated that, to a certain extent, stress scores might negatively correlate with academic performance among medical students8. In addition, many studies have shown evidence of a link between stressful events and physical health in all college students, including medical students10,11. For example, among several psychosocial factors, emotional stress has been recognized as a modifiable risk factor for cardiovascular disease12,13,14 and could cause cardiovascular consequences for nursing and medical students when long-term stressors are placed on them10. Continuous stress further impacts students by negatively affecting their self-concept, such as self-worth, general health, and immune functions15. Therefore, researchers have explored factors such as anxiety and depression, which are associated with stress16,17. The negative emotions caused by these pressures reduce life satisfaction18, threaten the mental health of nursing and medical students, hinder their self-development19, and cause serious socioeconomic burdens20. Therefore, it is essential to understand the detailed process of nursing and medical students when coping with stressors.
Coping has been described as an individual’s attempt to use cognitive and behavioral strategies to manage and regulate demands and emotions in response to stress21. Positive attitudes and successful adaptation to life require strategies to cope with stressful events22, and when individuals face negative or stressful life events, appropriate coping strategies play an important role in their physical and mental health23,24. Researchers have divided coping strategies into various categories: problem-focused vs. emotion-focused, adaptive vs. maladaptive, positive vs. negative, and active vs. passive25. In addition to classification disparities, other factors also affect nursing and medical students’ choice of coping strategy. Gender is a reason for these variations in coping strategies, as females rely more on social support and vent more emotions to cope with stress26, whereas males use more passive and/or avoidant methods of coping, such as alcohol or drugs27. Besides, the fact that school-year distinctions affect coping has been confirmed by growing body of evidence28. This can be further explained by the fact that when senior nursing and medical students transition to clinical training in undergraduate medical schools, higher-level strategies are needed to cope with further stress29. However, there is a lack of literature exploring the coping process and how to choose strategies when nursing and medical students face diverse stressors.
Many previous studies have focused on coping strategies, and it has been confirmed that these strategies affect coping processes through means marked by approach or avoidance23. One study investigated the structure of strategies based on a hierarchical conceptualization to conduct in-depth analyses of coping strategies30. However, the study on coping strategies and structures did not clarify what kind of experience nursing and medical students underwent when facing stress. Understanding the process of coping with stress from nursing and medical students’ perspectives can be targeted to deal with the adverse reactions caused by stress, and appropriate internal and external interventions can be implemented at different stages of the process of coping with stress. Hence, this study aims to explore the experiences of nursing and medical students coping with stress and construct an interpretive understanding from the nursing and medical students’ perspective by using constructivist grounded theory.