Stress and Anxiety
Definitions of stress and anxiety vary throughout the
literature; however, this article uses the definitions of psychologists
Lazarus and Folkman. Pioneers in stress theory
and research since the 1960s, they provided a definition
of stress that applies to the clinical stress undergraduate
nursing students experience. Lazarus and Folkman (1984)
defined stress as:
A particular relationship between the person and the
environment that is appraised by the person as taxing or
exceeding his or her resources and endangering his or her
well-being. (p. 19)
Clinical education provides the environment in which students
encounter stress, which can be
appraised as challenging or difficult to
manage, causing anxiety.
Lazarus and Folkman (1984) defined
anxiety as:
A vague, uncomfortable feeling exacerbated
by prolonged stress and the presence
of multiple stressors. (p. 4)
There are two states of anxiety: state
and trait. State anxiety, as described by
Spielberger (as cited in Kanji, White, &
Ernst, 2006), is the emotional state of
an individual in response to a particular
situation or moment, which includes
symptoms of apprehension, tension,
and activation of the autonomic nervous
system, and can include tremors,
sweating, or increased heart rate and
blood pressure. Trait anxiety is the tendency of an individual
to respond to stress with state anxiety. For the purposes
of this article, the term anxiety will be referred to
in the state form because the focus is on students’ anxiety
in response to stressors, demands, or stressful situations
within the clinical learning environment, not the tendency
to respond with anxiety