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
Stress and AnxietyDefinitions of stress and anxiety vary throughout theliterature; however, this article uses the definitions of psychologistsLazarus and Folkman. Pioneers in stress theoryand research since the 1960s, they provided a definitionof stress that applies to the clinical stress undergraduatenursing students experience. Lazarus and Folkman (1984)defined stress as:A particular relationship between the person and theenvironment that is appraised by the person as taxing orexceeding his or her resources and endangering his or herwell-being. (p. 19)Clinical education provides the environment in which studentsencounter stress, which can beappraised as challenging or difficult tomanage, causing anxiety.Lazarus and Folkman (1984) definedanxiety as:A vague, uncomfortable feeling exacerbatedby prolonged stress and the presenceof multiple stressors. (p. 4)There are two states of anxiety: stateand trait. State anxiety, as described bySpielberger (as cited in Kanji, White, &Ernst, 2006), is the emotional state ofan individual in response to a particularsituation or moment, which includessymptoms of apprehension, tension,and activation of the autonomic nervoussystem, and can include tremors,sweating, or increased heart rate andblood pressure. Trait anxiety is the tendency of an individualto respond to stress with state anxiety. For the purposesof this article, the term anxiety will be referred toin 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
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