Systematic Review Nursing

Systematic Review Nursing

Background information

            While undergoing through training, student nurses experience immense stress and as a result, there can be attrition, absence, and sickness. The need for coming up with stress management programs aimed at student nurses is increasingly becoming evident considering the global high dropout levels amongst trainees as well as nurses shortage (Galbrith & Bown, 2011).  Until now, only one review examined stress interventions’ effectiveness for the student nurses. However, the recent literature emergence warrants novel review.

Key elements

            The study under review aimed at identifying the kinds of interventions that are most effective in minimizing stress among student nurses as well as making recommendations for researches that could be done in future.

            The data sources used included research papers that were published between the April of 1981 and April of 2008, which were searched from databases such as Behavioral Sciences Collection, Psychinfo, IBSS, CINAHL, and Medline (Galbrith & Bown, 2011). This ensured that any potential trends in the data indicating patterns of stress reduction among nurses were identified. The databases used are acknowledged in nursing and, therefore, credible information was obtained.

            During review, there was use of a quantitative systematic review together with a narrative synthesis. The study had some key terms including nurse, nurses, or nursing; students or student; burnout or stress; and intervention. Additionally, the reference lists of particular papers were scanned after which the key authors were contacted. Manual searches of principal journals were also conducted. In addition to this, there was a strict inclusion criteria (Galbrith & Bown, 2011).   The papers were strictly published from January 1980- March 2009, and in English language. The studies were all empirical research reporting stress intervention evaluation for student nurses. the interventions had to be described and  as well as the outcome measures’ details. Out of 186 studies produced from the search, only 17 passed the inclusion criteria. It is noteworthy that the analysis trustworthiness and robustness were assessed via discussions between authors. Following the preliminary synthesis, the authors organized the studies based on the affects, methods, and design, and this easened the review process.

            The study identified that the interventions that were most effective offered coping skills for stressful situations and this was basically relaxation as well as skills through which maladaptive cognitions could be changed (Galbrith & Bown, 2011). The quantitative systemic review also identified that interventions promoting skills for minimizing the number or intensity of stressors were as well successful. However, in a majority of the cases, stress interventions were not associated with improved academic performance.

            The authors were keen to note that regardless of the fact that the review involved a wide range of studies, spanning approximately 3 decades, there could have been a limitation as a result of their diversity. Various methods were used and this could have made it hard drawing valid comparisons between the studies. Moreover, this excludes the opportunity for a meta-analysis. The review’s generalizability could be limited as a result of the variations between different methods and the studies being conducted in different locations (Galbrith & Bown, 2011). 

            The review came into a conclusion that the stress interventions’ design ought to be theory-driven. It was suggested that future studies need to concentrate on organizational and interface factors. Furthermore, the long-term advantages of interventions for the student nurses were yet to be realized.

Impact on clinical practice

            It is important for student nurse supervisors to realize that the student nurses experience high levels of stress that is course-related. Some of the results of the stress include high attrition rates and dropouts. In this regard, there is a need to consider applying stress management programs in learning institutions and hospitals where student nurses attend their practicum. This will go a long way in reducing stress that the student nurses experience (Galbrith & Bown, 2011). These institutions should use interventions that incorporate skills for promoting cognitive maladaptive cognitions’ reappraisal and relaxation since these are more effective. Managing stress among student nurses can assist them in coping with learning. Studies having a solid theoretical basis are also vital. Interventions involving personal factors can be tried out to assess if the intervention effects are confounded by factors such as family conflict and alcohol abuse.


Galbrith, D., & Bown, K. E. (2011). Assessing intervention effectiveness for reducing stress in    student nurses: quantitative systemic review. Journal of Advanced Nursing, 67(4), 709-     721.

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