Stressors for Spanish nursing students in clinical practice.

Background: Clinical practice is critical for nursing students to acquire the knowledge and skills needed to properly develop professionally. The presence of stress in clinical practice may negatively affect their training.

Objectives: To understand the extent to which clinical practice can be stressful for nursing students at a Spanish university and to determine the main stressors associated with the practice.

Design: Cross-sectional, descriptive, and observational study conducted in 2016 at the two nursing colleges of the University of Oviedo, located in Oviedo and Gijón in the Principality of Asturias, Spain.

Methods: A total of 450 nursing students at a Spanish university served as participants in this study from January to April 2016. A data collection sheet was developed to track different sociodemographic variables, and was distributed together with the KEZKAK questionnaire, a validated scale adapted to Spanish nursing students. It is composed of 41 items using a 4-point Likert scale, rating how much the described situation worries them from 0 ("Not at all") to 3 ("A lot").

Results: Students were most concerned about issues relating to causing harm to patients and lack of competence. Women found clinical practice to be more stressful than men did, both in general terms (p < 0.001) and with respect to all individual factors included in the questionnaire. In addition, there were associations between the "lack of competence" factor and having a job simultaneously (p = 0.011), the "contact with suffering" factor and the school year (p = 0.018), and the "being harmed by the relationship with patients" factor and the age group (p = 0.013).

Conclusions: Nursing students, particularly women, see clinical practice as "rather stressful", with the main stressors being those related to causing harm to patients.