Assessing intervention effectiveness for reducing stress in student nurses: quantitative systematic review

To identify the types of interventions that are effective in reducing stress in student nurses, and to make recommendations for future research.

Student nurses experience significant stress during their training and this may contribute to sickness, absence and attrition. Given the global shortage of nurses and high dropout rates amongst trainees, the importance for developing stress management programmes for student nurses is becoming more evident. To date, only one review has examined the effectiveness of stress interventions for student nurses, but the emergence of recent literature warrants a new review.

Research papers published between April 1981 and April 2008 were identified from the following databases: Medline, CINAHL, Behavioral Sciences Collection, IBSS and Psychinfo.

A quantitative systematic review with narrative synthesis was conducted. Key terms included 'nurses OR nursing OR nurse', 'student OR students', 'intervention', 'stress OR burnout'. In addition to database searches, reference lists of selected papers were scanned, key authors were contacted and manual searches of key journals were conducted.

The most effective interventions provided skills for coping with stressful situations (typically relaxation) and skills for changing maladaptive cognitions. Interventions which promoted skills to reduce the intensity or number of stressors were also successful. In most cases, stress interventions did not improve academic performance.

The design of stress interventions should be driven by theory. Future studies should focus on interface and organizational factors and the long-term benefits of interventions for student nurses are yet to be demonstrated.