Doctoral Dissertations

Date of Award


Degree Type


Degree Name

Doctor of Education



Major Professor

Gerald C. Cheek

Committee Members

Roger Haskell, Carroll Coakley, Malcolm McInnis


The purposes of this study were to document and describe the presence of anxiety in an incoming class of associate degree nursing students and to determine the effects of a stress management program on anxiety reduction and promotion of success in the first semester of a nursing program.

The population was 122 first year nursing students at Chattanooga State Technical Community College in Fall 1990. Treatment (n = 58) and control (n = 64) groups were assigned based on a common schedule of nursing classes.

During the semester, the treatment group voluntarily attended weekly one hour stress management/anxiety reduction sessions. The program, modeled after stress inoculation training described by Meichen baum (1985), was presented by the researcher. Students in the designated treatment group who attended at least six out of eight sessions comprised the experimental group (n = 20) .

At the beginning of the semester, all students completed the State-Trait Anxiety Inventory (STAI) and provided demographic and descriptive information: age, race, gender, marital status, number of children, NLN Preadmission Test score, semester credit hour load, and hours of employment.

Following the final course examination, all students were asked to complete the STAI posttest. Student who voluntarily withdrew prior to the end of the semester completed an exit interview with the researcher and the STAI.

The overall results of this study did not support the relationship between anxiety, an anxiety reduction intervention strategy, and attrition.

Finding 1. Mean state and trait anxiety of female nursing students were statistically different (state p =.05 and trait p =.00) from female students in the normative STAI population. Male nursing students showed a significant difference (p=.04) in trait anxiety.

Finding 2. Scholastic aptitude, as measured by the NLN Preadmission Test, was the only variable to demonstrate a significant relationship with anxiety level at the .05 level of significance. There' was a -.187 correlation between NLN Preadmission Test score and state anxiety.

Finding 3. In determining the effectiveness of the stress management program, independent t-tests showed that the stress management program did not result in a significant difference in state. (p = .35) or trait (p = .62) anxiety.

Finding 4. According to independent t-tests for difference, mean final nursing course grade for control (79.8) and experimental (82.7) groups were not significant at the .05 level of significance (p = .07).

Regarding attrition, there was no attrition in the experimental group, while eight out of 64 students (12.5percent) in the control group either withdrew or failed. The Z-score for this difference was significant at the .05 level.

Finding 5. When comparing pre- and posttest state and trait anxiety levels for nursing course completers and noncompleters, the results of independent t-tests demonstrated no significant differences at the .05 level.

Finding 6. Independent t-tests for differences between the completers and noncompleters with respect to age, NLN Preadmission Test score, semester credit hours, and hours of employment also were not significant at the .05 level.

The stress management intervention did not decrease the anxiety level experienced by students enrolled in an associate degree nursing program. However, attrition for students who received the intervention was significantly
different from the control group. It was concluded, therefore, that an intervention strategy could make a difference in the eventual success of students in the first nursing course. The resulting difference in attrition, however, could not be attributed to a significant reduction in anxiety.

It was further concluded that anxiety did not prove to be a significant variable. Reduction in anxiety was not evident, nor did a significant difference in anxiety level occur as a result of the stress management program. Therefore, students at risk of noncompletion could not be identified based on anxiety level.

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