Volume 8, Issue 1, January – 2023 International Journal of Innovative Science and Research Technology

ISSN No:-2456-2165

Psychological Distress and Coping among

Undergraduate Nursing Students of Kashmir during
Pandemic Covid 19
Shabnam Ara1, Rehana Qouser 2 Yasmeen Akhter 3 Sufoora Yaseen4, Umer Ramzan, 5Rais Ahmad6,Safiya7, Ruqeeb jan8
1.
Tutor Govt. Nursing College GMC Srinagar, PG Scholar Psychiatric Nursing & PG Applied Psychology
2.
Tutor Govt. Nursing College GMC Srinagar, PG Scholar Community Health
3.
Tutor Govt. Nursing College GMC Srinagar PG Scholar Medical surgical nursing,ratheryasmeen8389@gmail.com
4.
Tutor Govt. Nursing College GMC Srinagar, PG Scholar Gynecology nursing & obstetric nursing
5.
Tutor at Govt. Nursing of College GMC Srinagar, PG Child Health
6.
Tutor Govt. Nursing College GMC Srinagar, PG Scholar Community Health
7.
Tutor Govt. Nursing College GMC Srinagar PG Scholar Medical surgical nursing
8.
Tutor Govt. Nursing College GMC Srinagar, PG Scholar Psychiatric Nursing

Abstract:- Psychological distress refers non specific I. INTRODUCTION

symptoms of stress, anxiety and depression considered as a
warning to the mental health. This research was conducted Corona-virus disease was first found in china in late 2019
during COVID-19 to assess the major implications of declared as pandemic by world health organization globally in
mental health among nursing students due to closure of February 2020, that resulted massive disruptions to everyday
colleges, universities and offline classes which restricted one life,1 including in Jammu Kashmir which is one of the Union
to one and physical interaction globally, Kashmir as well. Territory of India.
The study examined the psychological distress and coping
adopted by nursing undergraduate students of Kashmir Mortality and Morbidity rates were significantly increased
during this pandemic Covid 19. Methods: A cross- sectional with implications on mental health and psychological
online descriptive study was conducted; using purposive wellbeing. Apparently, the pandemic was a major stressor as
sampling consists of 183 under graduate nursing students that of catastrophic events which according to diathesis-stress
from selected nursing colleges of Kashmir. Data was model leads psychological disorders among vulnerable groups
gathered as online responses to a questioner from17-10-20 such as students2. This pandemic has significantly affected
to 7-11-2020, includes socio demographic variables, college students physically, academically, financially and
psychological distress scale (K10) and brief coping psychologically. Colleges and universities have reported that a
resilience scale. Results: Among 183 participants the number of students were tested positive for COVID-193,4. In
majority of 171 (93.4%) were in the age group of 19-23 and order to prevent widespread transmission of the COVID-19
female 122(66.7%).Most had younger 80 (43.7%) birth virus among working staff, young and adult population, higher-
order belonging to nuclear family 141(77%) with majority education and other institutions except Health and Police across
from rural area 147 (80.3%).Over the last four weeks the country have rapidly switched from in-person to online
majority of study participants have perceived moderate learning. Within a short period of time, college students’ life
psychological distress 61(33.3) with Medium75(41%) and has drastically changed as they have been asked to leave
low 63(34.4) resilient copers with a p-value of campus, adjust to new living circumstances, and adapt to online
0.000*.Negative Correlation was found. Conclusions: Most learning platform5. Sudden change from offline to online,
of the study subjects reported sufferings from varying particularly in professional courses have increased distress
degree of psychological distress during covid crisis over the among students. Because these courses are designed to include
4 weeks. This reveals that there is need of an intervention to high levels of interaction and hands-on experiences such as
enhance skill of coping strategies and decrease distress in practical’s, labs, and/or artistic performance had a clear
this crisis situation. disadvantage in regards to the evaluation of students 6,7..
According to the students survey 4 out of 5 college students are
Keywords:- Covid -19, Psychological Distress, Coping facing financial difficulties due to the COVID-19 pandemic,
Resilience, Under Graduate Students, Mental Health. However humans are dynamic in nature and has an ability to
adapt with an ongoing situation of their life, people find out the
ways of coping within the restrictions to mitigate the pandemic
crisis. Such coping strategies include both behavioral and

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Volume 8, Issue 1, January – 2023 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
psychological efforts to gain mastery, toleration, and minimize participate. Exclusion criteria: (a) Postgraduate students of
stressful events8,9. Positive coping has been associated with nursing (b) not willing to participate.
reductions in stress levels that results improved well-being,
while as negative coping is associated with stress enhancement,  Data Collection Tools
resulting in increased psychological distress 9. The extent to Demographics: sociodemographic scale was formulated
which coping increases or reduces psychological distress is by researchers included Age, Gender, Birth order, family type
highly dependent upon the collection of stressors, adaptation and Domicile. The Kessler Psychological Distress Scale
manners, and resources and the coping responses chosen to (K10) developed by Kessler professor of health care and
combat such stressors. 10 policy, Harvard Medical School, Boston, USA. K10 is a 10-
item scale that assesses the frequency of nonspecific
 Need of study psychological distress symptoms experienced during the last 30
Researchers work at college of nursing and found that days. Study subjects are asked to answer on a 5-point scale(1 =
online classes during covid 19 pandemic situation has none of the time to 5 = all of the time) and the total score ranges
hampered abilities and proficiency among students as there is from 10 to 50.Score under 20 indicates well, Scores 20-24
no direct interaction between student and teacher .while talking likely to have Mild distress, Scores 25-29 indicates Moderate
to the students they felt distress and has changed their coping Distress, Score of 30 & more means highly distressed. Brief
resilience because college is a platform for students in reducing Resilient Coping Scale consists of 4 questions indicates level
distress/ mental illness and enhances their coping resilience so of resilience copers developed by Sinclair V G, & Wallston, KA
researchers found a need to assess the level of distress and level (2004). Total score ranges from 4 to 20. Scores of 4-13 indicate
of coping resilience during covid 19 pandemic situation. low resilient coping, 14-16 indicate medium resilient coping
and 17-20 indicate high resilient coping.
 Objectives
 To determine the levels of distress among undergraduate B. Statistical Analysis
nursing. An analysis was done by using SPSS 16.0 software.
 To assess the level of coping resilience among under Descriptive statistics was applied on demographic data and
graduate nursing students Kessler’s Psychological Distress Scale (K-10) & Brief Resilient
 To compare level of distress and level of coping resilience Coping Scale which was calculated and expressed in terms of
among under graduate nursing students. the total number of subjects and percentages of the sample.
 To find an association of selected demographic variables. ANOVA and Pearson Correlation were used to test the
significance.
II. METHODS
III. RESULTS
A. Research design
An online descriptive cross sectional research design was Table 1: Shows Frequency & Percentage of socio-
used. demographic variables N= 183
Frequency &
 Setting and Procedure Percentage
The study was carried out on a sample of Bsc nursing Age in years 19-23 171 (93.4%)
students through electronic consent form and questioner to take
their participation. Google form was disseminated by watsapps 24-27 12 (6.6%)
and emails. Data collection process took place over a period of Gender Male 61 (33.3%)
one month from17-10-2020 to 20-12-2020.
Female 122 (66.7%)
 Sampling; Birth order Elder 37 (20.2%)
Purposive sampling with a sample size of 183 Middle 66 (36.1%)
undergraduate nursing students of selected nursing colleges of Younger 80 (43.7%)
Kashmir with a total population of 600 students . The sample Family Type Nuclear 141 (77%)
size was estimated by using slovins formula of sample size with Joint 40 ( 21.9)
a margin error of 5%.These colleges closed their classes on Domicile Rural 147 (80.3%)
March 23 2020, and held its classes virtually in response to Urban 36 (19.7)
pandemic covid -19.

Selected Nursing Colleges of Kashmir approved the study

with an Inclusion criterion: (a) undergraduate nursing students
of selected nursing colleges of Kashmir. (b) Willing to

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Volume 8, Issue 1, January – 2023 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
Table 2: Frequency & Percentage distribution of subjects Table 5: Correlation between K10 scale & BRCS
according to Level of distress & Coping Resilience. (N=183) Mean ±SD df Significance
Level of Frequency Level of Frequency & K10 2.2623 ± 1.12760 -150 0.042*
severity & coping Percentage scale
Percentage Resilience BRCS 1.9016 ± 0.76399
<20 (well) 29 (15.8%) 4-13 (Low) 63 (34.4%) K10-- 0.644±1.4478 4.340 0.00
14-16( BRCS
20-24 (Mild) 56(30.6%) 75 (41.0%) (t-test)
Medium)
25-29
68(37.2%) 17-20 ( IV. DISCUSSION
(Mod) 45 (24.6%)
High)
30> (severe) 30(16.4%) Different Researches has studied a significant impact of
public health emergencies on mental health as covid one of the
Table 3: Shows an association of demographic variables with major crisis has described change in every activity of daily
distress score ( K10) living as well as drastic change in mental health of students. The
Variable Mean± F Df p. Inference current study was to examine the level of distress, level of
SD value coping resilience and its correlation among undergraduate
nursing students of selected college of Kashmir.
Age in 1.07 1.574 182 0.197 NS
years ±0.249 The current study confirms the findings of Distress and
coping resilience among undergraduate nursing students in
.Gender 1.67 5.189 182 covid 19 situations from selected colleges of Kashmir. It was
±0.473 0.002* S found that majority of students were lying in the age group of
Type of 1.24 ± 0.554 182 0.646 NS 19-23 (93.4%), had majority of subjects were females (66.7%),
family 0.453 mostly belonging to nuclear family (77%), had a domicile
majority from rural area (80.3%) with younger birth order
Birth 2.23±.760 0.276 182 0.843 NS (43.7%).While applying the K10 Distress scale majority of
order students had well (<20) mental health 29 (15.8 %,) followed by
Domicile 1.20 ± 1.496 182 0.218 NS moderate distress level 68 (37.2%) with a mild 56 (30.6%,) and
0.399 severe 30 (16.4%) distress level respectively. Subsequently
majority of students had medium 75 (41%) and low 63 (34.4
Table 4: Shows an association of demographic variables with %,) level of coping resilience. The results revealed that only 45
coping resilience (24.6%) had high level of coping resilience.
Variable Mean F Df p. Inference
±SD value The current study shows that Mean± SD of Gender is 1.67
±0.473 which is significant with a p-value of 0.002 and 0.01.
Age in 1.07 1.633 182 0.198 NS However other demographic variables are non-significant
years ±0.249 found when associated with (K10) Distress level and Coping
resilience as shown in table 4&5.Therefore mental health
Gender 1.67 4.770 182 0.01* S gender wise has been definitely affected during this covid 19
±0.473 situation and there is perfect negative correlation found
between distress and coping resilience that indicates whenever
Type of 1.24 ± 1.037 182 0.478 NS there is low distress level of coping is high and vice versa. The
family 0.453 findings of this study show that subjects had mild and moderate
distress level with moderate and low copers resilience as shown
Birth order 2.23±.760 0.742 182 0.357 NS in table 6.
Domicile 1.20 ± 4.581 182 0.011 NS
0.399

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Volume 8, Issue 1, January – 2023 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
Similiar Study in Guilan, Iran was conducted by Ali from: https://www.ramapo.edu/health/coronavirus-covid-
Monfared, Leila Akhondzadeh etal11, on Psychological Distress 19/#s1
and Coping Strategies among Clinicians and Medical Students [5]. Gewin V. Five tips for moving teaching online as COVID-
During the COVID-19 Pandemic. They used Kessler 19 takes hold. Nature. 2020 Apr;580(7802):295–6.
Psychological Distress scale (K10), and coping strategies pmid:32210377
among 109 clinicians and medical students working in Razi [6]. Sahu P. Closure of Universities Due to Corona-virus
Hospital of Rasht, Iran during the COVID-19 pandemic. The Disease 2019 (COVID-19): Impact on Education and
results were revealed as mean age of the responders was 36.14 Mental Health of Students and Academic Staff. Cureus.
years (SD = 10.68). The mean K10 total scores was 12.94 (SD 2020 Apr 4;12(4).
= 7.64). There was a significant negative correlation between [7]. Lederman D. How the shift to remote learning might
age and K10 total scores (r = -0.397, P < 0.001). Single affect students, instructors and colleges
participants had a higher K10 total score compared with .2020[cited2020Apr29].Availablefrom: https://www.insi
married ones (P = 0.003). Furthermore, interns had a higher dehighered.com/digitallearning/article/2020/03/25/how-
K10 total score compared with residents (P = 0.012) and faculty shift-remote-learning-might-affect-students-instructors.
members (P < 0.001).21 [8]. Student Loan Hero. 4 Out of 5 College Students Face
Troubles Due to Corona-virus Pandemic | Student Loan
V. CONCLUSION Hero. 2020 [cited 2020 Apr 18]. Available
from: https://studentloanhero.com/featured/college-
Several studies need to be done among the nursing students-financial-coronavirus-survey/
students as it is the vulnerable group in regard of their mental [9]. American College Health Association. American College
health belonging to Kashmir because the covid 19 pandemic has Health Association-National College Health Assessment
disturbed mental health of students because of online and III: Reference Group Executive Summary Fall 2019.
continuous classes, has decreased efficiency of professionals Silver Spring, MD; 2020.
which increased distress level and decreased coping resilience [10]. Wang C, Pan R, Wan X, Tan Y, Xu L, Ho CS, et al.
among the students of Kashmir with respect to conflict zone Immediate Psychological Responses and Associated
area. Our finding suggest that college students must be provided Factors during the Initial Stage of the 2019 Corona virus
with mental health interventions by professionally trained Disease (COVID-19) Epidemic among the General
person that could help students to address their distress level Population in China. Int J Environ Res Public Health.
and improve in their coping.. 2020 Mar 6;17(5):1729.
[11]. Ali Monfared, Leila Akhondzadeh etal, on Psychological
Acknowledgments: The researchers are grateful to all the Distress and Coping Strategies among Clinicians and
officials and students who helped us in this research. Medical Students During the COVID-19 Pandemic,
Published online 2021 April 10
Funding: Self

Conflict of interest: no conflict of interest.

Ethical clearance: Permission was granted by Head of

Institutions’

REFERENCES

[1]. COVID-19 Statistics for Jammu and Kashmir, Updated 27

November 2020, 04:54 GMT+5:30.
[2]. Siddaway, A.P(2020).Multidisciplinary research
priorities for the covid pandemic. Lancet
psychaitry7:e42:doi10.1016/S2215-O366(20)30249-2..
[3]. Bloomfield College. Important Update On COVID-19 At
Bloomfield College, Student Tests Positive TAPinto.
2020 [cited 2020 Apr 18].Available
from: https://www.tapinto.net/towns/nutley/articles/impo
rtant-update-on-covid-19-at-bloomfield-college-student-
tests-positive
[4]. College R. Corona-virus (COVID-19) Information and
Updates—Health Services. 2020 [cited 2020 Apr 23].
Available

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