Ashley, Dick, Unger, Yu, & Zimmerman

Student Stress and Coping Mechanisms

Student Stress and Coping Mechanisms

Michelle Ashley, Elisa Dick, William Unger, Michael Yu, and Rachel Zimmerman
Touro University Nevada

Ashley, Dick, Unger, Yu, & Zimmerman

Student Stress and Coping Mechanisms

The experience of stress contains the capacity to cause great harm, or conversely,
generate significant productivity. What decides the influence of stress on an individuals life is
the effectiveness of ones coping mechanisms. High levels of stress are considered prevalent in
college and graduate students, and various coping methods may be viewed to have positive or
negative consequences on the students wellbeing. Students in rigorous medical or health-related
academic programs often endure stress for long periods of time. As students in a medical and
allied-health centered university, we are interested in the experiences of students who have
experienced stress and employed a variety of coping mechanisms in response.
The purpose of this qualitative research study is to explore student stress and coping
mechanisms from the perspective of Touro University Nevada students through a
phenomenological approach. The phenomenon of coping is defined as the ways students deal
with stress. This topic is of importance because stress is experienced frequently, and can lead to
unhealthy coping strategies. Additionally, it is important to gain insight in order to determine
effective solutions to stress. Findings may contribute to university-wide seminars or workshops
that educate on positive coping and stress-management techniques. The present study aims to
investigate: How do Touro University Nevada students cope with stress?
Literature Review
College and graduate students in healthcare programs are faced with demanding didactic
coursework, clinical fieldwork requirements, and frequent exams, all of which can lead to high
stress levels. Students reported that taking and studying for exams, grade competition, and
mastering large amounts of content in a small amount of time contribute to their greatest source
of stress (McKean & Misra, 2000). In conjunction with specific academic stressors, the

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Student Stress and Coping Mechanisms

decreased amount of leisure time available may negatively influence coping mechanisms
(Shaikh, et al., 2004).
Various coping strategies have demonstrated effectiveness in decreasing stress levels in
healthcare students. Rizzolo, Zipp, Stiskal and Simpkins (2009) found that occupational therapy
masters and physical therapy doctorate students who spent 30 minutes either participating in
yoga, watching a humorous television show, or reading material not related to academics,
experienced lower blood pressure, heart rate, and decreased stress levels. Additionally, a sample
of Pakistani medical students reported the most frequent coping strategies to be spending time
with friends, followed by sleep, music, sports and isolation (Shaikh et al., 2004). Furthermore,
McKean and Misra (2000) found that students who incorporated time management techniques,
and participated in leisure activities exhibited a reduction in stress and anxiety levels.
Though several coping strategies have demonstrated positive outcomes in regards to
decreasing stress, certain behaviors have been correlated with higher stress levels. Specifically,
novelty-seeking behavior, avoidant coping strategies, and lack of active cognitive and behavioral
approaches are associated with high stress levels (An, et al., 2012).
Although stress commonly manifests through poor physical health, anxiety, or
depression, a moderate level of stress can positively impact a students academic experience. In
a sample of baccalaureate occupational therapy students, 86% of students reported examinations,
amount of class work, lack of free time, long hours of study, and grades to be top stressors.
However, 62% of subjects reported that the stress they experienced strengthened their
commitment to their professional education (Everly, Poff, Lamport, Hamant, & Alvey, 1994). In
this case, the ability of students to perceive their stress constructively serves as a coping
mechanism.

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Student Stress and Coping Mechanisms

Stress is commonly considered to be the forces from the outside world impinging on the
individual (Shaikh et al., 2004). From a medical perspective, stress is expressed through elevated
heart rate and blood pressure (Rizzolo, 2009). Nevertheless, stress need not be harmful if proper
coping methods are utilized. Like stress, coping mechanisms are not inherently positive or
negative; rather, they are any method chosen to manage stress.
Previous research has focused on the effects of various coping mechanisms on the
experiences of stress in students. However, descriptions and narratives of students facing
stressful situations, and choosing coping mechanisms are limited. The present study explores
Touro University Nevada student perceptions of stress and coping mechanisms with intent of
developing understanding on the topic. Significance in findings may contribute to universitywide seminars or workshops that educate on positive coping and stress-management techniques.
Methods
Research Design
Due to the personal nature of our research question, a qualitative study was deemed most
appropriate using a phenomenological approach. The structure of a quantitative study could
possibly overlook details of personal experiences and accounts that relate to the research topic.
We opted to use personal interview to allow participants an opportunity to elaborate on personal
effects of stress, as well as their chosen coping methods.
Participants
Students of Touro University Nevada were recruited through a university-wide requesting
volunteers for a stress-related study. This convenience sample was composed of five males and
four females between of the ages of 24-46. Included were five osteopathic medicine, one
physical therapy, two nursing, and one occupational therapy students. Interviews were conducted

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Student Stress and Coping Mechanisms

on campus in private study rooms. When briefing the participants, the researchers explained the
purpose of the study, as well as the concept of qualitative research in order to encourage active
participation. Verbal permission to record each interview was obtained from each participant.
Each participant was ensured that privacy and confidentially would be honored through
assigning code names in the final written report. Interviews lasted between five and fifteen
minutes.
Data Collection
Interviews were transcribed in order to encourage participants to elaborate on their
personal experiences. Three primary questions formed the main structure of each interview;
however, each interviewer asked follow-up questions that were individualized to the participants
responses. The following questions were asked:
1. Describe your stresses as a student at Touro University Nevada. How did they make you
feel?
2. What coping mechanisms did you implement to deal with your stress?
3. Did your coping mechanisms help you deal with your stress?
Interviews took place from early December through early January at Touro University Nevada in
person.
Data Analysis
The data were organized through the use of written transcripts of each interview, all of
which were shared amongst the researchers. Content analysis was chosen as the method of
analyzing the data, and was selected for its ability to systematically determine the occurrence of
common themes across multiple participant interviews. As the goal of this study was to discern
how Touro students experienced and coped with stress, a systematic approach was appropriate
and practical.

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Student Stress and Coping Mechanisms

Categories of codes were determined inductively through the use of the participants own
words, and deductively through the use of two categorical archetypes: stressors and stress
relievers. Initially, an open coding technique was implemented to produce codes which
represented the variety in the participants experiences of stress and stress relief. Once these base
codes had been established, they were then grouped and sorted into the broader subcategories of
stressors and stress relievers. This was done using axial coding, which involves organizing data
into categories and subcategories which influence the phenomenon being studied (see Appendix
A). It should be noted that two subcategories, Preparedness and Rest and Sleep, were grouped
into both the stress and stress relief categorical archetypes. This was due to the common
occurrence in participants experiences; either a lack of or sufficient amount of preparedness or
sleep would result in stress or stress relief, respectively. Once the subcategories had been
established, their occurrences were then tallied amongst the nine interviews to determine any
patterns.
One such example of this coding scheme can be seen through the process by which the
subcategorical code of Disruptive Thinking was generated. This code was synthesized by
grouping the more specific themes of Mind Racing, Overwhelmed, and Age Stigma. The
following is a selection of text from [*Camilla (change name)*]s interview in which the theme
of Overwhelmed was identified, Even though I studied every day and kept up with the material,
I still feel like I had to cram because theres just so much. It was really overwhelming. It was
very, very frustrating.
Findings
Two particular patterns emerged from the participants responses in terms of the type of
stresses and coping mechanisms. The first pattern was the subcategory of Preparedness. All of
the participants cited preparedness to be a stressor or stress reliever which included time

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Student Stress and Coping Mechanisms

management, anxiety, anxiety from being unprepared, and stress from the unknown. The second
pattern observed was the subcategory of Healthy Lifestyle. All of the participants had this
subcategory as one of their coping mechanisms which included exercise, sports, healthy habits,
and eating well.
The data analysis revealed several themes common among the participants. It was found
that the majority of our interviewees had comparable stressors such as difficult schoolwork,
preparedness, and lack of sleep which was not surprising since many graduate programs are
challenging and require a tremendous amount of time and dedication to succeed. One participant
described her schoolwork as being so difficult that she got to the point where she had to be okay
with the idea of failing (see Appendix __). The theme of preparedness was illustrated by a
participant when she stated that its just really frustrating because I want to learn everything but
theres just so much of it that there is no way to learn it all the first time around (see Appendix
__). Sleep was another theme and one participant mentioned that during first and second
semester, I had anxiety all the time, I wouldnt sleep, I wouldnt do anything (see Appendix __).
Additionally, the theme of a healthy lifestyle was present in every participants interview. One
participant stated, In general, to reduce stress I exercise. I do surfing contests which is kind of
my relaxation thing. Another participant stated that exercise helps a lot and many people at
Touro seem to be pretty well with their physical fitness levels.
Researchers coded transcripts from the interviews they conducted for key words and
patterns, which were then discussed as a group. A consensus was reached regarding the
prevalence of the common themes of Preparedness and Healthy Lifestyle. Through this process,
all reached agreement that various strategies were identified in answering the question of how
students at Touro University deal with stress.

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Student Stress and Coping Mechanisms

As stated previously, our research had three primary questions that pertained to the types
of stresses experienced by the participants and the coping mechanisms they utilized. It was found
that there were four categories of stressors: disruptive thinking, preparedness, challenging
academics, and rest and sleep. These stressors were managed by the participants through six
categories of coping mechanisms: healthy lifestyle, perseverance, social relationships,
recreational activities, spirituality, and unhealthy habits. All of the participants indicated that
their coping mechanisms did alleviate their stresses. For example, one participant noted that he
failed one of his tests and felt really stressed, so he began to manage his time better and get more
rest. As a result, he felt less stressed and began to perform better on his tests. Another participant
described of having stress and anxiety around exam time which caused her to have difficulty
falling asleep. To cope with her stress and anxiety, she decided to listen to nature sounds each
night which helped her go to sleep.
Findings of this study were similar to the ones found in previous published research. For
example, a study by Rizzolo et al. (2009) found that participation in yoga and watching a
humorous television show were effective coping strategies that helped to lower stress levels.
However, Rizzolo et al. (2009) also found that reading material not related to academics helped
lower stress which was not found in this research. Additionally, a study by Shaikh et al. (2004)
found similar coping strategies such as spending time with friends, sleep, music, and sports.

Conclusions
It is a common perception that graduate students experience stress, and this study makes
that experience personal with the accounts of nine Touro students. Although stress levels were

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Student Stress and Coping Mechanisms

found to be high amongst all participants, coping mechanisms resulted in effective stress
management. Although efforts were made to promote participant comfort and confidentiality, it
is acknowledged that participants may withhold some information pertaining to negative coping
mechanisms due to social desirability bias.
Most participants appeared to exhibit a level of self-awareness in regards to their personal
levels of stress and which coping strategies were effective. As it has been found in previous
research, certain individuals will respond well to exercise, and others to entertainment. Since the
approach of this research was phenomenology, it is important that the participants could
understand and articulate their experiences with stress. The axial coding of the data analysis
elucidated the themes that surfaced in the findings.
Future research can expand upon the results using students in other professional
disciplines. The effectiveness of on-campus stress management programs can be explored in
further research. An understanding of the phenomena of stress is pertinent not just to students,
but to the professionals they will become.

References
An, H., Chung, S., Park, J., Kim, S.Y., Kim, K.M., & Kim, K.S. (2012). Novelty-seeking and
avoidant coping strategies are associated with academic stress in korean medical students.
Psychiatry Research, 200 (2/3), 464-468. doi: 10.1016/j.psychres.2012.07.048
Everly, J.S., Poff, Lamport, N., Hamant, C., & Alvey, G. (1994). Perceived stressors and coping

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Student Stress and Coping Mechanisms

10

strategies of occupational therapy students. American Journal of Occupational Therapy,

48, 1022-1028.
McKean, M., & Misra, R. (2000). College students academic stress and its relation to
their anxiety, time management, and leisure satisfaction. American Journal of Health
Studies, 16 (1), 1-12.
Rizzolo, D., Zipp, G. P., Stiskal, D., & Simpkins, S. (2009). Stress management strategies for
students: The immediate effects of yoga, humor, and reading on stress. Journal of
College and Teaching & Learning, 6(8), 80-88.
Shaikh, B.T., Kahloon, A., Kazmi, M., Khalid, H., Nawaz, K., Khan, N.A., & Khan, S. (2004).
Students, stress and coping strategies: A case of pakistani medical school. Education for
Health, 17,(3). 346-353.

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11

Appendix A
Coping Mechanism Coding
KEY:
Light green: Disruptive Thinking
Yellow: Preparedness
Teal: Challenging Academics
Red: Healthy Lifestyle
Turquois: Rest and Sleep

Dark Green: Perseverance

Purple: Social Relationships
Gold: Recreational activities
Grey: Spirituality
Blue: Unhealthy habit

E:
Stress: time management, mind racing
Relief: exercise, perseverance
J:
Stress: anxiety from being unprepared
Relief: accepting outcomes, talking with others, exercise, recreational
distractions
S:
Stress: difficult schoolwork, anxiety from being unprepared
Relief: Talking with others, stress as a motivator, exercise, sports, spirituality
C:
Stress: anxiety from being unprepared, overwhelmed, lack of sleep
Relief: Sleep, exercise, pets, recreational distractions
R:
Stress: time management, overwhelmed
Relief: perseverance, positive attitude, mindfulness, exercise, meditation,
talking with others, drinking alcohol, recreational distraction, finding balance,
healthy habits
K:
Stress: difficult schoolwork, time management,

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12

Relief: seeking help, sleep, taking breaks, time management, exercise, going
out, recreational distraction, accepting outcomes, spirituality, relationships,
L:
Stress: time management, Age stigma,
Relief: exercise, rest, eating well, spending time with spouse, spirituality,
meditation, prayer, recreational writing
N:
Stress: anxiety, lack of sleep
Relief: exercise, relaxing sounds, going out, taking a drive
O:
Stress: time management, anxiety, stress from the unknown
Relief: entertainment, eating junk food, stress as a motivator, exercise, read
scripture,