Introduction:
Stress affects students’ health, their academic performance and personal and professional development.(1) It results in mental disorders like anxiety, depression, schizophrenia, dementia, suicidal ideation and behavioral problems like substance abuse.(2-4) Stress is influenced by the person’s ability to cope. World Health Organization defines stress as the response people may present with demands and pressures that do not match their knowledge and abilities and pose a challenge in their coping ability.(4)
Coping acts as a process for restoring the sense of control in environment in response to stressful feelings and experiences.(5) Students use different coping methods and strategies to tackle stress which may be either positive or negative. Inability to cope with the stress and stressful factors impairs health and results in the physical and mental health problems and disorders. Coping strategies controls or minimizes stress.(6) Students adopt active coping, planning, acceptance, positive reframing, denial, behavioral disengagement, venting, humor, religion, emotional support, self blaming, self distraction, instrumental support and substance use for coping stress.(7) Coping strategies and approaches are influenced by ethnic, cultural, and socioeconomic characteristics. For example, symptoms of stress rise with decreasing social status and females prefer emotional and avoidant coping strategies more than males do.(8)
The study was conducted to assess the coping strategies adopted by the undergraduate students of private universities in Himachal Pradesh, India.
Methods
The study conducted was cross sectional. Study was conducted in between March-April, 2016 using self administered questionnaire. Sample size was calculated using formula, n= z2pq/d2 by taking a precision (d) of 5%, prevalence (p) of 50% at 95% level of confidence which was obtained as 384. An addition was done with assumption of 10% non response rate final calculated sample size was 422. The study adopted convenient and simple random sampling techniques. In the study, 2 universities were selected from the cluster of 17 private universities in Himachal Pradesh using convenient sampling technique. From each University, 2 classes were selected from each course/stream from each university using simple random sampling. Undergraduate students available at University premises during the time of data collection were included in the study and those refusing to participate in the study were excluded.
Brief COPE inventory(7,9) was used for measuring coping strategies. Response choices ranged from ‘‘1. I have not been doing this at all’’ to 4: ‘‘I’ve been doing this a lot’’ based on 4 point likert scale. The students made their choices according to the 28 different coping techniques most frequently used to manage the stressful events experienced by them in University. Coping techniques were classified into 14 strategies as per 28 techniques used by the students; 1, 19 self distraction; 2, 7 active coping; 3, 8 denial; 4, 11 substance use; 5, 15 emotional support; 10, 23 emotional support; 6, 16 behavioral disengagement; 9, 21 venting; 12, 17 planning; 14, 25 planning; 18, 28 humor; 20, 24 acceptance; 22, 27 religion and 13, 26 self blame. Reliability coefficient (Cronchbach’s alpha) in the study was 0.73 for brief cope inventory.
Pre-testing was done among the 11.6% (49) students of total sample size in Eternal University. Pre-tested samples were excluded from study. Approval for study was taken from research committee of Eternal University. Informed consent was taken from undergraduate students of private universities. Verbal approval was also taken from administration of respective universities. Confidentiality of students has been maintained strictly.
Results
General background
Response rate was 99.05%. Students were of age group 17-26. Mean age of the respondents was 19.64+1.506. Majority of the respondents, 307(73.4%) were having age less than or equal to 20 years followed by 111(26.6%). Majority of the respondents, 307(73.4%) were having age less than or equal to 20 years followed by 111(26.6%).
Coping strategy adopted by students
Students adopted different coping techniques to reduce or manage stress. They gave responses for 28 different techniques ranging from never to a lot. Comparatively never using alcohol or other drugs had highest number of responses from students (76.1%). In case of doing a lot, Taking action to try to make the situation better had highest responses (42.8%) (Table 1) Students were found to use active emotion focused coping (mean=21.19+3.88) more than avoidant emotion focused (mean=17.96+3.28) coping strategies. Likewise, problem focused strategies (mean=16.93+3.37) were more preferred than the adjustment focused coping strategies (mean=15.00+3.00). The most used coping strategies were positive reframing (mean=5.85+1.583), active coping (mean=5.82+1.548), religion (mean=5.72+1.77), acceptance (mean= 5.67+1.581) planning (mean=5.65+1.491) and self distraction (mean=5.6+1.583). Least used coping strategies were (mean=2.83+1.478), denial (mean=4.64+1.567) and venting (mean=4.64+1.513). (Table 2)
Table 1: Responses made by students for Brief cope inventory |
| S.No. |
Activities |
Doing never |
Doing little bit |
Doing medium amount |
Doing a lot |
1 |
Turning to work/activities to take mind off things |
51(12.2) |
128(30.6) |
129(30.9) |
110(26.3) |
2 |
Concentrating efforts on doing something |
45(10.8) |
123(29.4) |
149(35.6) |
101(24.2) |
3 |
Saying to myself "this isn't real |
108(25.4) |
126(30.1) |
113(27.0) |
73(17.5) |
4 |
Using alcohol/other drugs to make feel better. |
318(76.1) |
40(9.6) |
30(7.2) |
30(7.2) |
5 |
Getting emotional support from others |
97(23.2) |
143(34.2) |
109(26.1) |
69(16.5) |
6 |
Giving up trying to deal with it |
83(19.9) |
148(35.4) |
119(28.5) |
68(16.3) |
7 |
Taking action to try to make the situation better |
32(7.7) |
86(20.6) |
121(28.9) |
179(42.8) |
8 |
Refusing to believe that it has happened |
104(24.9) |
149(35.6) |
109(26.1) |
56(13.4) |
9 |
Saying things to let unpleasant feelings escape |
|
|
|
|
10 |
Getting help and advice from other people |
59(14.1) |
119(28.5) |
127(30.4) |
113(27.0) |
11 |
Using alcohol/other drugs to help get through it |
318(76.1) |
57(13.6) |
28(6.7) |
15(3.6) |
12 |
Trying to see it in a different light, to make it seem more positive |
47(11.2) |
90(21.5) |
129(30.9) |
152(36.4) |
13 |
Been criticizing myself |
104(24.9) |
144(34.4) |
97(23.2) |
73(17.5) |
14 |
Trying to come with strategy about what to do |
43(10.3) |
120(28.7) |
167(40.0) |
88(21.1) |
15 |
Getting comfort and understanding from someone |
53(12.7) |
114(27.3) |
150(35.9) |
101(24.2) |
16 |
Giving up the attempt to cope |
91(21.8) |
149(35.6) |
118(28.2) |
60(14.4) |
17 |
Looking for something good in what is happening |
43(10.3) |
93(22.2) |
133(31.8) |
149(35.6) |
18 |
Making jokes about it |
122(29.2) |
130(31.1) |
85(20.3) |
81(19.4) |
19 |
Doing something to think about it less, such as going to movies, watching TV, reading, sleeping |
59(14.1) |
96(23.0) |
98(23.4) |
165(39.5) |
20 |
Accepting reality of fact that it has happened |
37(8.9) |
101(24.2) |
138(33.0) |
142(34.0) |
21 |
Expressing negative feelings |
111(26.6) |
163(39.0) |
74(17.7) |
70(16.7) |
22 |
Trying to find comfort in religion/spiritual beliefs |
57(13.6) |
87(20.8) |
117(28.0) |
157(37.6) |
23 |
Trying to get advice/help from people what to do |
57(13.6) |
105(25.1) |
141(33.7) |
115(27.5) |
24 |
Learning to live with it |
54(12.9) |
115(27.5) |
130(31.1) |
119(28.5) |
25 |
Thinking hard about what steps to take |
35(8.4) |
96(23.0) |
148(35.4) |
139(33.3) |
26 |
Blaming myself for things that happened |
101(24.2) |
124(29.7) |
104(24.9) |
89(21.3) |
27 |
Praying or meditating |
62(14.8) |
97(23.2) |
113(27.0) |
146(34.9) |
28 |
Making fun of the situation |
132(31.6) |
117(28.0) |
82(19.6) |
87(20.8) |
| # Figures in parentheses represent percentage |
Table 2: Coping strategy adopted by students |
| Coping strategy |
Mean |
Standard deviation |
Emotion Focused Coping |
39.15 |
5.815 |
Active emotion focused coping |
21.19 |
3.88 |
Acceptance |
5.67 |
1.581 |
Emotional support |
5.07 |
1.514 |
Positive reframing |
5.85 |
1.583 |
Humor |
4.59 |
1.825 |
Avoidant emotion focused coping |
17.96 |
3.28 |
Self distraction |
5.6 |
1.583 |
Behavioral disengagement |
4.76 |
1.545 |
Self blame |
4.78 |
1.70 |
Substance use |
2.83 |
1.478 |
Problem focused coping |
16.93 |
3.37 |
Active |
5.82 |
1.548 |
Instrumental support |
5.46 |
1.65 |
Planning |
5.65 |
1.491 |
Adjustment focused coping |
15.00 |
3.00 |
Denial |
4.64 |
1.567 |
Venting |
4.64 |
1.513 |
Religion |
5.72 |
1.770 |
Discussion
Coping strategies are any techniques, efforts and processes adopted to reduce or control stress. The major coping strategies adopted by the undergraduate students of Himachal Pradesh were positive reframing, active coping, religion, acceptance, planning and self distraction which is supported by the studies conducted in Nepal(10), Saudi Arabia(11), Hyderabad, India(12) and Karnataka, India. Least adopted strategy was substance use which is supported by studies in Rajasthan, India(14), Nepal(10), Maharashtra, India(15), and Hyderabad, India.(12) On contrary to the findings of this study, students in Malaysia(16) used negative coping methods like substance use. Students in the study preferred active emotion focused strategies than avoidant emotion focused strategies and problem focused strategies than the adjustment focused strategies which is supported by a study conducted in Australia which found students used emotion-and problem-focused coping more than the adjustment-focused coping.(17) Study in Malaysia found most common strategy used for coping stress was task-oriented and least was emotion oriented.(18)
Conclusion
Students used positive reframing, active coping, religion, acceptance, planning and self distraction frequently for coping stress. Students used positive coping strategies rather than the negative strategies to deal with stress. Though negative coping technique like substance were least adopted, such coping strategies need to be discouraged at the family, community and university level to deal with stress. Stress management classes should be regularly conducted at the university to manage or reduce the effects of stress.
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