Resilience and Coping Behaviors Among Palestinian Nursing Students During an Internship in Critical Care Units During the 7th of October War

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AIM: This study aimed to examine perceived stress among nursing students during their training in critical care units and its relationship with resilience and coping behaviors. BACKGROUND: Stress significantly impacts nursing students' critical thinking and academic performance. The events of the 7th of October 2024 war in Palestine have further exacerbated these challenges, forcing students into virtual learning, limiting clinical access, and increasing academic burdens. Resilience and coping behaviors have emerged as pivotal factors in predicting students' academic success and well-being, particularly during internship in high-pressure settings like critical care units. METHODOLOGY: A cross-sectional study design was employed, involving 352 nursing students at Arab American University during their internships in critical care units. Due to logistical constraints, data were collected through online surveys using the Perceived Stress Scale, the Brief Resilience Scale, and the Coping Behavior Inventory between June and July 2024. RESULTS: The mean overall perceived stress score was 1.37 (SD = 0.82), reflecting a moderate level of perceived stress. The most commonly reported source of stress was "stress from peers and daily life" with an average score of 1.50 out of 4.0 (SD = 0.96). Regarding resilience, the mean total score was 3.13 (SD = 0.74), with 59.0% of the students displaying a normal/moderate level of resilience. Problem-solving was the most frequently used coping strategy (M = 2.51, SD = 0.93). A negative correlation was found between perceived stress, resilience, and optimistic coping strategies. A positive association between perceived stress, avoidance, and transference coping strategies. Avoidance coping strategy was the main predictor of stress. CONCLUSION AND IMPLICATIONS FOR NURSING AND/OR HEALTH POLICY: These findings could assist policymakers in recognizing the critical role of resilience and coping behaviors in shaping nursing students' perceived stress. Strategies and interventions to enhance coping strategies and boost resilience need to be developed and implemented to reduce stress among intern nursing students.