Perceived stress, coping mechanisms, and influential factors among undergraduate nursing students during ICU clinical placements: A cross-sectional study

BACKGROUND: Intensive Care Unit (ICU) exposes nursing students to high workloads, emotional demands, and high-risk performance. Understanding perceived stress, coping strategies, and influential factors may enhance students' clinical experiences and outcomes. AIM: To assess perceived stress levels, identify coping mechanisms, and explore associations between stress, coping mechanisms, and demographic factors among nursing students during their Intensive Care Unit (ICU) clinical. SETTING: The study was conducted across three campuses of the Higher Colleges of Technology (HCT) in the United Arab Emirates (UAE). METHODS: A cross-sectional study design with a total sample of 127 undergraduate nursing students was conducted. Data were collected using the Perceived Stress Scale (PSS) and Coping Behavior Inventory (CBI). RESULTS: Students reported a moderate level of perceived stress (mean = 1.87, SD = 0.80). The highest-ranking stressors reported included assignments and workload, with (mean = 2.12, SD = 0.91), followed by peer-related stress (mean = 1.98, SD = 1.03). The most reported coping mechanism among students was the problem-solving mechanism (mean = 2.23, SD = 0.95), followed by the transference mechanism (mean = 2.17, SD = 1.00), and staying optimistic (mean = 2.15, SD = 0.95). Stepwise regression showed that the significant predictors of overall stress were avoidance coping, β = 0.65, p < 0.001, and transference coping, β = 0.24, p < 0.001, explaining 63% of variance, R² = 0.63. Problem-focused coping negatively predicted environmental stress, (β = -0.21, p = 0.021), highlighting its protective role. CONCLUSION: This research underscores the nursing students' moderate stress experienced during ICU nursing placements due to workload and peer pressure. Use of problem-focused coping strategies reduced stress, while maladaptive avoidance coping strategies increased stress. Stress was strongly predicted by avoidance and transference coping confirming the necessity for coping skills instruction in nursing. Teaching stress coping and resilience building in clinical education will improve students' well-being, performance, and preparedness for critical care nursing.