Relationship between perceived Stress and GPA among BSN Students: An ER-based Study

Abstract

Background: Nursing students often experience high levels of stress during clinical rotations, particularly in emergency room (ER) settings, due to patient acuity, rapid decision-making, workload, and fear of making errors. Such stress can impair concentration, learning, and academic performance. Despite its recognized impact globally, limited evidence exists on the relationship between perceived stress and GPA among BSN students in Peshawar, Pakistan.

Objectives: This study aimed to assess perceived stress among BSN students during ER rotations, compare stress levels between public and private hospitals, and examine the association between perceived stress and academic performance (GPA).

Methodology: An analytical cross-sectional study was conducted with 334 BSN students from five public and private nursing colleges in Peshawar. Data were collected using a structured questionnaire comprising demographic information, self-reported GPA verified against institutional records, and the Perceived Stress Scale (PSS-10). Descriptive statistics summarized participant characteristics, independent samples t-tests compared stress between hospital types, and Pearson’s correlation assessed the relationship between perceived stress and GPA.

Results: Most participants experienced moderate stress (88.7%), with low (4.4%) and high (5.9%) stress less common. Students in public hospitals reported significantly higher stress (M = 20.78, SD = 3.99) than those in private hospitals (M = 19.71, SD = 4.00, p = 0.015). Over half of the participants (52.1%) perceived ER-related stress as affecting their academic performance. Pearson correlation revealed a moderate, statistically significant negative association between perceived stress and GPA (r = -0.40, p < 0.001).

Conclusion: Perceived stress during ER clinical rotations adversely affects academic performance among BSN students, especially in public hospital settings. Targeted interventions, including structured mentorship, supportive supervision, and accessible counseling services, are recommended to reduce stress and enhance both academic achievement and professional development.