title: Psychological distress and coping amongst higher education students: a mixed method enquiry.
abstract: BACKGROUND
  Psychological distress among higher education students is of global concern. Students on programmes with practicum components such as nursing and teacher education are exposed to additional stressors which may further increase their risk for psychological distress. The ways in which these students cope with distress has potential consequences for their health and academic performance. An in-depth understanding of how nursing/midwifery and teacher education students experience psychological distress and coping is necessary to enable higher education providers to adequately support these students.
  
  
  METHODS
  This mixed method study was employed to establish self-reported psychological distress (General Health Questionnaire), coping processes (Ways of Coping Questionnaire) and lifestyle behaviour (Lifestyle Behaviour Questionnaire) of a total sample (n = 1557) of undergraduate nursing/midwifery and teacher education students in one university in Ireland. Individual interviews (n = 59) provided an in-depth understanding of students experiences of psychological distress and coping.
  
  
  RESULTS
  A significant percentage (41.9%) of respondents was psychologically distressed. The factors which contributed to their distress, included study, financial, living and social pressures. Students used varied coping strategies including seeking social support, problem solving and escape avoidance. The positive relationship between elevated psychological distress and escape avoidance behaviours including substance use (alcohol, tobacco and cannabis) and unhealthy diet is of particular concern. Statistically significant relationships were identified between "escape-avoidance" and gender, age, marital status, place of residence, programme/year of study and lifestyle behaviours such as diet, substance use and physical inactivity.
  
  
  CONCLUSIONS
  The paper adds to existing research by illuminating the psychological distress experienced by undergraduate nursing/midwifery and teacher education students. It also identifies their distress, maladaptive coping and the relationship to their lifestyle behaviours. The findings can inform strategies to minimise student distress and maladaptive coping during college and in future professional years.
authors.affiliation: Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland.
authors.forename: Christine
authors.initials: C
authors.lastname: Deasy
authors.affiliation: Department of Psychology, University of Limerick, Limerick, Ireland.
authors.forename: Barry
authors.initials: B
authors.lastname: Coughlan
authors.affiliation: ACTé, ESPE Clermont-Auvergne, Université Blaise Pascal, Clermont-Ferrand, France.
authors.forename: Julie
authors.initials: J
authors.lastname: Pironom
authors.affiliation: ACTé, ESPE Clermont-Auvergne, Université Blaise Pascal, Clermont-Ferrand, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Jourdan
authors.affiliation: Department of Education and Professional Studies, University of Limerick, Limerick, Ireland.
authors.forename: Patricia
authors.initials: P
authors.lastname: Mannix-McNamara
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007494:Ireland; D008297:Male; D008875:Middle Aged; D011340:Problem Solving; D012944:Social Support; D013315:Stress, Psychological / Q000523:psychology*; D013338:Students, Nursing / Q000523:psychology*; D011795:Surveys and Questionnaires; D014495:Universities; D055815:Young Adult