title: The relationship between educational stress, stress coping, self-esteem, social support, and health status among nursing students in Turkey: A structural equation modeling approach.
abstract: BACKGROUND
  Nursing education can be a stressful experience. To fully benefit from this experience and develop a positive professional identity, it is essential for nursing students to effectively cope with education-related stress.
  
  
  OBJECTIVE
  The aim of the study was to investigate the relationships between nursing students' education-related stress and stress coping, self-esteem, social support, and health status.
  
  
  METHODS
  This study utilized a cross-sectional, descriptive, and correlational design. The sample consisted 517 nursing students from a bachelor program in Turkey during the 2014-2015 academic year. Participants provided data on sociodemographic characteristics as well as completing the following instruments: Nursing Education Stress Scale, Coping Behavior Inventory for Nursing Students, Multidimensional Scale of Perceived Social Support, Rosenberg Self-Esteem Scale, and General Health Questionnaire. Relationships were examined using multivariate structural equation modeling.
  
  
  RESULTS
  Results indicated that nursing students' stress coping levels were affected by self-esteem and social support. Additionally, this interaction appears to affect general health status. Although the direct effect of stress on coping was non-significant, its overall effect was significant within the model.
  
  
  CONCLUSIONS
  It is necessary to conduct further intervention studies examining the role of self-esteem and social support in facilitating nursing students' stress-related coping during their education.
authors.affiliation: Duzce University, School of Health Sciences, Department of Nursing, Duzce, Turkey.
authors.forename: N
authors.initials: N
authors.lastname: Yıldırım
authors.affiliation: Duzce University, School of Health Sciences, Department of Nursing, Duzce, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Karaca
authors.affiliation: Duzce University, Faculty of Medicine, Department of Biostatistics and Medical Informatics, Duzce, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Cangur
authors.affiliation: Duzce University, School of Health Sciences, Department of Nursing, Duzce, Turkey. Electronic address: ferhanacikgoz@duzce.edu.tr.
authors.forename: F
authors.initials: F
authors.lastname: Acıkgoz
authors.affiliation: Duzce University, School of Health Sciences, Department of Nursing, Duzce, Turkey.
authors.forename: D
authors.initials: D
authors.lastname: Akkus
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D003430:Cross-Sectional Studies; D004508:Education, Nursing, Baccalaureate; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D015233:Models, Statistical; D012649:Self Concept; D012944:Social Support; D013315:Stress, Psychological / Q000523:psychology*; D013338:Students, Nursing / Q000523:psychology*; D011795:Surveys and Questionnaires; D014421:Turkey; D055815:Young Adult
keywords: Coping; Health; Nursing students; Self-esteem; Social support; Structural equation modeling