INTRODUCTION:

Life presents a continuous chain of struggle for existence and survival” says Darwin. The observation is since every one of us strives for the satisfaction of our needs in struggling to achieve something. If we find that the results are not satisfactory, we either change our goal or the procedure. While doing so, one protects oneself from possible injury to one’s ego, fails or frustration. It likes shifting to more defensive position in order to face the challenges of circumstances after the initial failure. This feature of the living organism is termed as adjustment [1].

People can be considered as maladjusted and well adjusted. This can be done on the basis of their relationship with the environment and self. Maladjusted persons have problems with his environment. Good overall adjustment and a sense of well being are very crucial factors in providing positive contributions to the society. When there are problems in adjustment it will leads to stress. Stress is an all pervading phenomenon in life .If a person is able to deal effectively with a difficult situation, the amount of stress he or she may be facing is less. Some events may be perceived in different people it depends upon the coping resources they use to solve the problems [2]. As per as the Indian youth are concerned they are dominated mainly by the parents and other elders in the family .All the important decisions pertaining to their life are taken by them. This in turn can treat a stressful situation for the students, ultimately Influencing their personality and behavior [3].

Need for the study:

Time to grow, to change, to learn and to adjust is human necessary usually neglected and even held in contempt by a computerized and technological society. The tremendous competition learning often finds student not getting into a desired programme or institution for his/her future studies. When the choice of vocation is done by compulsion from the part of the parents or when the choice made is unrealistic can lead frustration [4].

Many students are away from home and learn with little guidance as to how to manage their own affairs and how to become adjusted to new conditions. Some find the transition from a rural to an urban way of life upsetting and one feels anxious in their new surroundings.

According to WHO approximately 20.6% of the total population of 846 millions in India consists of youth between 15-24 years of age. For young adults, the college years are a very critical period in which they feel the pressure to achieve in a competitive world and to fulfill responsibilities. These critical years of adjustment are undermined by depression, anxiety, substance abuse and eating disorders, sometimes leading to suicide [5-6]. The Studies conducted in India, highlight the level of adjustment problems in different areas which are: getting tired easily (81.30%), worrying about examinations (68.9%), unable to concentrate on studies (79.3%), having no one to share problems (80.20%), having too many personal problems (70%), worried about finances (19.7%), being made fun of (82.17%), difficulty in communication (67.82%), and 7% difficulty in making friends etc [7].

Nursing students are in the developmental phase of adolescence or young adulthood they are in a crisis state where they have to face significant changes in their living circumstances. Entering world of nursing presents students with an array of changes. Still in their teens, they are asked to change both from adolescent to adult and from lay person to a professional .The student nurse is entering a vocation where she has to deal with many kinds of people, so it is necessary that she is well prepared for the same [8].

The students who enroll nursing are often not fully aware of the stress and strain that accompany training period this may be either because the relatives who influence the students neglect this aspect wanting better future for their children or because the media highlights only the glamour associated with the profession, which may explain why most of the nursing students come from low socio-economic status ultimately however, it is the students who are unprepared. To be an effective nurse the students should have mental and physical well being, spiritual sense of society, good habits of study and work, effective behavior in new situations and a commendable attitude expressed in action. This study will help in assessing the extent of their adjustment towards self, others and the profession as a whole [9].Today’s Nursing students are tomorrow’s nurses; Nurses are expected to provide holistic care to individuals and families. In the course of training to be a nurse, the student is exposed to a multitude of stressors. They have to take up the responsibility for giving patient care in various situations adolescents who are healthy want to help others and want to assume responsibility. For this these adolescent students of nursing should have good adjustment among themselves and to the environment.

A study was conducted on coping as used by senior baccalaureate nursing students in response to appraised clinical stress. Findings showed that the basic social problem experienced by these students was the chaos created in their lives while trying to manage the demands of appraised clinical stress the basic social process that assist the basic social process that assist the students in managing this chaos was the three stage process of seeking stress care .i.e encountering changing self and regaining managed self [10].

Objectives of the study:

1. To assess the knowledge and attitude regarding adjustment problems among nursing students.

2. To correlate the knowledge and attitude regarding adjustment problems among nursing students.

3. To determine the association between the levels of knowledge with selected Socio-demographic variables.

4. To determine the association between the level of attitude with selected Socio-demographic variables

Hypothesis:

H₁: There will be significant relationship between knowledge and attitude regarding adjustment problems among nursing students.

H_2: There will be significant association between the level of attitude with selected socio demographic variables.

H3: There will be significant association between the level of knowledge with selected socio demographic variables.

MATERIALS AND METHODS:

Research approach:

A descriptive research approach was considered the best to assess knowledge regarding adjustment problems among 3^rd year B.Sc. nursing students.

Research design:

The research design in the present study was descriptive research design.

Setting:

A study was conducted in selected BSc nursing colleges in Tumkur.

Population:

The population for this study was 3^rd year B.Sc. nursing student of selected nursing colleges in Tumkur.

Sample:

The sample for the present study composed of 100 3^rd year B.Sc. nursing students at nursing colleges in Tumkur, Karnataka.

Sample Technique:

Simple random sampling technique was used to select the samples.

Sampling Criteria:

Inclusion Criteria:

Ø This study is limited to the student those who are in 3^rd year B.Sc. nursing course.

Ø Who are willing to participate in study

Exclusion Criteria:

Ø Students who are not available at the time of data collection

Ø Who are not willing to participate in study

RESULTS:

The data were analyzed on the basis of the study objectives, using both descriptive and inferential statistics. Findings are organized in the following headings.

1. Findings related to demographic variables of nursing students.

1. Age: With regard to age of Nursing students, the maximum samples 72 (72%) were in the age group of 22 - 24 years, followed by 20 (20%) in 19-21 yrs and 08 (08%) in 25 yrs and above respectively.

2. Gender: Maximum number of students 70 (70%) were females and 30 (30%) were males.

3. Religion: findings related to religion showed that majority (85%) belonged to Christian followed by 10 (10%) were Hindu and least 01 (01%) were Muslim.

4. Name of the State: Findings related to the home state of samples showed that, majority samples 85 (85%) were from Kerala, followed by 13 (13%) from Karnataka and 02 (02%) were from Tamil Nadu

5. Place of Residence: With regard to place of residence, maximum members 80 (80%) were from urban area followed by 20 (20%) were from rural area.

6. Present place of stay: Findings of the study revealed that, majority samples 90 (90%) were residing in Hostel provided by the college followed by 08 (08%) were days scholar and least 02 (02%) were residing in P.G. Hostel respectively.

7. Type of Family: With regard to the type of family, maximum members 91 (91%) were in nuclear family followed by 09 (09%) were residing in joint family and none were reported to come from extended family

8. Income: Findings of the study revealed that, maximum members 83 (83%) had their ranging from Rs 10001 – 20000 followed by 10 (10%) had Rs. 20001 and above, least i,e 01 (01%) had their income below Rs 5000 respectively.

9. Source of Information: Findings of the study revealed that, maximum samples 58 (58%) had no previous information related to adjustment problem followed by 25 (25%) had information from their friends/ neighbors and 10 (10%) and 2 (02%) had information from mass media and self reading respectively.

2. Findings related to knowledge scores of nursing students:

The knowledge scores among nursing students ranged from 3-23, the mean knowledge score was 13.38 with standard deviation ±5.0528 and the median score is 13 among nursing students as shown in Table no.1. Based upon the level of knowledge the nursing students, majority 55 (55%) had average knowledge followed by 30 (30%) had good knowledge and 15 (15%) had poor knowledge regarding adjustment problems.

Table – 1: Showing Mean Standard Deviation, Median, and Range of knowledge scores of Nursing Students

Variable	Mean	Median	Range	Standard deviation
Knowledge	13.380	13	3-23	5.052

N = 100

3. Findings related to attitude scores of nursing students:

The attitude scores among nursing students ranged from 30-90, the mean attitude score was 61.16 with standard deviation ±15.767 and the median score is 61 among nursing students as shown in table no. 2. Based upon the level of attitude the nursing students, majority 45 (45%) had favorable attitude followed by 35 (35%) had positive attitude and 20 (20%) had negative attitude towards adjustment problems.

Table – 2: Showing Mean Standard Deviation, Median, and Range of Attitude scores of Nursing Students

Variable	Mean	Median	Range	Standard deviation
Attitude	61.16	61	30-90	15.767

N = 100

4. Findings related to relationship between knowledge and attitude:

The co-relationship between knowledge and attitude scores of Nursing students was significant (r = 0.760) at p<0.05 levels indicating significant positive relationship between level of knowledge and attitude among Nursing students as shown in table no.3

Table no. 3: Showing Correlation coefficient of Mean knowledge scores and mean attitude scores of nursing students

Score

Nursing students

Mean score

Correlation coefficient

Knowledge

Attitude

13.380

61.16

0.760

N =100

5. Findings related to Association of knowledge scores of Nursing students with their selected personal variable:

The obtained chi- square value was not significant for variables like age and gender at 0.05 level as shown in table no.4

Table no. 4. Showing association of knowledge scores of nursing students with selected personal variable

Selected personal variables

Nursing students

d(f)

χ²

Level of significance

0-8

9-16

17-23

Age:

· 19 – 21 yrs

· 22 - 24 yrs

· 25 yrs and above

32.08

Gender

· Male

· Female

26.76

Religion

· Hindu

· Muslim

· Christian

· Others

11.920

Name of the state

· Karnataka

· Kerala

· Tamil Nadu

· Others

5.567

Place of residence

· Rural

· Urban

3.46

Type of family

· Nuclear

· Joint

2.616

Present place of stay

· Hostel

· P.G hostel

· Days scholar

8.43

Income

· ≥Rs 5,000/-

· Rs5001-10000

· Rs10001-20000

· <20001

9.17

Source of information

· Mass media

· Self reading

· Formal education

· Friends/neighbor

· No information

6.95

NS = Not Significant S= Significant N =100

6. Findings related to Association of attitude scores of Nursing students with their selected personal variable viz., Age, Gender, Religion, Name of the state, place of residence, present place of stay, type of family, income, source of information.

The obtained chi- square value is significant for variables like age and gender, at 0.05 level as shown in table no. 5

Table no. 5. Showing association of attitude scores of nursing students with their selected personal variable.

Selected personal variables

Nursing students

d(f)

χ²

Level of significance

30-50

51-70

71-90

Age:

· 19 – 21 yrs

· 22 - 24 yrs

· 25 yrs and above

27.98

Gender

· Male

· Female

20.76

Religion

· Hindu

· Muslim

· Christian

· Others

16.05

Name of the state

· Karnataka

· Kerala

· Tamil Nadu

· Others

16.56

Place of residence

· Rural

· Urban

2.46

Type of family

· Nuclear

· Joint

3.173

Present place of stay

· Hostel

· P.G hostel

· Days scholar

6.173

Income

· ≥Rs 5,000/-

· Rs5001-10000

· Rs10001-20000

· <20001

8.18

Source of information

· Mass media

· Self reading

· Formal education

· Friends/neighbor

· No information

7.68

CONCLUSION:

The following conclusions were drawn based on the data analysis: The present study aimed to assess, explore the relationship between Nursing student’s knowledge and attitude related to adjustment problems among nursing students from selected nursing colleges at Tumkur.

The knowledge scores revealed that 55 (55%) of nursing students had average knowledge followed by 30 (30%) with good knowledge and least 15 (15%) with poor knowledge and the attitude scores revealed that majority 45 (45%) had favorable attitude and 35 (35%) nursing students had positive attitude towards adjustment problems.

The findings of the present study concluded that there is positive co-relation with nursing students’ level of knowledge and attitude towards adjustment problems and its ill effects.

It is also evident that there is significant association between attitude level and personal variables like age and gender related adjustment problems.

Thus, it was concluded that, significant number of nursing students had average knowledge and favorable attitude towards adjustment problems at selected nursing colleges of Tumkur. Hence, health care professionals should give importance to health education regarding the adjustment problems among nursing students and its methods of coping so as to prevention further consequences, and take interest in promotion of health among students population.

IMPLICATIONS OF THE STUDY:

The findings of the present study have implications for nursing practices, nursing education, nursing administration and nursing research.

§ Nursing Administration:

The nurse administrators can choose Role play and Traditional method of teaching for conducting in-service education programs and continuing nursing education program. Nursing administrator should take interest to plan, organize and conduct planned teaching programmes on adjustments problems in colleges, rural and urban community areas to help the people in improving their knowledge and attitude, for prevention ill effects of adjustment related ailments and promotion of positive health. The study reveals that planned teaching programmes were necessary for effective strategies to enhance knowledge and attitude of nursing students. Therefore, the nurse administrator should implement planned teaching programmes in their educational activities.

· Nursing Education:

Nursing students should be provided with learning experiences in planning and organizing health education programmes on prevention, causes and management of adjustment problems. The findings of the study paved the way for an innovation in Nursing Education. Role play can be suggested as a teaching method in nursing education to enhance the learning outcomes of the students in more creative way instead of monotonous traditional teaching methods. As role play is a multi-sensory input, entertaining and educating methodology which consist of conscious acting out and discussion of the role in a group it gives more freedom for students to enjoy in their studies. This method of teaching will enhance the curiosity of students to learn and make them to be self responsible in their education. By these methods of teaching we are able to ensure creative learning instead of rote learning.

§ Nursing Practice:

The findings of the study revealed that nursing students have average knowledge and favorable attitude regarding adjustment problems and review of literature shown that prevalence of adjustment problems is high among the students. Nurses can play a pivotal role in organizing and executing creative awareness programmes for all vulnerable sections of society to improve knowledge and develop positive attitude towards adjustment problems. As the nursing practice is based on thorough theoretical basis, hence these educational methods can be used to educate the students in primary settings for prevention of adjustment related ailments and promote health.

§ Nursing Research:

This topic has great importance to the present days as prevalence of adjustment problems and its related ailments on health are high. This study helps to reduce the morbidity related to adjustment problems among nursing students and prevent future complications. The findings of this study points out the importance of further researches on teaching strategies in nursing. Obviously the present study can support future research efforts to emerge with similar results.

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2. K P Neeraja. A Text Book of Essentials of Mental Health and Psychiatric Nursing. 1^sted. New Delhi: JP Publishers; 2008; 104 – 106

3. Mangal S K Abnormal Psychology (1^st edition) Stesling Publication Pvt Ltd 1987, p no 32-37

4. Yassin Mohammed, Major adjustment problems of private nursing college students, VDM, Verlag, Germany Book publisher, 2010-8-19.

5. Sanjay Sevak. (2016).Psychological and Social problems among first year B. Sc. Nursing students in selected institutions of Pune City. IJNS Vol 1 (1), 101-107, 2016.

6. Kumar Sai Sailesh et al. (2014). Controlled Vestibular Stimulation: A Physiological Method of Stress Relief. JCDR Vol 8 (12)

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Received on 17.02.2017 Modified on 18.04.2017

Asian J. Nur. Edu. and Research.2017; 7(3): 423-428.

DOI: 10.5958/2349-2996.2017.00084.2