Clinical training exposure and perceived stress among nursing students: Examining the moderating role of social support

BACKGROUND: Psychological stress is highly prevalent among nursing students. The clinical exposure is a major factor contributing to psychological stress, but there is a lack of consistent evidence, particularly in the context of Middle Eastern countries. The aim of this study was to quantify the association between clinical exposure and perceived stress among nursing students, and to assess whether perceived social support moderates this relationship. METHODS: We conducted a cross-sectional study among nursing students from King Saud University. The Perceived Stress Scale was used to measure psychological stress, and the Multidimensional Scale of Perceived Social Support was employed to measure perceived social support. The clinical exposure was quantified as the average number of hours spent per week. We employed multivariable linear regression to determine the association. The regression analysis was adjusted for age, gender, living arrangements, and employment status. RESULTS: Higher perceived social support was significantly associated with lower perceived stress (β = -0.05, 95% CI -0.09 to -0.01). Clinical exposure was not significantly associated with perceived stress. Students living alone had significantly lower levels of perceived stress (β = -0.37, 95% CI -0.63 to -0.11), as did students working part-time (β = -0.34, 95% CI -0.54 to -0.13). The interaction model revealed that perceived social support was inversely associated with perceived stress levels (β = -0.14, 95% CI -0.23 to -0.04). A statistically significant interaction was observed among students with less than 10 hours of clinical exposure per week. This exploratory finding suggests that the association between perceived social support and stress may differ among students with limited clinical exposure. However, the finding was based on a single statistically significant interaction and should be considered preliminary and hypothesis-generating. CONCLUSIONS: Higher perceived social support was associated with lower levels of perceived stress among nursing students. Interventions aimed at enhancing the social support system may be beneficial in reducing stress, especially during the early clinical exposure period.