<b>ASSESSMENT OF ACADEMIC AND CLINICAL STRESSORS AND COPING PATTERNS AMONG BSN STUDENTS AT MEDICARE NURSING COLLEGE, MULTAN</b>

Background: Nursing education is globally recognized as one of the most demanding professional programs due to its dual emphasis on theoretical knowledge acquisition and clinical skill development. Bachelor of Science in Nursing (BSN) students face unique challenges as they navigate academic responsibilities alongside extensive clinical training, exposing them to significant physical, emotional, and psychological stressors. Unmanaged stress can negatively impact students' academic performance, mental health, professional competence, and overall well-being. Despite increasing recognition of mental health importance in nursing education, limited research has been conducted to assess academic and clinical stressors and coping patterns among BSN students in private nursing institutions of Pakistan, particularly in Multan. Objective: This study aimed to assess academic and clinical stressors and coping patterns among BSN students at Medicare Nursing College, Multan. The specific objectives included determining the level of academic stress, identifying clinical stressors, assessing coping mechanisms adopted by students, determining the association between stress levels and coping strategies, and identifying demographic factors associated with stress levels. Methodology: A quantitative cross-sectional descriptive research design was adopted for this study. The study was conducted at Medicare Nursing College, Multan, among BSN students enrolled in all academic years. The sample size was calculated using Slovin's formula, yielding 109 participants recruited through convenience sampling technique. Data were collected using a structured self-administered questionnaire comprising three sections: demographic information, Perceived Stress Scale (PSS) for assessing academic and clinical stressors, and an adapted Brief COPE Inventory for assessing coping mechanisms. Content validity was ensured through expert review, and reliability was established through pilot testing (Cronbach's alpha = 0.80). Data were analyzed using SPSS version 27, employing descriptive statistics (frequency, percentage, mean, standard deviation) and inferential statistics (chi-square test) with significance level set at p ≤ 0.05. Ethical principles including institutional permission, informed consent, confidentiality, and voluntary participation were strictly maintained. Results: The study included 109 BSN students with mean age of 21.4 ± 2.1 years. Female students constituted the majority (78.9%, n=86). Regarding academic stress, 57.8% (n=63) of students experienced moderate stress, 22.9% (n=25) experienced high stress, and 19.3% (n=21) experienced low stress. For clinical stress, 55.0% (n=60) reported moderate stress, 23.0% (n=25) reported high stress, and 22.0% (n=24) reported low stress. Problem-focused coping was the most commonly adopted strategy (44.0%, n=48), followed by emotion-focused coping (34.0%, n=37), while avoidance coping was least used (22.0%, n=24). A statistically significant association was found between stress levels and coping strategies (χ² = 11.42, p = 0.021). Students with low stress predominantly used problem-focused coping, whereas those with high stress tended to use avoidance coping. Furthermore, a significant association was observed between academic year and stress level (χ² = 9.36, p = 0.032), with senior students experiencing higher stress. Conclusion: The study concluded that stress is prevalent among BSN students, with the majority experiencing moderate levels of both academic and clinical stress. Academic workload, examination pressure, and clinical responsibilities were identified as major stressors. The significant association between stress levels and coping mechanisms highlights the importance of promoting adaptive coping strategies in nursing education.