Perceived stress and academic achievement: a comparative analysis of hostel students and day scholars

This research is an attempt to examine the perceived level of stress and academic achievement between boarders and day scholars. Increased technology, more competition, and schedule overload affect the quality of student’s performance due to inability to manage their stress levels. College students may neglect their physical and emotional well being due to pressure to perform well in their classes, and lack of time management and stress management practices. Although proper nutrition, physical activity, various coping techniques and practices can enhance academic performance as well as health and well being, education and awareness programs are essential to implementing these practices. For the last five decades the term stress has enjoyed increasing popularity in the behavioral and health sciences.

It first was used in physics in order to analyze the problem of how manmade structures must be designed to carry heavy loadsand resist deformation by external focus. In this analysis, stress referred to external pressure or force applied to a structure, while strain denoted the resulting internal distortion of the object (for the term’s history, cf. Hinkle 1974, Mason 1975a, 1975c). In the transition from physics to the behavioral sciences, the usage of the term stress changed. In most approaches it now designates bodily processes created by circumstances that place physical or psychological demands on an individual (Selye 1976). The external forces that impinge on the body are called stressors (McGrath 1982).

Definition of stress: Stress can be defined as; A feeling that is created when we react to particular events. It’s the body’s way of rising to a challenge and preparing to meet a tough situation with focus, strength, stamina, and heightened alertness Stress is a feeling that’s created when we react to particular events. It’s the body’s way of rising to a challenge and preparing to meet a tough situation with focus, strength, stamina, and heightened alertness. The events that provoke stress are called stressors, and they cover a whole range of situations – everything from outright physical danger to making a class presentation or taking a semester’s worth of your toughest subject. The human body responds to stressors by activating the nervous system and specific hormones. The hypothalamus signals the adrenal glands to produce more of the hormones adrenaline and cortisol and release them into the bloodstream.

These hormones speed up heart rate, breathing rate, blood pressure, and metabolism. Blood vessels open wider to let more blood flow to large muscle groups, putting our muscles on alert. Pupils dilate to improve vision. The liver releases some of its stored glucose to increase the body’s energy. And sweat is produced to cool the body.

All of these physical changes prepare a person to react quickly and effectively to handle the pressure of the moment. This natural reaction is known as the stress response. Working properly, the body’s stress response enhances a person’s ability to perform well under pressure. But the stress response can also cause problems when it overreacts or fails to turn off and reset itself properly. Stress and academic achievement College students have many obstacles to overcome in order to achieve their optimal academic performance. It takes a lot more than just studying to achieve a successful college career.

Different stressors such as time management, financial problems, sleep deprivation, social activities, and for some students even having children, can all pose their own threat to a student’s academic performance. The way that academic performance is measured is through the ordinal scale of grade point average (GPA). A student’s GPA determines many things such as class rank and entrance to graduate school. Much research has been done looking at the correlation of many stress factors that college students’ experience and the effects of stress on their GPA. A name given to such stress factors by Hatcher and Prus (1991) referred to these stress factors as academic situational constraints. Their study took into account a variety of factors that can diminish a student’s academic performance.

Factors such as fraternity and sorority activities, job responsibilities, or having a boyfriend or girlfriend taking away from valuable time. One extraneous variable that was taken into account was that at most universities students involved in activities such as fraternities or sororities, and also athletics, must maintain an acceptable GPA to participate. This factor by itself could attribute to these students GPAs being higher than the average college student. This study did not take into account a main factor that a lot of college students have to deal with, aving children and families to care for. Today more and more people are deciding to return to college after being out in the work force.

Coming back to college puts high demands on older people, who sometimes have family already. This factor of having a family could itself contribute to a lower GPA, but one study looked at this factor of family and found the contrary. What helped these students was the support they found within the University, support such as childcare services, and also courses in how to hone superior studying skills (Hammer, Grigsby, ; Woods, 1998). One extraneous factor in the study of family and school demands was that most of the students surveyed were only part-time students and therefore not a representative sample of the general college population. There are also a number of health–related factors that can contribute to a student’s academic performance, and therefore have an effect on his or her GPA.

The amount of exercise, nutritional routines, and also the amount of social support the student perceives all can contribute to how a student academically performs (Hammer et al, 1998). Exercising too much or not at all can influence academic performance. Taking time out of frequent study hours to work out pulls away from grades. A frequent occurrence on college campuses is students becoming almost addicted to exercise, turning a healthy behavior into one that is psychologically unhealthy. In a study in 2000 Trockel, Barnes, and Egget found “ That students who exercised seven or more hours a week obtained significantly lower grades than students who exercised six or fewer hours weekly or not at all “. Nutrition is also a problem with college students.

Students may have difficulty finding the time to cook adequate meals. Most students are just learning to live on their own, and learning to cook can prove to be a challenge. Finding time to go to the grocery store once every couple of weeks can be a demanding task. Little storage space is available in the average dorm room, and food storage may not be possible at all (Trockel et al, 2000). The effects of perceived social support are mixed. Some studies have shown that the amount of social support from the university and outside contributors like family, friends and mentors can make a huge impact on a student’s success.

Support such as emotional, academic, and financial are tremendous factors in the success of a college student. The years spent at college can be a stressful and life-changing experience, having your family and friends, along with the university all be there is crucial. If the student has a family that involves his or her own children, the support of everyone is needed even more, to achieve the goal of graduation. (Trockel et al. , 2000).

The correlation between hours worked in a week and GPA seems obvious. The more time spent at work, the less time a student spends studying. Having to hold down a job and still be a college student is a constant source of stress (Calderon, Hey, ; Seabert, 2001). Also, mentally juggling the two roles of workplace and college student can itself be stressful. Finding the time to work a full or part time job and take it as seriously, and also maintain focus on academic studies can be perceived as stressful.

Being exhausted from working the night before can cause a poor attendance record and also give a student less time to study, resulting in a poor academic performance. The most important contribution that was found was the effects of sleep on students’ GPA. One study took into account previous research that had been done in the area of sleep, not just on college students but also on the general population. Kelly, Kelly, and Clanton (2001) “ classified sleepers into three categories. 1) Short sleepers, individuals who, when left to set their own schedule, slept six or fewer hours.

2) Average sleepers, individuals who slept seven or eight hours, and 3) long sleepers, individuals who slept nine or more hours out of twenty-four ” (p. 84). The study found that people who were considered to be long sleepers reported higher GPAs. One thing that this study did not take into account was that some past research on sleep suggests that people who sleep fewer hours a night may have psychological maladjustment. Sleeping shorter amounts of time has shown to increase factors such as anxiety and stress, which have been associated with academic performance (Kelly et al, 2001).

These factors cause students problems by causing shortened attention span and also increasing the number of errors students make on tests. Another study took the hours of sleep correlation with GPA to another level by taking factors into account like amount of sleep a student gets on the weekends versus during the week, the average time a student gets up in the morning during the week, and waking time on the weekends. Trockel, Barnes, and Egget (2000) found that variables such as later weekday wake-up and later weekend wake-up times were associated with a lower GPA. This study seems to take the research from previous study further, by asking questions specifically related to when the sleep is obtained and what time of the morning a student wakes up. Another health-related factor that can influence student’s GPA is class attendance.

Attendance itself can be related to stress factors like insufficient sleep, job responsibility, illness and also having a family or children to care for. Having a class at seven in the morning can be a huge problem for students deprived of sleep, especially for those students who attend classes during the day and work at night. Students who have children to take care of can often find themselves being held out of class for reasons like their children being ill or not having the proper child care readily available. Grades, motivation and prior GPA can also be reasons for class attendance (Devadoss ; Foltz, 1996). With attendance having a major influence on academic performance, even to the point of some professors using it as a requirement to pass a course, it is a great indicator of a students overall GPA. One major prediction of class attendance is a student’s GPA prior to enrolling in the class.

Students who have done better in previous classes are likely to attend classes more frequently. Other factors in class attendance include the level of courses the student is taking. On average, junior and senior level courses have a higher attendance record than freshman and sophomore courses (Devadoss & Foltz, 1996). One finding that is contradictory to that of other studies is that students who work and are financially independent are more likely to attend classes and take their education more seriously. This is maybe due to the fact that paying for their education themselves makes them value their college careers more than students who do not pay for it themselves.

There are many factors that can cause stress and influence a student’s academic performance and therefore affect his or her overall GPA. The factors include exercise, nutrition, sleep, work and class attendance. A college student may find him or herself in a juggling act, trying to support a family, taking care of job responsibilities, and at the same time trying to make the most of the college career. All of these factors can affect the grades of students, which ultimately affect the rest of their lives. All of the factors that have been reviewed in the literature can contribute to a college student’s level of stress.

By themselves these constraints may have no effect at all on a student, but when combined, a student could perceive them as stressful, and the stress factors could have a dramatic effect on a student’s academic performance. With too many stress factors present and with limited resources of time and energy, a student could easily become overwhelmed. What one student perceives as stressful may not be a factor of stress at all for another student. The Perceived Stress Scale was developed by Cohen and Mermeistein (as cited in Calderon et al, 2001) to measure the amount of stress that a person perceived during past semesters. The Perceived Stress Scale is a 14-item scale designed to measure the degree to which situations in one’s life are appraised as being stressful. Some students may perceive factors such as nutrition, exercise routines, sleep patterns, social activities, and work as stressors that they need to overcome in order to achieve a higher academic standing.

On the other hand, other students may not perceive these life situations as factors of stress at all. Stress itself has been proven to be a factor affecting a college student’s GPA. Moreover the way the student perceives his or her stress can determine how much stress the student is actually under. A student who has a high score on the Perceived Stress Scale has experienced high levels of stress, and his or her GPA at that time should show that negative effect. The purpose of this present study is to determine if there is a negative correlation between perceived stress in a given semester and that semester’s GPA.

Perceived stress will be measured by the Perceived Stress Scale, and GPA by the grades obtained that semester (Fall of 2001). I hypothesize that a higher score on the Perceived Stress Scale resulting in a higher level of stress, the correlated GPA should be lower during that specific semester. Good Stress and Bad Stress The stress response (also called the fight or flight response) is critical during emergency situations, such as when a driver has to slam on the brakes to avoid an accident. It can also be activated in a milder form at a time when the pressure’s on but there’s no actual danger — like stepping up to take the foul shot that could win the game, getting ready to go to a big dance, or sitting down for a final exam. A little of this stress can help keep you on your toes, ready to rise to a challenge.

And the nervous system quickly returns to its normal state, standing by to respond again when needed. But stress doesn’t always happen in response to things that are immediate or that are over quickly. Ongoing or long-term events, like coping with a divorce or moving to a new neighborhood or school, can cause stress, too. Long-term stressful situations can produce a lasting, low-level stress that’s hard on people. The nervous system senses continued pressure and may remain slightly activated and continue to pump out extra stress hormones over an extended period. This can wear out the body’s reserves, leave a person feeling depleted or overwhelmed, weaken the body’s immune system, and cause other problems.

Theories of Stress Theories that focus on the specific relationship between external demands (stressors) and bodily processes (stress) can be grouped in two different categories: approaches to `systemic stress’ based in physiology and psychobiology (among others, Selye 1976) and approaches to `psychological stress’ developed within the field of cognitive psychology (Lazarus 1966, 1991, Lazarus and Folkman 1984, McGrath 1982). Systemic Stress: Selye’s Theory The popularity of the stress concept in science and mass media stems largely from the work of the endocrinologist Hans Selye. In a series of animal studies he observed that a variety of stimulus events (e. g. , heat, cold, toxic agents) applied intensely and long enough are capable of producing common effects, meaning not specific to either stimulus event.

(Besides these nonspecific changes in the body, each stimulus produces, of course, its specific effect, heat, for example, produces vasodilatation, and cold vasoconstriction. ) According to Selye, these nonspecifically caused changes constitute the stereotypical, i. e. , specific, response pattern of systemic stress. Selye ( 1976, p.

4) defines this stress as `a state manifested by a syndrome which consists of all the nonspecifically induced changes in a biologic system. ‘ This stereotypical response pattern, called the `General Adaptation Syndrome’ (GAS), proceeds in three stages. (a) The alarm reaction comprises an initial shock phase and a subsequent countershock phase. The shock phase exhibits autonomic excitability, an increased adrenaline discharge, and gastro-intestinal ulcerations. The countershock phase marks the initial operation of defensive processes and is characterized by increased adrenocortical activity.

b) If noxious stimulation continues, the organism enters the stage of resistance. In this stage, the symptoms of the alarm reaction disappear, which seemingly indicates the organism’s adaptation to the stressor. However, while resistance to the noxious stimulation increases, resistance to other kinds of stressors decreases at the same time. (c) Ifthe aversive stimulation persists, resistance gives way to the stage of exhaustion. The organism’s capability of adapting to the stressor is exhausted, the symptoms of stage (a) reappear, but resistance is no longer possible.

Irreversible tissue damages appear, and, if the stimulation persists, the organism dies. Although Selye’s work influenced a whole generation of stress researchers, marked weaknesses in his theory soon became obvious. First of all, Selye’s conception of stress as a reaction to a multitude of different events had the fatal consequence that the stress concept became the melting pot for all kinds of approaches. Thus, by becoming a synonym for diverse terms such as, for example, anxiety, threat, conflict, or emotional arousal, the concept of stress was in danger of losing its scientific value (cf. Engel 1985). Besides this general reservation, specific critical issues have been raised.

One criticism was directed at the theory’s core assumption of a nonspecific causation of the GAS. Mason ( 1971, 1975b) pointed out that the stressors observed as effective by Selye carried a common emotional meaning: they were novel, strange, and unfamiliar to the animal. Thus, the animal’s state could be described in terms of helplessness, uncertainty, and lack of control. Consequently, the hormonal GAS responses followed the (specific) emotional impact of such influences rather than the influences as such. In accordance with this assumption, Mason ( 1975b) demonstrated that in experiments where uncertainty had been eliminated no GAS was observed.

This criticism lead to a second, more profound argument: unlike the physiological stress investigated by Selye, the stress experienced by humans is almost always the result of a cognitive mediation (cf. Arnold 1960, Janis 1958, Lazarus 1966, 1974). Selye, however, fails to specify those mechanisms that may explain the cognitive transformation of `objective’ noxious events into the subjective experience of being distressed. In addition, Selye does not take into account coping mechanisms as important mediators of the stress–outcome relationship. Both topics are central to psychological stress theories as, for example, elaborated by the Lazarus group.

A derivative of the systemic approach is the research on critical life events. An example is the influential hypothesis of Holmes and Rahe ( 1967), based on Selye’s work, that changes in habits, rather than the threat or meaning of critical events, is involved in the genesis of disease. The authors assumed that critical life events, regardless of their specific (e. . , positive or negative) quality, stimulate change that produces challenge to the organism.

Most of this research, however, has not been theoretically driven and exhibited little empirical support for this hypothesis (for a critical evaluation, see Thoits 1983). Psychological Stress: The Lazarus Theory Two concepts are central to any psychological stress theory: appraisal, i. e. , individuals’ evaluation of the significance of what is happening for their well-being, and coping, i. e. , individuals’ efforts in thought and action to manage specific demands (cf.

Lazarus 1993). Since its first presentation as a comprehensive theory (Lazarus 1966), the Lazarus stress theory has undergone several essential revisions (cf. Lazarus 1991, Lazarus and Folkman 1984, Lazarus and Launier 1978). In the latest version (see Lazarus 1991), stress is regarded as a relational concept, i. e. , stress is not defined as a specific kind of external stimulation nor a specific pattern of physiological, behavioral, or subjective reactions.

Instead, stress is viewed as a relationship (`transaction’) between individuals and their environment. Psychological stress refers to a relationship with the environment that the person appraises as significant for his or her well being and in which the demands tax or exceed available coping resources’ (Lazarus and Folkman 1986, p. 63). This definition points to two processes as central mediators within the person–environment transaction: cognitive appraisal and coping. The concept of appraisal, introduced into emotion research by Arnold (1960 ) and elaborated with respect to stress processes by Lazarus ( 1966, Lazarus and Launier 1978), is a key factor for understanding stress-relevant transactions.

This concept is based on the idea that emotional processes (including stress) are dependent on actual expectancies that persons manifest with regard to the significance and outcome of a specific encounter. This concept is necessary to explain individual differences in quality, intensity, and duration of an elicited emotion in environments that are objectively equal for different individuals. It is generally assumed that the resulting state is generated, maintained, and eventually altered by a specific pattern of appraisals. These appraisals, in turn, are determined by a number of personal and situational factors. The most important factors on the personal side are motivational dispositions, goals, values, and generalized expectancies.

Relevant situational parameters are predictability, controllability, and imminence of a potentially stressful event. In his monograph on emotion and adaptation, Lazarus ( 1991) developed a comprehensive emotion theory that also includes a stress theory (cf. Lazarus 1993). This theory distinguishes two basic forms of appraisal, primary and secondary appraisal (see also Lazarus 1966). These forms rely on different sources of information.

Primary appraisal concerns whether something of relevance to the individual’s well being occurs, whereas secondary appraisal concerns coping options. Within primary appraisal, three components are distinguished: goal relevance describes the extent to which an encounter refers to issues about which the person cares. Goal congruence defines the extent to whichan episode proceeds in accordance with personal goals. Type of ego- involvement designates aspects of personal commitment such as self- esteem, moral values, ego-ideal, or ego-identity. Likewise, three secondary appraisal components are distinguished: blame or credit results from an individual’s appraisal of who is responsible for a certain event.

By coping potential Lazarus means a person’s evaluation of the prospects for generating certain behavioral or cognitive operations that will positively influence a personally relevant encounter. Future expectations refer to the appraisal of the further course of an encounter with respect to goal congruence or incongruence. Specific patterns of primary and secondary appraisal lead to different kinds of stress. Three types are distinguished: harm, threat, and challenge (Lazarus and Folkman 1984). Harm refers to the (psychological) damage or loss that has already happened. Threat is the anticipation of harm that may be imminent.

Challenge results from demands that a person feels confident about mastering. These different kinds of psychological stress are embedded in specific types of emotional reactions, thus illustrating the close conjunction of the fields of stress and emotions. Lazarus ( 1991) distinguishes 15 basic emotions. Nine of these are negative (anger, fright, anxiety, guilt, shame, sadness, envy, jealousy, and disgust), whereas four are positive (happiness, pride, relief, and love). (Two more emotions, hope and compassion, have a mixed valence.

) At a molecular level of analysis, the anxiety reaction, for example, is based on the following pattern of primary and secondary appraisals: there must be some goal relevance to the encounter. Furthermore, goal incongruence is high, i. e. , personal goals are thwarted. Finally, ego- involvement concentrates on the protection of personal meaning or ego- identity against existential threats.

At a more molar level, specific appraisal patterns related to stress or distinct emotional reactions are described as core relational themes. The theme of anxiety, for example, is the confrontation with uncertainty and existential threat. The core relational theme of relief, however, is `a distressing goal-incongruent condition that has changed for the better or gone away’ (Lazarus 1991). Coping is intimately related to the concept of cognitive appraisal and, hence, to the stressrelevant person-environment transactions. Most approaches in coping research follow Folkman and Lazarus (1980, p. 23), who define coping as `the cognitive and behavioral efforts made to master, tolerate, or reduce external and internal demands and conflicts among them.

‘ This definition contains the following implications. (a) Coping actions are not classified according to their effects (e. g. , as reality-distorting), but according to certain characteristics of the coping process. (b) This process encompasses behavioral as well as cognitive reactions in the individual.

(c) In most cases, coping consists of different single acts andis organized sequentially, forming a coping episode. In this sense, coping is often characterized by the simultaneous occurrence of different action sequences and, hence, an interconnection of coping episodes. (d) Coping actions can be distinguished by their focus on different elements of a stressful encounter (cf. Lazarus and Folkman 1984 ). They can attempt to change the person–environment realities behind negative emotions or stress (problem-focused coping).

They can also relate to internal elements and try to reduce a negative emotional state, or change the appraisal of the demanding situation ( emotion-focused coping). Resource Theories of Stress: A Bridge between Systemic and Cognitive Viewpoints Unlike approaches discussed so far, resource theories of stress are not primarily concerned with factors that create stress, but with resources that preserve well being in the face of stressful encounters. Several social and personal constructs have been proposed, such as social support (Schwarzer and Leppin 1991), sense of coherence (Antonovsky 1979), hardiness (Kobasa 1979), self-efficacy (Bandura 1977), or optimism (Scheier and Carver 1992). Whereas self-efficacy and optimism are single protective factors, hardiness and sense of coherence represent tripartite approaches. Hardiness is an amalgam of three components: internal control, commitment, and a sense of challenge as opposed to threat.

Similarly, sense of coherence consists of believing that the world is meaningful, predictable, and basically benevolent. Within the social support field, several types have been investigated, such as instrumental, informational, appraisal, and emotional support. The recently offered conservation of resources (COR) theory (Hobfoll 1989, Hobfoll et al. 996) assumes that stress occurs in any of three contexts: when people experience loss of resources, when resources are threatened, or when people invest their resources without subsequent gain. Four categories of resources are proposed: object resources (i. e.

, physical objects such as home, clothing, or access to transportation), condition resources (e. g. , employment, personal relationships), personal resources (e. g. , skills or self-efficacy), and energy resources (means that facilitate the attainment of other resources, for example, money, credit, or knowledge).

Hobfoll and co-workers outlined a number of testable hypotheses (called principles) derived from basic assumptions of COR (cf. Hobfoll et al. 1996). 1. Loss of resources is the primary source of stress.

This principle contradicts the fundamental assumption of approaches on critical life events (cf. Holmes and Rahe 1967) that stress occurs whenever individuals are forced to readjust themselves to situational circumstances, may these circumstances be positive (e. g. , marriage) or negative (e. g.

, loss of a beloved person). In an empirical test of this basic principle, Hobfoll and Lilly ( 1993) found that only loss of resources was related to distress. 2. Resources act to preserve and protect other resources. Self-esteem is an important resource that may be beneficial for other resources. Hobfoll and Leiberman ( 1987), for example, observed that women who were high in self-esteem made good use of social support when confronted with stress, whereas those who lacked self-esteem interpreted social support as an indication of personal inadequacy and, consequently, misused support.

. Following stressful circumstances, individuals have an increasingly depleted resource pool to combat further stress. This depletion impairs individuals’ capability of coping with further stress, thus resulting in a loss spiral. This process view of resource investment requires to focus on how the interplay between resources and situational demands changes over time as stressor sequences unfold. In addition, this principle shows that it is important to investigate. National Research ResultsA question in the NCHA was designed to determine what students considered as their causes of poor academic performance.

Table 1 presents the top 10 reasons for poor academic performance. Six of these are mental health or stress related. Only two of the health impediments are biological or medical and, therefore, related to a traditional clinical health care agenda. Figure 1 Top 10 Impediments to Academic Performance NCHA Spring 2004, Content Area: Impediments to Academic Performance Students’ self-reported data (n = 47, 202), (ACHA, 2004a)Definition of Boarders A scholar, a student or trance admitted to an institution or enrolled within an organization for research purpose or education having no family house or a rented housed by his family and a result living in a hostel or rented accommodation at his own or by the organization is called hostalides or boarders. Definition of day scholars A student admitted to an institution or enrolled within an organization for research purpose or education having house by his family is called day scholar.? Literature review: Rashmita S.

Mistry, Aprile D. Benner, Connie S. Tan and Su Yeong Kim (2009), conducted a study the examined the pathways by which family economic stress influenced youth’s educational outcomes in a sample of 444 Chinese American adolescents (Mages _ 13. 0, 17. 1 years at waves 1 and 2, respectively).

Using latent variable structural equation modeling, results across two waves of data, spanning early to late adolescence, demonstrated that the influence of parent report of economic stress on youth academic achievement (i. e. GPA), school engagement, and positive attitudes about education was mediated through youth’s perceptions of family economic strain and self-reports of depressive symptoms. These relationships were observed to remain significant after accounting for selection bias using individual fixed-effects models. Finally, youth’s perceptions of family economic strain were found to more strongly predict depressive symptoms during later, as compared to earlier, adolescence; all other modeled relationships were equivalent across the two time periods. Another research was conducted by Poonam R.

Malik and Shanti Balda in (2006) to find if any relationship exists between psychological stress and academic achievement of high IQ adolescents. Subjects were high IQ adolescents having IQ 110 and above. Bisht Battery of Stress Scales was used to assess the amount of stress on these adolescents. Academic achievement was assessed on the basis of average of marks obtained in last three examinations. Correlation coefficients between stress scores and academic scores were computed.

Academic achievement was found to be negatively and significantly correlated with all types of stress except existential stress. Mohsin Shah, Shahid Hasan, Samina Malik, Chandrashekhar T and Sreeramareddy (2010) conducted a study on Perceived Stress, Sources and Severity of Stressamong medical undergraduates in a Pakistani Medical School A cross-sectional, questionnaire-based survey was carried out among undergraduate medical students of CMH Lahore Medical College, Pakistan during January to March 2009. Perceived stress was assessed using the perceived stress scale. A 33-item questionnaire was used to assess sources of stress and their severity. The overall response rate was 80. 5% (161 out of 200 students).

The overall mean perceived stress was 30. 84 (SD = 7. 01) and was significantly higher among female students. By logistic regression analysis, stressed cases were associated with occurrence of psychosocial (OR 5. 01, 95% CI 2. 44-10.

29) and academic related stressors (OR 3. 17 95% CI 1. 52-6. 68). The most common sources of stress were related to academic and psychosocial concerns.

‘ High parental expectations’, ‘ frequency of examinations’, ‘ vastness of academic curriculum’, ‘ sleeping difficulties’, ‘ worrying about the future’, ‘ loneliness’, ‘ becoming a doctor’, ‘ performance in periodic examinations’ were the most frequently and severely occurring sources of stress. There was a negative but insignificant correlation between perceived stress and academic performance (r = -0. 099, p ; gt; 0. 05). A higher level of perceived stress was reported by the students. The main stressors were related to academic and psychosocial domains.

Further studies are required to test the association between stressed cases and gender, academic stressors and psychosocial stressors. Jackson and Weinstein (1997) suggest that “ a healthy campus is one in which the health risks of a population are assessed and appropriate population-based interventions are designed and implemented to mitigate the impact of these risks. ” The 2004 NCHA results from surveying over 47, 000 students open one’s eyes to problems which deserve concern. The results indicate the need for re-engineering college health program core activities and transforming values and attitudes to meet the mission of the university by helping students manage stress; and prevent colds, flu, and sore throat; and internet and alcohol use. Addressing the health impediments related to mental health have the potential for the greatest impact on the university mission.

Five agencies (AAAHC, ACHA, CAS, NASPA and USDHHS) now include recommendations for education on stress management, mental and emotional relationships, and personal health. Education for prevention of colds, flu, and sore throat should be given also; however, because between 70 and 80 percent of health related problems are either precipitated or aggravated by stress, the emphasis should be on stress management education (Pelletier, 1992). With the recent flu vaccine shortage and NCHA data showing that for low risk age students, those under 65, the vaccine provides no protection from academic impairment it is even more important to apply theory- and evidence based health promotion with individual, community, mass communication and policy strategies (Clark, 1995; Courage, Godbey, 1992; Forbes, 1996). Behaviors to reduce spread of influenza must for taught and followed by traditional age college age students (ACHA, 2004b). Stress is a significant health issue for students and will continue to be one in different ways after graduation unless university health services activities are re-engineered.

A study of students perceived needs (Brown, Grizzell, 1998) indicate that most students feel stress management skills are the ones with which they have the least competence. Based on other health surveys asking a Transtheoretical Model / Stages of Change (Forbes, 1996) question “ What do you want to do in the next six-months to improve your health? continue to show want to be able to manage stress more effectively. Additional indicators of the importance of stress issues are that each academic stress management course taught often have a waiting list with 25% of the seat limit and there are not enough sections and seats offered for the number of students who are affected by stress. Hypothesis H1; There is a relation between perceived level of stress and the academic achievement, H2; there is a difference of perceived level of stress between boarders and day scholars.