A comparative study of factors contributing to acculturative stress in chinese and nepalese nursing students in australia

Abstract

Background. Worldwide, a large body of literature is devoted to studying the experiences of international students and the challenges they face. Major issues reported are language, cultural, academic and financial difficulties, as well as discrimination and social isolation. Asian students, for example, experience more psychological difficulties than other groups of international students. There are only a small number of studies of international nursing students' experiences in Australia, with none focusing on factors contributing to acculturative stress among Chinese or Nepalese nursing students. Given the increasing enrolments from these countries and given their dominance at the Australian Catholic University (the study site), this thesis is an attempt to address the gap in the literature. Aim. The aim was to explore Chinese and Nepalese international nursing students' experiences while living and studying in Australia. The specific objectives were to compare the two groups' levels of acculturative stress, sense of coherence (SOC), social support, ways of coping and depression; to examine the correlations between these measures; and to understand the predictors of acculturative stress. Method. This study comprised three phases. Phase A was a Master of Philosophy project that focused on Chinese international nursing students' (n = 119) experiences using a quantitative research design. Upgrading to a PhD project, Phase B and Phase C were added and focused on a comparison between Chinese and Nepalese international nursing students' experiences through a mixed methods design. Phase B used five questionnaires to measure the levels and inter-correlations of acculturative stress, depression, sense of coherence, ways of coping and social support of the participants (n = 187). Phase C, a qualitative design, used one-to-one interviews (n = 52) to supplement the quantitative findings. Results. Both student groups showed high levels of acculturative stress, with the Nepalese students rating higher than that of the Chinese. The Chinese students had a moderately low SOC, but the Nepalese students' scores were even lower. No participants displayed significant depression. There were no significant statistical differences between the two groups in terms of social support or ways of coping. The Chinese students adopted problem-focused coping strategies more often, while the Nepalese students used emotion-focused coping strategies. A significant positive correlation was found between acculturative stress and depression, and between SOC and social support. There was also a significant negative correlation between acculturative stress and sense of coherence, between acculturative stress and social support, and between depression and sense of coherence. The predictors of acculturative stress were identified as religion, sense of coherence, depression and perceived satisfaction with social support. Qualitative findings supplemented these results. The dominant problem among both groups was acculturative stress, which was associated with academic, financial and culture-related difficulties.Conclusion. The current study provides a more in-depth understanding of the factors contributing to acculturative stress among Chinese and Nepalese international nursing students. Insights produced should assist universities to offer more effective support for international students, including academic literacy skills. Findings should also assist international students to better prepare for the Australian study experience.