Some people think that children’s world is full of games and free from any tension. However, children might feel mental and emotional pressure due to different stressors. Therefore, this study was conducted to assess the stress symptoms among students in elementary school in Kashan, Iran.
A cross sectional study, was conducted on 130 girl students in the first to sixth grade of a primary school in Kashan. Data collection instrument was the children’s stress symptom scale designed by Sharrer and RyanWenger. Data analysis was done using descriptive statistics by absolute numbers and percentages.
Of all items in the questionnaire, fast heart beating, being afraid, Stomachache, worry, bad temper, crying, feeling sad, face blushing and warmness, weakness, early agitation, muscle stiffness, and embarrassment and shame were reported in more than 70% percent of students.
Findings showed that stress symptoms are prevalent among school age children. Stress may affect on the students learning and achievement. Then, teachers should be familiar with stress symptoms in children and pay more attention in students with stress symptoms. Moreover, School nurses should be employed to help diagnosis and treating the stress symptoms in students.
Stress or tension is caused when requirements of a position are more than individual’s ability to cope with them (1-3). Response to a stressful event has three components including emotional and physical responses, coping strategies and defense mechanisms (4).
Some people think that children’s world is full of games and free from any pressure and tension. However, children might also feel mental and emotional pressure due to different stressors (2). It has been shown that 35% of American children experience stress-related health problems (1). Today there are many issues in children’s life which are considered as stressors. Family migrations are now more common that cause school change and separation from friends. Also, in many families, both parents need to work outside and children have to stay home alone after returning from school (1). Studies showed that psychological and physical signs of stress are common among school-aged children (10,11). Then, teachers in schools as family counselors must have adequate information on common stress symptoms in children.
According to statistics of Education Ministry, there are about 5 million primary school students in Iran. However, most of studies related to childhood stress have been done in western countries and there are very limited studies in Iran in this regard. Therefore this study was conducted to assess the stress symptoms among students in elementary school in Kashan, Iran.
A cross sectional study, was conducted on all girl students in the first to sixth grade of a primary school in Kashan. 130 students were enrolled in the study.
Data collection was performed after obtaining permission from the authorities in the school. Data collection instrument included questions on demographics and the 24-item self-report questionnaire of children’s stress symptom scale (designed by Sharrer and RyanWenger (3). Two items of “nausea-vomiting” and “feeling sad” were added to other items in a previous study (7). The questionnaire validity and reliability has been confirmed in previous studies (7). Then the final version had 26 items. This questionnaire assesses the experiences of stress in 7 to 12-year-old children. Presence of a symptom was recorded as yes or no.
Data collection was done in a quiet room of school through interviewing with children in non-education hours.
Ethical consideration of this study was approved by the institutional review board. Permissions were obtained from the official authorities in the school and the education department. All of the participants’ rights were observed according to the Declaration of Helsinki.
Data analysis was done using descriptive statistics by absolute numbers and percentages.
There were 130 female students in this study. The mean age of the students was 9.23 ± 1.41 years.
125 students (96.2%) lived with their both parents and 5 ones with other their mothers or fathers only. The most important events occurred for children during last year were “death of a close relative” (19.2%), “car accident” 6.15% and “birth of a new brother or sister in 10%. 7.69% of children expressed more than 14 symptoms. Of all items in the questionnaire, fast heart beating, being afraid, Stomachache, worry, bad temper, crying, feeling sad, face blushing and warmness, weakness, early agitation, muscle stiffness, and embarrassment and shame were reported in more than 70% percent of students. The most common stress symptoms in children are given in Table 1.
This study aimed to investigate the stress symptoms in a group of primary girls’ school students in kashan. Accordingly, the students showed a wide range of symptoms in confrontation with stressful events. The entire twenty-six items of the questionnaire was mentioned as stress symptoms and 23 symptoms were experienced by at least one third of the students. Also 12 symptoms were reported by more than 70% of the students.
The findings of the present study to some extent were consistent with results of Valizadeh et al (7) and Sharrer and Ryan-Wenger (3) although the rank of symptoms were different in those studies. For example, worry, being afraid and fast heart beating was the first three symptoms in Valizadeh et al. (7) and rage and irritability were the highest stress symptoms in Sharrer and Ryan-Wenger’s study (3). However, several researchers such as confirmed that physical and psychological symptoms of stress are common among children (10, 13, 14). Also, in most of the studies, headache and stomachache were the most common stress symptoms in school-aged children. However, in the current study Fast heart beat were most common but headache was also reported in 50% of the students and stomachache was reported in more that 88%.
The present study investigated the prevalence of stress symptoms among the girl students in an elementary school. Findings showed that stress symptoms are prevalent among school age children. Stress may affect on the students learning and achievement. Then, teachers should be familiar with stress symptoms in children and pay more attention in students with stress symptoms. They also should have necessary skills to recognize stresses symptoms and be able to provide required facilities and tools to prevent and control high-stressful situations for children. Also the schools authorities should train the parent on this issue and empower then in recognizing and prevention stressful situations for their children.
Conducting further studies in this field and in a wider age range is recommended.
We had some limitations in this study. Individual differences may affect on responding in different ages. The subjects Also, the small sample size may limit the generalizability of the results.
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Source(s) of Funding
The author declares no conflict of interest in this study.