Date

11-13-2025

Department

School of Nursing

Degree

Doctor of Philosophy in Nursing (PhD)

Chair

Theresa M. Pape

Keywords

Perceived Stress, Adverse Childhood Experiences, Traditional Nursing Students, Non-Traditional Nursing Students

Disciplines

Nursing

Abstract

The purpose of this non-experimental comparative cross-sectional quantitative study was to identify the differences between perceived stress levels and adverse childhood experiences in traditional and non-traditional nursing students at an eastern Tennessee state university. Elevated levels of stress impact nursing students and hinder learning, cause mental health issues, and contribute to attrition, especially when there are adverse childhood experiences (ACEs). The study used the ACEs questionnaire, Perceived Stress Inventory, and demographic survey. Data were collected using a Qualtrics online survey sent by email to potential participants. A multivariate analysis of variance (MANOVA) compared perceived stress and ACE scores simultaneously across the traditional and non-traditional nursing student types, requiring a total of 66 participants. A multiple regression analysis was used to evaluate how the student types, ACE scores, and potential confounders of age and work hours predict perceived stress levels, and asked for the identification of ethnicity, requiring 85 participants. The statistical analysis procedures were followed by using the assumption testing model for both the MANOVA and the multiple regression models. Results of the analysis determined that there are no statistically significant differences in ACE or stress scores between traditional BSN and LPN to BSN students, and no significant difference between traditional and non-traditional students’ perceived stress scores and ACE scores. The results of the linear regression analysis determined that ACE scores significantly predicted stress scores, while program type, age, and working hours were not significant predictors. As such, the null hypothesis failed to be rejected. Larger and more diverse studies are needed.

Available for download on Friday, November 13, 2026

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