STRESS MANAGEMENT SURVEY OF NURSING STUDENTS IN FACE TO FACE LEARNING POST ONLINE LEARNING: A CROSS-SECTIONAL STUDY

Background: Almost two years of online learning, finally in early 2022 the Indonesian government began to implement a face-to-face learning model. This can trigger stress for students who will return to carrying out offline learning. Purpose: This study aims to determine stress management in terms of gender, education level, and place of residence for undergraduate nursing students in the Mojokerto district. Methods: Correlation analytic research design with a cross sectional approach of 85 nursing students. The instrument used in the study was a modified questionnaire by researchers who had been tested on the instrument. Results: Showed that almost half of the respondents carried out stress management by listening to music by 18 students (21,2%), surfing the internet by 16 students (18,8%) and praying/listening to prayers by 14 students (16,5%). Conclusion: Stress management that is done to deal with stress on each student has relatively the same characteristics. This is possible because students live in the same area and the characteristics of students in relatively the same year are almost the same. Universities, especially the College of Health Sciences, can provide more facilities for students in reducing stress to improve the results and quality of education.


INTRODUCTION
The Covid-19 pandemic that has occurred since the end of 2019 has become a problem for all people in the world, including in Indonesia.The problem that often arises is psychological problems at all age levels in society.The pandemic also has the potential to affect students both financially, physically, psychologically and academically (Indriyanti, Yuniarsih, & Rusdi, 2022).This problem can occur because for almost two years students have to undergo learning with a distance or online learning model.This online learning is a learning model that utilizes internet networks as a form of interaction in learning, both for conveying material, discussions and assignments (Andiarna & Kusumawati, 2020).
Stress is a common feeling when you are under pressure, feeling overwhelmed, or having trouble dealing with a situation.Stress within certain limits can have a positive impact and motivate someone to achieve a goal.However, excessive stress, especially when it feels difficult to control, can negatively impact mood, physical and mental health, and relationships with others (UNICEF, 2022).
Online learning is very effective in preventing the spread and transmission of Covid-19, but this learning model also creates new problems for students.Some studies say that one of the problems that arises is stress on students.(Lubis, Ramadhani, & Rasyid, 2021) said that from the results of his research there were 39.2% of students experiencing moderate academic stress and there were also 27% of students experiencing severe stress, this means that during the online learning period many students experienced academic stress.(Andiarna & Kusumawati, 2020) in their research also said that online learning causes academic stress for students due to several obstacles during learning, such as poor internet signal, lots of assignments, lack of focus on the lecture process and difficulty sleeping.
After almost two years of online learning carried out with various modifications such as 50% online and 50% offline which were implemented alternately, finally in early 2022 the Indonesian government began to implement a face-toface learning model.
The Ministry of Education and Culture has prepared a circular for the implementation of the latest learning model related to limited Face-to-Face Learning (PTM) adjustments.This limited PTM can be implemented in schools starting Thursday, 3 February 2022(Kominfo, 2022).Since 2021, the government has actually considered implementing limited PTM, but due to the Covid-19 cases, which at that time suddenly experienced a spike again.One of the considerations for implementing limited PTM is that there is a negative social impact on students.They have difficulty implementing distance learning (PJJ).These negative social impacts include student academic stress, decreased learning achievement (learning loss), students dropping out of school, and also violence against children (Kemendikbud, 2021).
After more than one semester of implementing this limited face-to-face learning model (PTM), it is necessary to evaluate the psychological picture of students while participating in limited PTM.During this limited PTM students can take part in lectures directly without being disturbed by the internet network, getting material explanations and discussions directly and can return to socializing with their peers, this allows for a different psychological condition when compared to during distance learning.Likewise for the implementation of PTM in higher education institutions in the field of health, it is necessary to evaluate students while undergoing face-to-face lectures regarding the level of stress that may be experienced.
One of the health education institutions in Mojokerto is the Bachelor of Nursing study program, where students come from various regions in Indonesia, which will greatly affect stress levels and stress management for students.Researchers are interested in knowing stress management in undergraduate nursing students in the Mojokerto area in terms of gender, grade level, and place of residence.
The results of research conducted by (Prayogi, Rahmawati, & Apriliyani, 2022) found that academic pressure for face-toface learning (PTM) after the Covid-19 pandemic at Junior High School X Purwokerto was mostly in the moderate category (79.1%).Students from Junior High School X Purwokerto experiences moderate academic pressure in face-to-face classes.
Stress management in college students consists of various ways such as managing stress from within and involving other people in dealing with stress.There can also be different ways of managing stress between one and another student.This is because humans have their own character in dealing with stress.This is unique and specific to each individual (Puspitaningsih, 2020).
Based on the background above, this research focused in conducting research on how students undertake stress management in face-to-face learning after online learning.The novelty of this research is to find out the coping mechanisms for stress in students who have just entered offline lectures.This makes it easier for universities to determine the methods used in the learning process at the start of face-to-face learning.Regarding the result of this study, it is hoped that it can be a solution in overcoming stress on students in face-to-face learning, and can be used as material for consideration in determining further policies.

METHOD
This research used a descriptive analytic research design.This aimed to test stress management in nursing students in terms of gender and class level in the Mojokerto Regency area.Stress management referred to student behavior in overcoming problems and reducing frustration and stress, as well as controlling the stability of activities.Thus, students will feel comfortable and happy.The population in this study were undergraduate nursing students from health science high schools in Mojokerto Regency.Active students in the 2021 academic year's odd semesters at all academic levels of 533 respondents were used to compute the population.The Slovin formula collected a total of 85 responses for its sample using the simple random sampling method.
The instrument used to measure stress management variables was a questionnaire which included 5 aspects: sharing feelings, adjustments, changes in feelings, recreational activities, and interesting activities.Based on the results of the validity and reliability tests, the Cronbach alpha value = 0.876 while the r calculated value for the validity test can be seen in the corrected item total corelation table where all r calculated values of all questions have a value of > 0.361.Hence, all questions on this instrument were valid.
The researchers determined respondents based on inclusion and exclusion criteria.The inclusion criteria were undergraduate nursing students who were active in Higher Education Database in the odd semester of the 2021 academic year and willing to be used as respondents.The exclusion criteria were undergraduate https://doi.org/10.51602/cmhp.v6i1.98 http://cmhp.lenterakaji.org/index.php/cmhpnursing students who were currently practicing clinically at a hospital and had not been on campus for more than a week.Respondents were divided in each class according to the proportion calculation.Each respondent in each class will be determined randomly.The researchers distributed questionnaires to the respondents who had been determined.If there were respondents who refuse, substitute respondents will be determined randomly from the same institution as the initial respondent.
Researchers will visit the specified institution to meet respondents who have been collected in one class.Then, the researcher distributed questionnaires to respondents after previously being given an inform concern and an explanation of how to fill it out.While filling out the questionnaire, the respondent will be accompanied by the researcher so that if there were difficulties, the respondent can directly ask.The results of the questionnaire that had been filled out by the respondents were returned to the researcher on the same day.This research has been subjected to ethical trials conducted at the Health Research Ethics Committee of the Sekolah Tinggi Ilmu Kesehatan Majapahit with certificate number 189/KEPK-SM/2022.

RESULT
Based on the research conducted, the results are obtained are shown in the tables below:   Based on the characteristics of the respondents' domicile, it can be shown in the Table 3 that 40 respondents chose boarding outside the campus (47.1%).exploring the internet (18.8%) and praying (16.5%) were another way to manage stress.
The results of the study showed that the general characteristics of the response to stress management as displayed below: Based on Table 5 above, the average value of stress management for respondents was 18.5 with a standard deviation of 4.6.The Table above explained that the average stress management for men was greater than for women.The results of the study explained that level 2 students had higher stress management than the other groups.However, level 3 students had the lowest stress management.The results of the study explained that students who lived at relatives' places have better stress management while those who lived at home have the lowest stress management.

DISCUSSION
Stress management is a way to control or manage stress that aims to identify the causes of stress and know stress management techniques so that people are better at handling stress in life (Guyton, 1996).When they returned to campus after the prolonged pandemic and online period, students were excited but also worried so they were required to be able to control and manage the stress they experienced.Thus, they could adapt to circumstances and lead a better, peaceful, and calm life.

Individuals
often respond spontaneously related to their coping mechanisms, which are carried out naturally by these individuals based on what has been done before.But, these efforts are not enough.The stressor may become more severe, causing the individual's stress reduction efforts to fail.Individuals have problems controlling their stress, which results in stress management, which is something that can be learned (Taylor, Lillis, & Le More, 2003).
Stress management is not only about dealing with stress but also about how to deal with it adaptively and effectively (Puspitaningsih, 2020).As a strategy of coping with stressors, stress management entails altering one's thoughts, feelings, and behaviors in relation to one's surroundings (Widyastuti, 2004).
Stress management that is mostly done by students is with panic activities.The most common healing activities are listening to music and exploring the internet.The third place is stress management which is mostly done by undergraduate nursing students was praying.As research has been conducted (Rahmadiyani, 2012), listening to music is the most effective way to reduce stress.

Stress management in Sekolah Tinggi
Ilmu Kesehatan Majapahit undergraduate nursing students does not depend on the general characteristics of the respondents which include gender, grade level, and domicile.Even though there are different values from the raw data of the respondent's choice, the value is small so it can be said that the respondent's stress management from the general characteristics of the respondent is relatively the same.
The limitation of this research is that researchers conducted descriptive research using questionnaires that were filled independently by respondents without indepth interviews to obtain more accurate results.

CONCLUSION AND SUGGESTION
Stress management that is often used by undergraduate nursing students at the Majapahit Health Science College, among others, is listening to music, exploring the internet, and praying the most.Stress management carried out by students is based on the general characteristics of the respondents which include gender, grade level, and relatively the same place of residence.Future research should test the impact of stress management intervention above on reducing stress among students.

Table 1 .
Distribution of respondents based on gender.

Table 2 .
Distribution of respondents based on educational level.

Table 3 .
of respondents based on domicile.

Table 4 .
Student Stress Management.

Table 6 .
Average stress management by gender of the respondents.

Table 7 .
Average stress management based on the education class of the respondents.

Table 8 .
Average stress management based on respondent's domicile.