| Summary: | Bibliography: pages 169-183. === The present investigation was initiated with the aim of assessing the efficacy of multicomponent treatment programmes for test-anxiety in student nurses, in order to develop a programme that could be included in the nursing curricula. The subjects were 103 student nurses currently in their first year of the four-year Diploma in Nursing (General, Community and Psychiatry) and Midwifery at Carinus Nursing College CCNC). They had been randomly allocated to four classes at the College. The study compared high-test-anxious, low-test-anxious and mid-test-anxious subjects within these four groups, three of which received multicomponent treatment programmes, while the fourth was the control· group. Programmes comprised Systematic Desensitisation (SD), Progressive Muscle Relaxation Training and Guided Imagery (PMRT & Gl) and Study Skills Training (SST), each of which included a core component of cognitive restructuring. Treatment spanned six weeks. The following self-report questionnaires were used at pre- and post-intervention: The Anxiety Achievement Test <AATl, the Anticipated Anxiety Rating Scale (AARS) and the Subjective Units of Disturbance (SUD). Academic achievement was also measured at both pre- and post-intervention by means of examination scores. Differences between pre and post scores were analysed by means of One- and Two-Way Multivariate Analysis of Variance. The only group to differ significantly from the Control group at post-test was the SD group, showing reductions on the Debilitative scale of the AAT (p < 0.01), the SUD (p < 0.01) and the AARS (p < 0.05). However, this group expressed less satisfaction with the programme than the PMRT & GI group on the Treatment Evaluation Questionnaire. A subsidiary study compared the CNC student nurses (n = 103) with first-year paramedical students from the following disciplines: logopaedics (n = 12); physiotherapy (n = 24); occupational therapy (n = 18); BSc nursing (n = 12); radiography (n = 27), on the Profile of Mood States (POMS), Health Behaviour Assessment Scale (HBAS) and Matric scores. CNC nurses obtained significantly lower Matric scores than the other .students (p < 0.0001), and showed significant differences on other variables, indicating higher negative mood states and less healthy lifestyles. At one-year follow-up; 33 of the original 103 subjects had failed or resigned: sixteen of whom were high-test-anxious, nine low-test-anxious, eight mid-test-anxious. The drop-out rate was consistent across groups, i.e. treatment had had no long-term effect. Reasons for this are discussed, and the conclusion reached that high levels of test anxiety were realistically felt by student nurses with comparatively low Matric scores when faced with the demands of the four-~ear Diploma course. Such anxiety which at present tends to be dealt with by somewhat self-destructive behaviours could not be easily alleviated by short-term anxiety management programmes. Recommendations are made regarding possible alternative nurse training programmes. There would appear to be good reason to offer a programme with emphasis on clinical skills in addition to the heavily academic four-year Diploma course. A prophylactic stress management programme emphasising healthy lifestyles, and commencing at the start of training, was recommended.
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