Abstract
BACKGROUND:
In this competitive world, students undergo various scholastic stress and mental health issues. The scholastic stress has a great impact on students’ life and results in the prevalence of several psychological consequences such as stress-related disorders, anxiety, depression, and nervousness, which disturb their academic performances. Therefore, the present study was conducted to assess academic stress, perceived parental pressure, and anxiety related to competitive entrance examinations and the general well-being among adolescents.
MATERIALS AND METHODS:
A cross-sectional survey was conducted in 2023 among 570 adolescents who were planning to give competitive entrance examination in Pre-University Colleges of Udupi District, Karnataka, India. The data were collected using Background Proforma, Academic Stress Scale related to Competitive Examination, Perceived Parental Academic Pressure Scale, Westside Test Anxiety Scale, and General Well-being Scale. The purposive sampling technique was used to select Pre-University Colleges, and the adolescents were selected using cluster sampling. The collected data were analysed by Jamovi 2.3.21 software using descriptive statistics.
RESULTS:
The results showed that the majority of adolescents, 490 (86.0%), have high academic stress, 496 (87.0%) experienced high perceived parental pressure, 163 (28.5%) had moderately high anxiety, and 351 (57.7%) have low general well-being. There was no significance difference between class of study and stream of study.
CONCLUSION:
The study concluded that it is essential for the health care professionals to collaborate with parents and teachers to support adolescents and give them a congenial environment that will promote the healthy physical and psychological well-being of the adolescents.
Keywords: Academic stress, adolescence, anxiety, competitive entrance examination, general well-being, perceived parental pressure
Introduction
School education is the foremost foundation of every individual’s academic life. It provides knowledge, skills, and information to broaden the students’ views and outlook and help them decide on the next phase of education.
Academic stress appears to be intensive among adolescents, especially the higher secondary school students. The significant stressors were lack of time for revision, queries from neighbors or relatives, and parental expectations on academic performance.[1] Parental expectations, academic competition, too many tests, fear of failure in exams, uncertainty about the future, and comparison with others are some of the major sources of academic stress among adolescents.[2,3]
The adolescents who experienced academic stress had a greater probability of developing depression.[4] The worldwide-pooled prevalence of anxiety among adolescents was 6.5%.[5] A study conducted in India reported that 81.6% of adolescents had examination-related anxiety and 66% felt parental pressure for higher academic performance.[6] Anxiety among adolescents was associated with parental age, educational level, student grade, family size, and residential setting.[7] Adolescence general well-being positively influences the academic success and academic achievement.[8]
Competitive entrance examinations are considered as an integral part of entry into elite institutions. These types of examinations are conducted to test and rank students according to their grades, percentage, or percentile for various fields like engineering, medicine, and law. Competitive entrance examinations create significant academic stress and pressure among the students. A study conducted in India among the competitive entrance examination aspirants revealed that 48% had academic stressors, 39% had personal stressors, and only 8% had personal stressors.[9] Parental pressure, competitive spirit, high parental expectations, issues with personal relationships, and addiction issues are some of the factors that affect the academic stress and suicidal ideation among the competitive examination aspirant students.[10]
The academic stress, perceived parental pressure, and anxiety have a great impact on the adolescent’s general well-being. Competitive entrance examinations can increase the level of stress and pressure among students due to parental expectations and high expectations from themselves, which is an evolving concern in the country. These cause students to become capricious and inattentive and have insomnia, which can lead to self-negativism, self-harm, and failures. Globally, there are inadequate research studies related to competitive entrance examinations and general well-being as compared to academic stress, parental pressure, and anxiety. Hence, there is a need to conduct research on this topic to identify the mental health issues faced by adolescents and their general well-being. As a result, the study sought to assess the academic stress, perceived parental pressure, and anxiety related to competitive entrance examinations and the general well-being among the adolescents.
Materials and Methods
Study design and setting
A cross-sectional survey was conducted among 570 adolescents who were studying in 11th and 12th grades in selected Pre-University Colleges (PUCs) of Udupi District, Karnataka, India, and were planning to appear for competitive entrance examination. The study was conducted in randomly selected three blocks (out of seven blocks) of Udupi District. The data was collected from January 2023 to May 2023.
Study participants and sampling
The participants in the present study included 570 students from the 11th and 12th grades studying in selected English Medium PUCs in Udupi District, who were planning to appear for competitive entrance examinations and were willing to take part in the research study. A total of eight English Medium PUCs were selected for the study. A purposive sampling technique and cluster sampling technique were adopted for the selection of PUC and the sample, respectively [Figure 1]. The sample size was calculated based on the margin of error at 5% and a confidence interval of 95%; assuming 63% of participants have high academic stress, with a design effect of 1.5, the estimated sample size was 570.
Figure 1.
Schematic representation of the sampling technique
Data collection tools and techniques
The data were collected using validated, pretested, and reliable structured questionnaires. The tools included background proforma, academic stress scale related to competitive entrance examinations (22 items), perceived parental academic pressure scale (20 items), Westside test anxiety scale (10 items), and the General well-being scale (55 items).
Background proforma: The tool was developed by the researcher to gather baseline information about the students. There were two sections. Section A consists of demographic information and some items related to the competitive entrance examination. Section B of the tool was based on the Modified Kuppuswamy Socioeconomic Status Scale to assess the socioeconomic status of the students. It consisted of questions regarding their parent’s educational qualifications, occupational status, and family income per month. The scoring and interpretation were done as per the scale norms, with the scores from <5 indicating a lower (V) socioeconomic status, 5–10 indicating an upper-lower (IV) socioeconomic status, 11–15 indicating a lower-middle (III) socioeconomic status, 16–25 indicating an upper-middle (II) socioeconomic status, and 26–29 indicating an upper (I) socioeconomic status.[11]
Academic stress scale related to competitive entrance examinations: The tool was designed by the investigator and comprises of 22 Likert-type items to assess the academic stress related to competitive entrance examinations. There were four domains in this tool, that is, coping with an academic course, self-inflicted stress, cognitive, and expectations from others. The tool is a 5-point rating scale from ‘strongly disagree’ (score 1) to ‘strongly agree’ (score 5). Negative items were reversely scored. The total score was 110. The minimum score was 22, and the maximum score was 110. The reliability of the tool was done using Cronbach’s alpha. The content validity index (CVI) was 0.95, and the reliability was 0.71.
Perceived parental academic pressure scale: It is a standardized scale developed by Kaynak, Koçak, and Kaynak to assess the perceived parental pressure. It consists of 20 items in three dimensions: psychological pressure, restriction, and too-high expectations. The scale is a 5-point rating scale with a score of 1 to 5, indicating absolutely inappropriate = 1, inappropriate = 2, neither appropriate nor inappropriate = 3, appropriate =4, and absolutely appropriate = 5. There is no reverse scoring for this tool. The highest possible score was 100 and the lowest possible score was 20, with higher scores indicating greater perceived parental academic pressure.[12]
Westside test anxiety scale: This tool is a standardized scale developed by Richard Driscoll to assess the anxiety among the students. The scale consists of 10 items, and the score for each item was ‘5’, extremely or always true; ‘4’, highly or usually true; ‘3’, moderately or sometimes true; ‘2’, slightly or seldom true; and ‘1’, not at all or never true. To get a total score, the sum of the 10 questions was taken. For scoring, sum up the score and divide the sum by 10. The value after dividing by 10 is the Test Anxiety score. The scores were divided into five categories: 1.0–1.9 for comfortably low-test anxiety, 2.0–2.5 for normal or average test anxiety, 2.5–2.9 for high normal test anxiety, 3.0–3.4 for moderately high, 3.5–3.9 for high test anxiety, and 4.0–5.0 for extremely high anxiety.[13]
The General well-being scale: It is a 55-item standardized scale developed by Ashok K Kalia and Anita Deswal to measure the general well-being of adolescents in four dimensions, that is, physical well-being, emotional well-being, social well-being, and school well-being. The tool was a 5-point Likert scale with a score of 1 to 5 for positive items. The key scoring was Strongly disagree = 1, Disagree = 2, Uncertain = 3, Agree = 4, and Strongly agree = 5. Negative items were reversely scored. The participants were also asked to give a response to the first thought that came to their mind. The highest possible score was 275, and the lowest possible score was 55. A high score indicates an enhanced sense of general well-being, and a low score denotes a diminished sense of general well-being.[14]
Data were collected from the eligible participants using the questionnaires after obtaining formal administrative permissions and informed consent from the participants.
Statistical analysis
For data analysis, Jamovi 2.3.21 software was used. Descriptive statistics such as mean, standard deviation, frequency, percentage, maximum, and minimum values were used for describing the background information, academic stress, perceived parental pressure, anxiety, and general well-being.
Ethical consideration
Prior to carrying out the research study, a formal administrative permission was obtained from the institution, and approval from the Institutional Ethics Committee (IEC:592 / 2022) was obtained. The Clinical Trials Registry of India registration (CTRI/2023 / 03/05073) was done before the commencement of data collection. Permission from the college authorities was obtained. Informed consent from parents and assent from the participants were obtained from all participants prior to the data collection. Research objectives and working methods were explained to the study participants. The participants were assured that their information would remain confidential.
Results
Out of 570 adolescents, most of the adolescents, 300 (52.6%), were in the age group of 17 years. The mean age of the participants was 16.7 ± 0.64 years. Most of the adolescents, 326 (57.2%), were females, and 428 (75.1%) were studying in II PUC. Around 363 (63.7%) participants belonged to nuclear families, and 257 (45.1%) were from the science stream. A total of 215 (37.8%) adolescents belonged to the Lower Middle (III) Socio-Economic Status [Table 1].
Table 1.
Frequency and percentage distribution of samples based on demographic characteristics (n=570)
| Sample characteristics | Frequency (f) | Percentage (%) | ||
|---|---|---|---|---|
| Age of the student (in years) | ||||
| 16 | 216 | 37.9 | ||
| 17 | 300 | 52.6 | ||
| 18 | 50 | 8.8 | ||
| 19 | 4 | 0.7 | ||
| Gender | ||||
| Female | 326 | 57.2 | ||
| Male | 244 | 42.8 | ||
| Class of study | ||||
| I PUC | 142 | 24.9 | ||
| II PUC | 428 | 75.1 | ||
| Type of family | ||||
| Nuclear | 363 | 63.7 | ||
| Joint | 197 | 34.6 | ||
| Extended | 10 | 1.8 | ||
| Birth order | ||||
| First | 292 | 51.2 | ||
| Second | 197 | 36.4 | ||
| Third | 58 | 10.2 | ||
| Fourth | 13 | 2.3 | ||
| Others | 10 | 1.8 | ||
| Steam | ||||
| Science | 248 | 43.5 | ||
| Commerce | 257 | 45.1 | ||
| Arts | 65 | 11.4 | ||
| Socioeconomic status | ||||
| Lower V | 1 | 0.17 | ||
| Upper Lower IV | 207 | 36.3 | ||
| Lower Middle III | 215 | 37.8 | ||
| Upper Middle II | 129 | 22.6 | ||
| Upper I | 18 | 3.15 |
Table 2 shows that most of the adolescents were planning to appear for Karnataka entrance test, 236 (41.4%), and 279 (48.9%) started preparing for the competitive entrance exam from class 11. Around 279 (48.9%) were preparing for competitive examinations through online coaching classes [Table 2].
Table 2.
Frequency and percentage distribution of samples based on the preparation of adolescents for competitive entrance examinations (n=570)
| Variables | (f) | (%) | ||
|---|---|---|---|---|
| Competitive examination students planning to appear (Multiple response Item) | ||||
| Karnataka Common Entrance Test (KCET) | 236 | 41.4 | ||
| Joint Entrance Examination (JEE) | 63 | 11.1 | ||
| National Eligibility cum Entrance Test (NEET) | 151 | 26.5 | ||
| National Aptitude Test or Architecture (NATA) | 21 | 3.7 | ||
| Common Law Admission Test (CLAT) | 22 | 3.9 | ||
| National Defense Academy and Naval Academy Examination (NDANAE) | 18 | 3.2 | ||
| All Indian Entrance Examination for Design (AIEED) | 19 | 3.3 | ||
| Others | 40 | 7.0 | ||
| Class of start for preparation of competitive examinations | ||||
| 8 standard | 46 | 8.1 | ||
| 9 standard | 19 | 3.3 | ||
| 10 standard | 90 | 15.8 | ||
| 11 standard | 279 | 48.9 | ||
| 12 standard | 136 | 23.9 | ||
| Method of preparing for competitive examinations (Multiple response item) | ||||
| Preparing by self | 46 | 8.1 | ||
| Going for coaching centers | 19 | 3.3 | ||
| Attending coaching classes at college | 90 | 15.8 | ||
| Attending online coaching classes | 279 | 48.9 | ||
| Preparing through online websites | 136 | 23.9 | ||
| Preparing through online apps | 18 | 3.2 | ||
| Competitive exam books | 19 | 3.3 | ||
| Any other modes | 40 | 7.0 |
The majority of the adolescents, 490 (86.0%), have experienced high academic stress related to competitive entrance examinations, and 55 (9.6%) have experienced extremely high academic stress. The mean score of academic stress was 70.8 ± 10.3, indicating a high level of academic stress [Table 3].
Table 3.
Academic stress, perceived parental pressure, anxiety, and general well-being (n=570)
| Variables | Domains | f | % | Mean | SD± | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| Academic stress | Less academic stress (≤27) | 0 | 0 | 70.8 | 10.3 | |||||
| Moderate academic stress (28-55) | 25 | 4.3 | ||||||||
| High academic stress (56-85) | 490 | 86.0 | ||||||||
| Extremely high academic stress (86-110) | 55 | 9.6 | ||||||||
| Perceived parental pressure | Less perceived parental pressure (<=45) | 74 | 13.1 | 58.4 | 14.5 | |||||
| High perceived parental pressure (46-100) | 496 | 87.0 | ||||||||
| Anxiety | Comfortably low-test anxiety (1.0-1.9) | 46 | 8.2 | 3.29 | 0.80 | |||||
| Normal or average test anxiety (2.0-2.5) | 50 | 8.8 | ||||||||
| High normal test anxiety (2.5-2.9) | 58 | 10 | ||||||||
| Moderately high anxiety (3.0-3.4) | 163 | 28.0 | ||||||||
| High test anxiety (3.5-3.9) | 103 | 18 | ||||||||
| Extremely high anxiety (4.0-5.0) | 150 | 26.3 | ||||||||
| General well- being | High general well-being (231-275) | 0 | 0 | 161 | 21.6 | |||||
| Average general well-being (168-230) | 219 | 42.3 | ||||||||
| Low general well-being (below 167) | 351 | 57.7 |
f=Frequency; %=Percentage; SD=Standard Deviation
Most of the adolescents, 496 (87.0%), have experienced high perceived parental academic pressure related to competitive entrance examinations, and the mean score was 58.4 ± 14.5, indicating high perceived parental pressure. However, 163 (28.6%) adolescents have experienced moderately high anxiety. The mean score was 3.29 ± 0.80, which indicates moderately high anxiety. Most of the adolescents, 351 (57.7%), have low general well-being. The mean score was 161 ± 21.6, which indicates low general well-being [Table 3].
The data presented in Table 4 reveal that the mean score of coping with academic course, self-inflicted stress, and self-inflicted stress was 22.8 ± 4.53, 26.7 ± 5.16, and 5.76 ± 2.08, respectively, which indicates high coping with the course, self-inflicted stress, and high cognition. However, the mean score of expectation from other domains was 15.5 ± 2.83, indicating extremely high expectation from others.
Table 4.
Mean, standard deviation based on domains of academic stress, perceived parental pressure, and general well-being related to competitive entrance examination (n=570)
| Variables | Domains | Mean | SD± | Max possible score | Min possible score | Max obtained score | Min obtained score | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Academic stress | Coping with academic course | 22.8 | 4.53 | 35 | 7 | 35 | 12 | |||||||
| Self-inflicted stress | 26.7 | 5.16 | 45 | 9 | 45 | 13 | ||||||||
| Cognitive | 5.76 | 2.08 | 10 | 2 | 10 | 2 | ||||||||
| Expectation from others | 15.5 | 2.83 | 20 | 4 | 20 | 6 | ||||||||
| Perceived parental pressure | Psychological pressure | 22.0 | 5.82 | 35 | 7 | 35 | 7 | |||||||
| Restriction | 20.2 | 6.33 | 35 | 7 | 35 | 7 | ||||||||
| Too high expectations | 19.8 | 4.73 | 30 | 6 | 30 | 6 | ||||||||
| General well- being | Physical wellbeing | 31.7 | 7.22 | 55 | 11 | 50 | 11 | |||||||
| Emotional wellbeing | 40.5 | 7.68 | 70 | 14 | 66 | 48 | ||||||||
| Social wellbeing | 51.2 | 10.2 | 85 | 17 | 75 | 17 | ||||||||
| School wellbeing | 36.6 | 8.66 | 78 | 13 | 60 | 12 |
SD=Standard Deviation; Min=Minimum; Max=Maximum
The mean scores of psychological pressure, restriction, and too high expectation were 22.0 ± 5.82, 20.2 ± 6.33, and 19.8 ± 4.73 respectively, indicating high perceived parental stress. However, the mean scores of physical, emotional, social, and school well-being scores were 31.7 ± 7.22, 40.5 ± 7.68, 51.2 ± 10.2, and 36.6 ± 8.66, respectively, indicating average physical, emotional, social, and school well-being [Table 4].
Table 5 shows that the adolescents studying in both the standards of I and II PUCs have higher levels of academic stress, high perceived parental pressure, and moderately high levels of anxiety, while all the adolescents experienced lower levels of overall general well-being.
Table 5.
Mean and standard deviation of academic stress, perceived parental pressure, anxiety, and general well-being based on the class and stream of study (n=570)
| Variables | Academic stress | Perceived parental pressure | Anxiety | General Well-being | ||||
|---|---|---|---|---|---|---|---|---|
| Mean±SD | Mean±SD | Mean±SD | Mean±SD | |||||
| Class of study | ||||||||
| I PUC (n=142) | 69.7±11.91 | 58.8±14.4 | 3.2±0.7 | 162±20.1 | ||||
| II PUC (n=428) | 71.1±9.69 | 58.3±14.5 | 3.3±0.8 | 161±22.1 | ||||
| Stream of study | ||||||||
| Arts (n=65) | 69.0±7.89 | 56.1±16.4 | 3.22±0.80 | 159±21.5 | ||||
| Commerce (n=248) | 71.1±10.52 | 58.9±13.9 | 3.34±0.79 | 159±20.3 | ||||
| Science (n=257) | 70.9±10.60 | 58.5±14.5 | 3.26±0.86 | 163±22.6 | ||||
SD=Standard Deviation
Arts, Commerce, and Science stream students have high academic stress, high perceived parental pressure, and moderately high levels of anxiety, whereas in terms of general well-being, the adolescents in all the streams have low general well-being [Table 5].
Discussion
The present study finding identified that the majority of adolescents experienced high levels of academic stress and high perceived parental pressure. This result is consistent with the findings of Deb et al.,[6] which reported nearly two-thirds of the students reported stress due to academic pressure and about two-thirds of the students reported parental pressure to perform better in academic performance. The study of Sangma et al.[15] also shows that more than half of the students experince a high level of parental pressure to perform well in the academic courses. The study also reported that the students were deprived of sleep and experience depression due to the pressure. Another study conducted by Shriharsha et al.[16] also reported that 53% of adolescents had moderate stress and 48% had high parental expectation.
The present study had found that adolescents have moderate anxiety, and more than half of adolescents had low general well-being. These findings were supported by Chowdhury (2019), who reported that almost 39.67% of secondary school students experience very high or high levels of anxiety over their examinations.[17] Nag et al.[18] also reported that 43.3% of students had moderate anxiety and male students had higher prevalence of anxiety than the females. Another study conducted by Jeyarani et al.[19] supported the current study findings by stating that more than half of adolescents who were in institutional care had low general well-being.
The present study also identifies that the mean academic stress, perceived parental pressure, anxiety, and general well-being between class of study and steam of study were almost similar. All the adolescents from both the class of study and stream of study experience high academic stress, perceived parental pressure, moderate anxiety, and low general well-being. This study finding was consistent with the study conducted by Reddy et al.,[20] indicating that there were no significant stream differences across the different dimensions of stress. Another study conducted by Rajesh et al.[21] stated that academic stress is higher in science students than in commerce students, and the majority of students appearing for competitive entrance examinations report a high level of academic stress and axiety.
Academic stress, perceived parental pressure, and anxiety play a major role in mental health issues and general well-being in adolescents. School health nurses’ primary roles are to monitor and treat students who have been identified as having health issues by preventing them, promoting early detection, and referring them to appropriate medical institutions. Most physical and mental health issues relating to academics may be identified and treated at this level before progressing to the critical stage.
The results of this study will help nurse researchers to understand how the physical and mental health of adolescents has been negatively impacted by academic pressure, parental pressure to do better, and anxiety related to competitive examinations. This study’s findings will enable the nurse researchers to further investigate strategies for reducing examination stress, pressure, and anxiety, as well as academic stress, which will reduce the burden on this age group and allow the development of interventions to support and enhance adolescents’ mental health.
Limitation and recommendation
The limitation of the study was that data were gathered via a self-reported questionnaire and proportionate samples from each of the three streams (arts, science, and commerce) were not included due to the data collection timing and the board examination of the students. The present study was conducted in only one district of Karnataka state from selected English Medium PUCs, which limits the generalization of the study findings. The present study recommends that in order to reduce the consequences of academic stress and to improve the general well-being of the adolescents’ group, the future studies can be planned using a mixed method design or an intervention study on parents and teachers regarding strategies to reduce the anxiety and academic stress.
Conclusion
The present study concluded that adolescents experience high academic stress, high perceived parental pressure, and moderately high anxiety related to competitive entrance examinations and low general well-being. Competitive entrance exams are one of the factors contributing to several physical and mental health issue in students, especially during the adolescent’s period. The key factors affecting the mental health of the students are academic stress, anxiety, and expectations from parents and teachers over exanimations.
The study also identifies that the adolescents find it difficult to handle the stress and stress themselves out by trying too many things at once and become overly competitive with their peers. Adolescents also experience high levels of perceived parental pressure due to their parents’ high expectations for academic performance and comparisons to their peers, which cause anxiety and lead to poor academic performance and poor general well-being. Therefore, it is essential for the health care professionals to collaborate with the parents and teachers to support the adolescents and give them a congenial environment that will promote healthy physical and psychological well-being of the adolescents.
Conflicts of interest
There are no conflicts of interest.
Acknowledgments
The authors hereby extend their gratitude to the Institutional Ethics Committee, Principals of all the college who permitted to conduct the study, parents and the participants for their involvement and unwavering support.
Funding Statement
Nil.
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