Journals / Higher Education Governance and Policy / 2026 / Volume: 7 Issue: 1

The Effect of a Peer-Assisted Adjustment Programme for International Nursing Students on Adjustment to University Life and Nursing Education Stress

Fatma Tanrıkulu(SAKARYA UYGULAMALI BİLİMLER ÜNİVERSİTESİ)0000-0003-1203-5852
Ayşe Gül Burcu(SAKARYA ÜNİVERSİTESİ, SAĞLIK BİLİMLERİ ENSTİTÜSÜ)0009-0003-3008-0523
Esmanur Karaman(SAKARYA UYGULAMALI BİLİMLER ÜNİVERSİTESİ, SAĞLIK BİLİMLERİ FAKÜLTESİ)
Sevcan Alioğlu(SAKARYA UYGULAMALI BİLİMLER ÜNİVERSİTESİ, SAĞLIK BİLİMLERİ FAKÜLTESİ)0009-0000-8625-7154
Pages
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Publication Date
2026-04-28
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

The results showed that international nursing students’ overall university adaptation significantly improved after participating in the peer-assisted adjustment program.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:International nursing students often encounter challenges related to unfamiliar educational systems, cultural differences, and language barriers, leading to economic, psychological, and social difficulties.
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Key Findings & Data:A single-group pretest post-test design was used with 31 first- and second-year international nursing students at a university in northwestern Türkiye.
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Conclusion & Impact:The results showed that international nursing students’ overall university adaptation significantly improved after participating in the peer-assisted adjustment program.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:adaptation · nursing education · international students

Abstract

International nursing students often encounter challenges related to unfamiliar educational systems, cultural differences, and language barriers, leading to economic, psychological, and social difficulties. This study evaluated the effectiveness of a peer-assisted adjustment program in enhancing university adjustment and reducing nursing education-related stress among international nursing students. A single-group pretest post-test design was used with 31 first- and second-year international nursing students at a university in northwestern Türkiye. Participants completed the International Nursing Students Identification Form, University Adjustment Scale (UAS), and Nursing Education Stress Scale (NESS) before and after participating in a peer-assisted adjustment program, which included adaptation sessions, online support groups, and community activities. Paired-sample t-tests were employed to analyse the data. The results showed that international nursing students’ overall university adaptation significantly improved after participating in the peer-assisted adjustment program. Additionally, total nursing education stress scores, including academic and clinical practice-related stress, demonstrated a statistically significant reduction following the program. These findings suggest that structured peer-assisted adjustment programs may offer sustainable support for international nursing students and contribute to improved university experiences.

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Cite This Article

Tanrıkulu, F., Burcu, A. G., Karaman, E., Alioğlu, S. (2026). The Effect of a Peer-Assisted Adjustment Programme for International Nursing Students on Adjustment to University Life and Nursing Education Stress. Higher Education Governance and Policy, Volume: 7 Issue: 1. https://doi.org/10.55993/hegp.1690945

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References (34)

  1. Akbalık, G. (1997). The effect of information sessions and group psychological counseling on first-year university students’ adjustment to university life. Ankara University Journal of Faculty of Educational Sciences, 30(1), 1–15. https://doi.org/10.1501/Egifak_0000000268
  2. Al-Khatib, A., & Kağnıcı, D. Y. (2023). The effect of culture-based adjustment program on international students’ adaptation. Journal of International Students, 13(4), 115–134.
  3. Antón-Solanas, I., Tambo-Lizalde, E., Hamam-Alcober, N., Vanceulebroeck, V., Dehaes, S., Kalkan, I., Kömürcü, N., Coelho, M., Coelho, T., & Casa Nova, A. (2021). Nursing students’ experience of learning cultural competence. PLoS ONE, 16(12), e0259802. https://doi.org/10.1371/journal.pone.0259802
  4. Council of Higher Education. (2022). University monitoring and evaluation general report 2022. https://www.yok.gov.tr/Documents/Yayinlar/Yayinlarimiz/2022/2022-universite-izleme-ve-degerlendirme-genel-raporu.pdf
  5. Çalık, T., & Sezgin, F. (2005). Globalization, information society, and education. Gazi University Kastamonu Education Journal, 13(1), 55–66.
  6. Elyeli, K., Esmaeilzadeh, S., & Chikwana, S. (2024). Stress and anxiety levels of international nursing students: Case of Northern Cyprus. UHS Journal of Nursing, 6(1), 65–72. https://doi.org/10.48071/sbuhemsirelik.1395467
  7. Gökyer, N. (2017). Psychological adaptation of foreign university students. Journal of Higher Education and Science, 7(1), 98–108. https://doi.org/10.5961/jhes.2017.188
  8. Güneş Şan E., Yıldız, S., Nur Çetin, R., Çekerek, E., & Canlıca, A. (2025). The effect of medication administration training provided through peer education to nursing students taking the child health and diseases nursing course. Artuklu Health, (11), 10–17. https://doi.org/10.58252/artukluhealth.1612108
  9. Gürbüz, R., & Güleç, İ. (2016). Ideas on Turkish of foreign students who are educating in Turkey: Example of Sakarya University. Sakarya University Journal of Education, 6(2), 141–153. https://doi.org/10.19126/suje.18712
  10. Hellstén, M., & Prescott, A. (2004). Learning at university: The international student experience. International Education Journal, 5(3), 344–351.
  11. Iorga, M., Soponaru, C., Muraru, I.-D., Socolov, S., & Petrariu, F.-D. (2020). Factors associated with acculturative stress among international medical students. BioMed Research International, 2020, 2564725. https://doi.org/10.1155/2020/2564725
  12. İmamoğlu, H. V., & Çalışkan, E. (2017). Opinions of teachers on the primary education of foreign students in public schools: The case of Sinop province. Karabük University Journal of Institute of Social Sciences, 7(2), 529–546.
  13. Johnston, C., & Mohide, E. A. (2009). Addressing diversity in clinical nursing education: Support for preceptors. Nurse Education in Practice, 9(5), 340–347. https://doi.org/10.1016/j.nepr.2008.08.005
  14. Karaca, A., Yıldırım, N., Ankaralı, H., Açıkgöz, F., & Akkuş, D. (2014). Adaptation to Turkish of Nursing Education Stress Scale. Hemşirelikte Araştırma Geliştirme Dergisi, 16(2), 29–40.
  15. Kaş Alay, G. & Ulaş Karaahmetoğlu, G. (2024). The effect of peer education on pediatric nursing students’ clinical comfort and anxiety levels. Ege University Journal of Nursing Faculty, 40(3), 447–455. https://doi.org/10.53490/egehemsire.1166433
  16. Kaur, G., Chernomas, W. M., & Scanlan, J. M. (2020). Nursing students’ perceptions of and experiences coping with stress in clinical practice. International Journal of Nursing Education Scholarship, 17(1), 20200005. https://doi.org/10.1515/ijnes-2020-0005
  17. Kim, Y.-H. (2015). The effects of college life adaptation program on nursing students’ college life adaptation and nursing professional attitude. Journal of the Korea Academia-Industrial Cooperation Society, 16(12), 8948–8956. https://doi.org/10.5762/KAIS.2015.16.12.8948
  18. Kol, E., Arikan, F., Arikan, C., Yabarow, F., & Günbayi, İ. (2021). Being an international nursing student in Turkey: A qualitative study. Perspectives in Psychiatric Care, 57(1), 66–72. https://doi.org/10.1111/ppc.12525
  19. Korkmaz, M., & Tek-Ayaz, S. (2025). Determining the effect of a peer mentoring programme applied to nursing students on perceived stress and adaptation to university life: A quasi-experimental study. Educational Academic Research, (57), 23–30. doi:10.33418/education.1554788
  20. Kumcağız, H., Dadashzadeh, R., & Alakuş, K. (2016). The problems of international students in Ondokuz Mayıs University according to their grade levels. Ondokuz Mayıs University Journal of Faculty of Education, 35(2), 37–50. https://doi.org/10.7822/omuefd.35.2.3
  21. Labrague, L. J., McEnroe-Petitte, D. M., Papathanasiou, I. V., Edet, O. B., Tsaras, K., Leocadio, M. C., Colet, P., Kleisiaris, C. F., Fradelos, E. C., & Rosales, R. A. (2018). Stress and coping strategies among nursing students: An international study. Journal of Mental Health, 27(5), 402–408. https://doi.org/10.1080/09638237.2017.14175528
  22. Malekısanımalekı, R., & Altay, B. (2017). The determination of social support and loneliness levels of foreign students studying at Ondokuz Mayıs University. Ankara Sağlık Bilimleri Dergisi, 6(1), 71–96. https://doi.org/10.1501/Asbd_0000000063
  23. Mitchell, C., Del Fabbro, L., & Shaw, J. (2017). The acculturation, language and learning experiences of international nursing students: Implications for nursing education. Nurse Education Today, 56, 16–22. https://doi.org/10.1016/j.nedt.2017.05.019
  24. Narouz, L. (2018). Challenges and culture shock symptoms among international nursing students at Cairo University. IOSR Journal of Nursing and Health Science, 7(4), 58–66. https://doi.org/10.9790/1959-0704055866
  25. Özaslan, Z., Yalçın, S. U., Alptekin, H. M., Şimşek Şahin, E., Erdoğan, B., & Aydın Er, R. (2019). The study process experience of foreign students in nursing department. Journal of Anatolian Nursing and Health Sciences, 22(3), 170–178.
  26. Parlar Kılıç, S., Karadağ, G., Kılıç, N., & Demirel, C. (2021). Difficulties and expectations of foreign nursing students in the clinic. Journal of Comparative & International Higher Education, 13(1), 114–132. https://doi.org/10.32674/jcihe.v13i1.1684
  27. Rhead, M. (1995). Stress among student nurses: Is it practical or academic? Journal of Clinical Nursing, 4(6), 369–376.
  28. Schlicht-Schmälzle, R. (2020). Education at a glance. In Miriam E. D. & Marilyn J. A. (Eds.), The SAGE encyclopedia of higher education (pp. 420–422). SAGE Publications.
  29. Tanrıkulu, F., Öner, Ö., Gürçay, B., & Akgül, E. (2024). A qualitative study of foreign nursing students’ experiences of the educational process. Journal of Qualitative Research in Education, 39, 1–18. https://doi.org/10.14689/enad.39.1732
  30. Tuzcu, A., Bademli, K., Kırca, N., & Günbayı, İ. (2020). International nursing students’ views on the education process: A phenomenological study. Journal of Düzce University Health Sciences Institute, 10(1), 100–107. https://doi.org/10.33631/duzcesbed.548669
  31. Ünsal, E., Yalcinkaya, T., Dönmez, A., & Cinar Yucel, S. (2024). “A different country, a different language, a different culture…” Educational experiences of international nursing students studying in Turkey: A qualitative study. Nurse Education in Practice, 77, 103950. https://doi.org/10.1016/j.nepr.2024.103950
  32. Yılmaz, D., Mıstık, Ö., Arkan, B., & Gökdere Çınar, H. (2021). An examination of adaptation problems of foreign students studying in the nursing department: An example from Bursa Uludağ University. Journal of Innovative Healthcare Practices, 2(1), 23–32.
  33. Kaş Alay, G. & Ulaş Karaahmetoğlu, G. (2024). The effect of peer education on pediatric nursing students’ clinical comfort and anxiety levels. Ege University Journal of Nursing Faculty, 40(3), 447–455. https://doi.org/10.53490/egehemsire.1166433
  34. Özaslan, Z., Yalçın, S. U., Alptekin, H. M., Şimşek Şahin, E., Erdoğan, B., & Aydın Er, R. (2019). The study process experience of foreign students in nursing department. Journal of Anatolian Nursing and Health Sciences, 22(3), 170–178.