Alarm fatigue and its association with perceived stress, resilience, and coping behaviors among Palestinian nursing students during clinical internship in critical care units: a cross-sectional study

Background There is a lack of studies on alarm fatigue among nursing students during their internships in critical care units. Therefore, this study aimed to examine the association between alarm fatigue and perceived stress, resilience, and coping behaviors among Palestinian nursing students during their internships in critical care units. Methods A cross-sectional study was adopted involving 141 nursing students during their internships in critical care units in Palestine. A self-reported online questionnaire was used to collect data. It included the Alarm Fatigue Questionnaire, Perceived Stress Scale (PSS), Brief Resilience Scale (BRS), and Coping Behavior Inventory (CBI). Descriptive statistics, correlation, and multiple linear regression were used for data analysis. The data were collected at the end of the internships in January 2024. Findings: The results showed that the participants had moderate levels of alarm fatigue (M = 21.71, SD = 7.78 out of 52), perceived stress (M = 1.36, SD = 0.83 out of 4), and resilience (M = 3.25, SD = 0.60 out of 5). Problem-solving was the most frequent coping behavior. A weak positive correlation was found between alarm fatigue and perceived stress (r = 0.22, p < 0.01). In contrast, a negative moderate relationship existed between alarm fatigue and resilience (-0.40, p < 0.001) and problem-solving behavior (r= -0.34, p < 0.001). Resilience and problem-solving behavior were the main predictors of alarm fatigue. Conclusion This study highlights the importance of recognizing the correlated factors of alarm fatigue among nursing students during their internships, especially in critical care units. Strategies that foster resilience and positive coping mechanisms and minimize the perceived stress should be implemented to minimize alarm fatigue among nursing students and enhance their well-being and clinical performance. Ongoing guidance and training on effective alarm control practices are vitally important. Implementing effective stress-reduction measures, such as mindfulness-based practices and adopting positive coping strategies are essential.