الفهرس 
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Abstract
Stress is a fact of everyday life for students at university. For most students, entering college can be an overwhelming issue, as well as an important cultural transition. They are not just have to manage rigorous academic demands; they have also to cope with developmental challenges s well as new relationships and new personal responsibilities. Combination of all these stressors can not only disrupt the academic performance of students but also have serious consequences that include increasing their vulnerability to psychological distress.
Self –concealment has been defined as a tendency to actively conceal distressing personal information from others. Previous literatures have documented an association between self-concealment and psychological distress. Self- concealment impairs the person’s ability to get social support and limits their coping options, including seeking professional psychological help. The students’ attitude toward seeking professional psychological help can intern affect their level of distress and so on.
The present study aimed to assess the level of self-concealment, psychological distress and attitude toward seeking professional psychological help and determine the relation between self-concealment, psychological distress and attitude toward seeking professional psychological help among Faculty of Nursing Students, Alexandria University.
The study was conducted at the Faculty of Nursing Alexandria University and followed the descriptive correlational research design.
The study subjects were composed of 30.2 % of the registered students enrolled at the faculty during the academic year 2015-2016. These students were randomly selected using a systematic random sampling method and amounted to 437 students.
Data of present study were obtained using the following tools:-
Tool 1: A Socio-demographic and Academic Data Questionnaire:
This tool was developed by the researcher to elicit data about the socio demographic data such as students, age, sex …etc., in addition to academic such as academic year, specialty of nursing at this semester… etc.
Tool 2: Self-concealment Scale (SCS)
The self-concealment scale was developed by Larson and Chastain (1990). It was used to measure the person’s tendency to conceal personal and distressing information .The scale contains 10 statements that are rated on a five -point Likert scale ranging from, 1 (Strongly disagree) to 5 (Strongly agree).A score of 10 indicates total self-disclosure and a score of 50 indicates total concealment. Respondents who obtained a score of 30 and above (≥30) are qualified as high-concealers while those with a score less than 30 (<30) are considered low self-concealers.
Tool 3: The Brief Symptom Inventory–18
This inventory was developed by Derogatis and Melisaratos (1993) to measure psychological distress. It contains 18 symptoms under three subscales of indicators, namely somatization, depression and anxiety, with 6 symptoms for each indicator. The respondents were asked to rate how much they have been “distressed or bothered” in the past 7 days, including the day of data collection on a five -point Likert scale from 0 (not at all) to 4 (extremely).For all these indicators scores ranging (0-9) indicates low symptoms, (10-18) moderate symptoms, and (19-24) severe symptoms. The total score for the indicator ranges from 0 to 72, with higher scores indicating higher levels of psychological distress, in which (0-24) indicates low level of psychological distress, (25-48) means moderate level of psychological distress, and (49-72) indicates high levels of psychological distress.
Tool 4: Attitude towards Seeking Professional Psychological Help (ATSPPH) scale:-
This scale is a self-report questionnaire developed by Fischer and Turner (1970) to measure Attitude towards Seeking Professional Psychological Help. It consists of 29 items (18 negative statements and 11 positive statements .It compromises 4 subscales namely,
1. Recognition of Need subscale
2. Stigma Tolerance subscale
3. Interpersonal Openness subscale
4. Confidence subscale
The scale contains
Each item is scored on a 3-point Likert-type scale ranging from 1(Strongly Disagree) to 3(Strongly Agree); negative items will have reversed score.
This scale score was modified to a 3-point likert –type scale from 1(disagree) to 3(agree). The overall score ranges from (1-87) and divided as following (1-29) means low positive attitudes toward seeking professional psychological help, (30-58) moderate positive attitudes toward seeking professional psychological help and (59-87) highly positive attitude toward seeking professional psychological help.
The Socio-demographic and academic Data Questionnaire (tool 1) was developed by the researcher. Attitude towards Seeking Professional Psychological Help (ATSPPH) scale (tool 2), Self-concealment Scale (tool 3) and The Brief Symptom Inventory–18 (tool 4) was translated by the researcher into Arabic language. Content validity was done by a jury of 3 experts in the Psychiatric Nursing, and 2 psychologists for tool 2, 3 and 4, appropriate modification was done. Reliability test was done using the appropriate test (Cronbach’s Alpha test) for tools 2, 3 and 4, and the result was 0.756 for self- concealment scale, 0.884 for The Brief Symptom Inventory–18, and 0.783 for attitude towards Seeking Professional Psychological Help (ATSPPH) scale .A pilot study was carried out on 25 students to assess the clarity and applicability of the study tools. These students will be excluded from the study subjects. To assure that the subjects represent all the students at the faculty of nursing, cross section sampling method was used (30.2% of student of each of the 8 semesters).Students have been met on a small group basis to explain the purpose of the study and to give instructions on how to fill the study tools. The total number of students in the study was to be 500, among those, about 63 refused to participate in the study, leaving a total final number 437 student. The data were collected over a period of five months, starting from November 2016 until March 2017.
The present study revealed the following results:
• More than two-thirds (68.6%) of the studied students were females and 31.4% of them were males with a mean age of 20.25±1.75 years, the majority of the studied subjects (91.5%) were living in urban areas.
• More than three quarter (77.6%) of the studied students reported that they didn’t work during academic year. It was also noticed that 82.2% of the studied students were living with their families.
• It was observed that more than one third (36.4%) of the studied students were registered in the second semester while the rest of the studied students were registered in the fourth, sixth, and eighth semesters respectively and Nearly half of them (45.3%) obtained a grade of very good.
• It was illustrated that 61.9% of the students had high self-concealment
• It can be observed that nearly half (47.4%) of the studied students had low level of psychological distress as indicated by somatization, depression and anxiety.
• It was evident that more than half of the studied students have high positive attitude toward seeking professional psychological help (59.3%)
• It was noticed that the students have high level of Recognition of need and Interpersonal openness were 68.2%, 66.6% respectively, and those with moderate levels of stigma tolerance and confidence in mental health practitioners 72.5%, 61.1% respectively.
• It can be observed that the highest percentage of self- concealment level was found among students from urban areas (92.2%) , followed by those who are not working during academic year , female and at age group of <20 (73.7%,65.9%,57.4%) respectively . while the lowest level self-concealment was found among those who live alone during academic year (4.8%).
• It can be observed that there was statistically significant relation between Attitude toward seeking professional psychological help, age, residence and academic year.
• On the other hand there was no statistically significant relation between Attitude toward seeking professional psychological help and students’ sex, Work condition, household inhabitants.
• There was statistically significant positive relation between Psychological distress, and academic semester.
• There was a statistically significant positive relation between Self–concealment and total psychological distress, its three subtypes (Somatization –depression and anxiety) (p=0.00, r=0390 ; p=0.000, r = 0.217 ; p=0.000, r=0.400 ;p=0.000; r=0.373) respectively
• There is a statistically significant positive relation between psychological distress and only two subscales of attitude toward seeking professional psychological help (interpersonal openness –stigma tolerance) (p=0.001, r=0.154; p=0.008; r=0.128) respectively.
• There is a statistically significant positive relation at the level of significance (0.01) between Awareness of need of seeking professional help and (attitude toward seeking professional psychological help - interpersonal openness –stigma tolerance-confidence) (p=0.000, r= 0.366; p=0.000, r= 0.301; p=0.000, r=0.368; p=0.000, r= 0.262) respectively.
According to the study results, the main recommendations are:-
Counseling services for students are needed to teach students how to cope with psychological distress instead of using self- concealment as a mal adaptive method so, Dissemination of information about the avoidable professional psychological help sources including counseling center should be done for nursing students.
Nursing Course dealing with human psychology should emphasize the drawbacks of self- concealment especially its effect on psychological health.
Implementing developmental and educational programs are needed to maximize self-disclosure especially for newly admitted students.