Abstract
Introduction
Late adolescence or emerging adulthood is a phase of life between adolescence and full-fledged adulthood that spans the ages of 18 to 25 years (Arnett, 2000). It is a transitional period of time when late adolescents struggle with identity exploration, instability, and self-focus while achieving autonomy, personal identity, and the development of coping skills (Kinnunen, Laukkanen, Kiviniemi, & Kylma, 2010). According to the World Health Organization (WHO), today’s society has the largest population of young people in reported history, with 1.8 billion 10- to 25-year-olds globally. Research suggests that the lifetime prevalence rates for depression among adolescents is 7.6% in Canada and from 3.2% to as high as 8.9% worldwide (Statistics Canada, 2004; WHO, 2012). There is a large comorbidity rate with anxiety, ranging from as low as 15.9% to as high as 75% (WHO, 2012).
Anxious adolescents create heavy burdens on society because as they suffer with their own personal struggles, they engage in increased problem behaviors, have poor self-concept, and show low school achievements, such as absenteeism, avoidance, and difficulty concentrating (Dia & Bradshaw, 2008). Schools are the primary setting in which youth exhibit signs of anxiety, which, in turn, interfere with their school experience (Mychailyszyn et al., 2011). Studies have found that school avoidance resulting from symptoms caused by anxiety accounts for 20% of youth absenteeism (King & Bernstein, 2001). If left untreated or ignored, everyday anxiety among late adolescents could lead to anxiety disorders or other mental health problems, with poor social and developmental outcomes later in adult life (Saavedra, Silverman, Morgan-Lopez, & Kurtines, 2010).
Review of the Literature
Research on adolescent anxiety has focused on the psychodynamics, turmoil, and conflict often experienced by adolescents and has investigated the relationship between anxiety disorders and other health effects, such as depression (Collins, 1991; Dusek, 1987). Many studies have examined developmental patterns and specific triggers of anxious situations and coping responses of adolescents. Altshuler and Ruble (1989) examined developmental changes in children’s abilities to cope with uncontrollable stress at various age levels (5-6 years, 7-9 years, and 10-12 years). Study findings showed that as children age, they tend to use more behavioral distraction strategies to cope with uncontrollable, stressful situations rather than cognitive distraction strategies. Others have examined the development of coping related to medical stressors and stressful situations in children and have reported similar results (Band, 1990; Band & Weisz, 1988). Styles of coping varied based on the specific stressful circumstance. School failure resulted in high levels of primary coping, whereas medical stress evoked high levels of secondary coping. As age increased, primary coping decreased and secondary coping increased (Band, 1990; Band & Weisz, 1988). Older children and adolescents are more likely to utilize secondary coping such as emotion-focused coping and cognitively based interventions compared to younger children who use primary coping such as problem-solving skills. Areas of stress for school-age children include academic demands, fear of success, fear of failure, friendship initiation, and peer conflict (Pincus & Friedman, 2004). Adolescents aged 14 to 17 years most commonly reported school, parents, friends, and significant others as the most common type of everyday stressor (Stark, Spirito, Williams, & Guevremont, 1989).
Several studies from Australia, the United States, and Canada have examined the effectiveness of school-based prevention/intervention programs targeted at decreasing anxiety symptoms through various coping mechanisms, gender differences in coping strategies and interventions, and metacognition in adolescents (Berry & Hunt, 2009; Brandibas, Jeunier, Clanet, & Fouraste, 2004; Pincus & Friedman, 2004; Sung, Puksar, & Sereika, 2006). All of the studies used specific tools to measure the level of anxiety, coping strategies, and related factors such as depression and self-esteem. In addition, two of the studies used structured interviews based on four hypothetical stressful scenarios to evaluate coping responses. Interventions used in each study consisted of behavioral interventions through groups sessions, psycho-education, realistic thinking, and social skills aimed at reducing anxiety (Berry & Hunt, 2009; Brandibas et al., 2004; Pincus & Friedman, 2004; Sung et al., 2006).
Two quantitative studies examined gender differences in anxiety and coping using self-reported anxiety scales (Berry & Hunt, 2009; Sung et al., 2006). Berry and Hunt (2009) revealed that through a cognitive-behavioral intervention targeting individual factors that increase adolescents’ vulnerability to bullying boys were able to reduce their bullying experiences, anxiety, and depression. Sung et al. (2006) found that adolescents living in rural communities had significantly higher levels of avoidance coping types than the normative samples. Overall, adolescent boys and girls differ in their levels of anxiety and coping strategies. Research on the role of metacognition and cognitive risk factors during adolescence has revealed cognitive risk factors to include anxiety sensitivity, negative affectivity, and positive affectivity (Wilson et al., 2011). Adolescents’ metacognitions about worry and their inability to control their worrying are associated with increased worrying and anxiety among adolescents (Dia & Bradshaw, 2008; Wilson et al., 2011). Evidence suggests that identification of risk factors for adolescent anxiety is critical for the development of prevention and early intervention programs for adolescents as well as utilizing the school environment to address adolescent coping (Berman, Weems, & Stickle, 2006).
In a mixed-methods, longitudinal study by Rew, Tyler, Fredland, and Hannah (2012), the main concerns of 216 adolescents were addressed as they progressed through high school. Twenty-one categories of concerns were identified. The categories endorsed most frequently were education, relationships, expectations, and the future.
To summarize, the literature review provided much quantitative research on specific anxiety disorders among adolescents, evaluation of anxiety scales, gender differences, treatment methods such as behavioral interventions, and school-based interventions. One mixed-methods study was found on the concerns of adolescents transitioning through high school. There was a gap in the research literature on the lived experience of everyday anxiety among late adolescents. Since not all anxiety denotes a diagnosis of an anxiety disorder, it is important to recognize everyday anxiety as a common emotion of human life that can significantly affect the daily functioning of adolescents. Understanding the lived experience of everyday anxiety of late adolescents will inform early detection and prevention programs and offset the development of more serious anxiety disorders for this population.
Method
An interpretive phenomenological methodology was the framework for the study (Merleau-Ponty, 1945/1962). The four existentials by Merleau-Ponty of lived body (corporeality), lived space (spatiality), lived time (temporality), and lived human relation (relationality) were reflected on and used to guide the analysis to yield a richly textured understanding of everyday anxiety.
Sample
Once institutional review board approval was granted, a purposive sample of eight participants were recruited via posters with contact information displayed at family physicians’ offices in an urban setting in southwest Ontario. There were three males (age 20, 23, and 24 years) and five females (age 18, 20, 21, 21, and 22 years). All the participants were single and Caucasian. Seven were in school and one was employed. Inclusion criteria included the following: late adolescents (age 18-24 years) with current everyday anxiety, either presently attending high school or having attended high school within the past 5 years. No compensation was offered for participation. For the purpose of this study, everyday anxiety was defined as having symptoms such as avoidance; hypervigilance and hyperarousal; feelings of worry, apprehension, or dread; and impaired concentration and so on but not the full criteria of symptoms needed to be clinically diagnosed with an anxiety disorder. After written consents were obtained, one semistructured audiotaped interview with each participant lasting 60 to 90 minutes was conducted at a family physicians’ private office.
Data Analysis
Data analysis did not include a computerized program. Six interactive approaches by Van Manen (1998) for interpretive phenomenological inquiry and analysis of the data were used: orienting oneself to the phenomenon of interest and explicating assumptions and preunderstandings; investigating experiences as lived through conversational interviews rather than as we conceptualize it; reflecting and conducting thematic analyses that characterize the phenomenon and interpreting through conversations; describing the phenomenon through the art of writing and rewriting (rethinking, reflecting, recognizing), which aims at creating depthful writing; maintaining a strong and oriented relation to the fundamental question about the phenomenon; and balancing the research context by considering parts and wholes. Specifically, for thematic analysis, the researcher followed the three methods by Van Manen (1998): (a) the holistic approach: the researcher viewed the text as a whole and tried to capture its meanings; (b) the selective or highlighting approach: the researcher highlighted or pulled out statements or phrases that seemed essential to the experience under study; and (c) the detailed or line-by-line approach: the researcher analyzed every sentence. An initial coding with similar words and phrases was completed to organize the data into categories. Several categories were collapsed into themes that emerged in all of the transcripts and then moved to higher levels of abstraction. As the themes evolved, the primary researcher returned to the transcripts several times for verification of meaning and to find exemplary quotes. To ensure rigor, four methods identified by Guba and Lincoln (1994) were utilized. Transferability was accomplished by ensuring a detailed description of the setting to provide enough information to be able to judge the applicability of the findings to other settings. Dependability was achieved by providing an audit trail (documentation of data, methods, etc.) that can be judged for external scrutiny. Confirmability was achieved through triangulation of data, researcher, and context (through ongoing feedback with the thesis committee) to invoke auditing in order to demonstrate quality. The primary researcher performed “member checks” for credibility by verifying the analysis of the findings with four of the eight participants available by phone. The four participants included two males (ages 20 and 23 years) and two females (ages 18 and 20 years) who confirmed the analysis of the findings.
Findings
Three main themes and seven subthemes emerged to characterize late adolescents’ experiences of everyday anxiety during high school. The themes were the following: the embodied experience of anxiety, with the subthemes of (a) the body and mind responds; feeling uncomfortable in the lived space of school, with the subthemes of (b) the lived relations of bullying, (c) the internal/external space of isolation, (d) the constant pressure to perform well; life at home, with the subthemes of (e) the lived space of home, (f) the lived relations of pressure from parents, and (g) life will get better. Although presented separately, the three main themes are closely intertwined with each other and together illustrate the lived experience of everyday anxiety. Excerpts from the participants’ interviews are used to illustrate each of the three main themes and subthemes. For the purposes of anonymity, participants were given a fictitious name.
The Embodied Experience of Anxiety
The late adolescents’ everyday anxiety was an embodied experience. Merleau-Ponty (1945/1962) defined embodiment in a way that reflects how we live in and experience the world through our bodies, especially through perception, emotion, language, movement in space, time, and sexuality. He spoke of existence as known only in and through the body. The subthemes of the body and mind responds is discussed.
The Body and Mind responds
The bodily responses were both internal (felt only by the individual experiencing it), including increased heart rate, nausea, or upset stomach, and external (noticed by others), including sweating, skin rashes, heavy breathing, or shortness of breath. Michelle, a 20-year-old female describes her bodily symptoms: The fast heart rate and sweaty palms, I didn’t get sick to my stomach or headaches or anything like that. But definitely, when I feel myself getting anxious, my heart starts to beat quickly and my hands sweat. No one can really tell that it’s happening, but I can definitely feel it inside of me.
Phenomenologically, we know that the lived body records everything (Ray, 2009). Many of the feelings that arose within the adolescents’ lived body were a result of experiencing anxiety on a daily basis. Internal feelings of sadness decreased motivation and elicited self-doubt and often left adolescents feeling sick (i.e., nauseous) and worthless. Erin, a 21-year-old female describes the physical effects of living with the stress of everyday anxiety: A lot of what goes on in the personal life is shown through in other areas like school, work and social areas. Stress has a very interesting way of showing itself. I have stress in between my fingers, its peeling because of the stress. It actually shows through in different ways, it comes through the body in different ways.
Although Erin did not experience anxiety attacks, her experiences of anxiety on a daily basis resulted in her lived body reacting to the daily experiences of anxiety, as evidenced through other aspects of her physical health.
The embodied experience of anxiety included the mind responding with constant worry and fear. The participants’ worry and fear made it difficult to concentrate, especially at school because they were constantly thinking about other things in their life. The inability to dismiss their thoughts and relax created problems in their daily life, such as relationships with others, sleeping at night, and focusing on tasks. Many participants were concerned about various aspects of school. Hailey, a 21-year-old female explained how she worried about what others were thinking of her: Those girls just caused me more stress and anxiety. I was always worried about what people were thinking about me, or how they were looking at me . . . it made my anxiety a lot worse.
Hailey has been unable to let go of her past worries of attending high school, which has had a negative impact on her present lived time. Merleau-Ponty (1945/1962) conceptualized the embodied person as existing in a knot of relationships that opens a person to the world. The body catches, comprehends, and responds to the communications of other people. Past, present, and future temporalities are all interconnected. Lived time is reflected in the way a person understands himself or herself from the past and how he or she projects into the future (Benner, 2000). The late adolescents’ embodied experience of anxiety in the responses of their body and mind created unease in the external lived spaces and the internal space within their body and mind. Jessica, an 18-year-old female still attending high school states: My head just wouldn’t stop talking. I couldn’t relax, I couldn’t concentrate. No matter where I was, something was always talking inside of me, which further added to my anxiety.
Dealing with constant worry and fear added to late adolescent everyday anxiety. Constant worry and fear throughout their high school years affected the late adolescents’ school work, attendance, and relationality with those around them.
Feeling Uncomfortable in the Lived Space of School
Not being completely comfortable within their own bodies and minds increased late adolescents’ anxiety in the lived space of their schools. Van Manen (1998) writes that lived space (spatiality) is “felt space” (p. 102) and suggests that we become the space we are in. The late adolescents’ everyday anxiety was often influenced by the high school environment in which they were situated. Erin describes her complete dislike for the lived space of high school: I wouldn’t say that high school was a very pleasant time, at all. I hated it, if you want the honest truth. I was never one of those girls who totally fit it. Everything was a big deal for me; everything made me nervous and anxious in school.
Erin’s lived space within high school lacked a sense of safety and, as a result, increased her everyday anxiety. The following are the three subthemes that emerged from the participants’ experience of feeling uncomfortable in the lived space of school.
The Lived Relations of Bullying
Bullying was a common experience for the participants during high school. On a daily basis, several of the participants faced taunting, name-calling, hitting, and social forms of bullying while attending school. Michelle describes her experiences of bullying while attending school: I was bullied as a kid for being overweight. It started in grade school . . . Grade 1 or 2 when it started. It was mostly name-calling and taunting, but it did get physical at times. They would try to lock me in a locker or push me against the fence.
Bullying was a daily occurrence for Michelle, ultimately having a negative impact on her overall self-esteem and creating feelings of anxiety. She found herself becoming more reserved and isolated from other students. Michelle’s lived relations with her peers in the school setting created a constant threat of being hurt or alienated. The danger she experienced in the lived space of high school intensified her feelings of everyday anxiety. Similarly, Hailey also experienced significant amounts of bullying from male and female students: You always have to worry about the high school drama. I find that you have a group of friends and then you find out a couple of your friends are going behind your back saying stuff about you and then worrying about that one big girl who’s going to meet you behind that school to beat you up.
The excerpts illustrate the daily struggles of attending school while experiencing or anticipating the lived relations of bullying. Attending high school created a very uncomfortable lived space for both participants, routinely disrupting their embodied experiences at school. Fear of attending school relates to not knowing what they might encounter from those around them. Fear of the unknown or prolonged physical or emotional harm will negatively affect the lived body and affect relationships over time (Allison, Roeger, & Reinfield-Kirkman, 2009). Participants felt unwanted and alone in the lived space of school, which automatically increased their chances of being bullied.
The Internal/External Space of Isolation
All participants expressed internal/external isolation, which worsened their everyday anxiety while attending high school. The embodied experience of anxiety among late adolescents created both an internal and an external lived space of isolation because they often kept their pain and suffering silent. They felt they needed to hide their everyday anxiety from their peers. Matt, a 23-year-old male describes his anxiety attack during a class: When I was having an attack, I kind of singled myself out. I didn’t want to talk to anybody; I was trying to avoid everything and everybody. And because I am a guy, I didn’t want to tell anyone what was going on. I felt like I had to put up a front in front of my friends.
Matt’s embodied experience of anxiety altered his external lived and internal lived space while attending school. Hiding his internal feelings of everyday anxiety added to Matt’s feelings of isolation. The lived relations of bullying were a constant reminder of the external lived space of isolation.
The Constant Pressure to Perform Well
The constant pressure to perform well (i.e., achieving high marks, participating in extracurricular activities, and owning name brand possessions) ultimately worsened the late adolescents’ embodied experience of everyday anxiety. The ability to succeed academically and maintain extracurricular activities was considered important by all the adolescents. Grades were important because high marks were needed to gain admission to postsecondary institutions. Dani, a 22-year-old female explains her anxiety as worsening as the pressure of achieving marks increased: As I went through the high school years, my marks became more important because I wanted to get into university. I kept putting pressure on myself to do well and that’s when the anxiety started getting worse.
Dani explained that schoolwork was not difficult to complete. However, she did not know why she wanted everything to be perfect. Many of adolescents used the word perfect in their narratives. They felt the pressure to always be perfect and recognized that most of the pressure came from within themselves. The lived relations of bullying, the internal/external space of isolation, and the constant pressure to perform well (including the importance of name brand possessions) compounded the adolescents’ feelings of an unsafe and insecure learning environment, which worsened their experience of everyday anxiety.
Life at Home
Life at home with the subthemes of the lived space of home and the lived relations of pressure from parents contributed to the late adolescents’ embodied everyday anxiety. Their narratives included both positive and negative factors at home that influenced their everyday embodied anxiety. Their experiences at home affected aspects of their school and social lives. The subtheme of life will get better occurred toward the end of high school or on graduation.
The Lived Space of Home
The late adolescents’ lived space of home included families whose parents were married and parents who had divorced. They included both supportive and nonsupportive households. Hailey describes how her lived space at home affected her everyday anxiety: When we first moved here, my parents were like always fighting all the time. The constant noise and screaming at home literally haunted me. It just made my anxiety worse. And even when I was away from my house, I could still feel the tension. It was like I couldn’t escape.
Hailey found herself in a very hostile lived space of home, which ultimately forced her to move away. The lived space of home created the “felt” space of unease and increased her everyday anxiety. Even when separating from home, Hailey carried those unsettling embodied feelings. Hailey’s lived time at home resulted in a lack of relations with her parents. Other adolescents, despite experiencing everyday anxiety, reported the lived space of home as very positive. Michelle experienced anxiety on a daily basis at home; however, support from her mom and a safe lived space made her experiences with anxiety much easier: My mom’s a big motivator. She was always very supportive of me and did her best to try and help me. I was never scared to talk to her or tell her about my anxiety. This made it much easier to deal with the anxiety.
Having a positive lived space at home, a place to feel safe and secure, helped adolescents deal with their embodied experience of everyday anxiety. Although they still had experiences with anxiety outside of the home, they were able to return to the safe lived space of home.
The Lived Relations of Pressure From Parents
Pressure placed on the late adolescents by their parents increased their everyday anxiety. Jessica encountered a great deal of pressure from her parents at home. She had to face their disapproval and criticism of her inabilities. Jessica was continually compared to her older sister who was strong academically and maintained extracurricular activities. Ultimately, Jessica became depressed and faced further academic challenges at school: I am already stressed enough because I am in high school. And I am in a self-paced school. I am probably not the best for being at a self-paced school, but it’s kind of too late to leave now because I am in Grade 12. All the stress of school, plus the stress of family, made me worse. The constant fighting at home and my mom getting mad at me for not doing well in school just added to it. Plus they always compared me to my sister which I didn’t like it. I felt like I wasn’t enough.
The constant reminders of her inabilities and failures created tension at home and made Jessica’s experience of embodied everyday anxiety worse. The lived relations of pressure from parents was also felt when trying to deal with embodied everyday anxiety. Adolescents reported that their parents did not always understand how or what they were experiencing with everyday anxiety which added more burden. Matt describes his struggles with gaining support from his parents: I was stressed out a lot. I was always going back and forth with my parents. It wasn’t the best situation. I mean, in high school, I didn’t have the best behavior. They were always . . . you have to calm down . . . No one was really helping me figure it out . . . they were just telling me what I had to do.
Life Will Get Better
All the adolescents noted improvements in their everyday anxiety toward the end of high school or on graduation. Improvements included being out of the lived space of high school, having control over their everyday anxiety, and being able to function within their life again. As they matured and learned to cope with their embodied everyday anxiety, the participants expressed a renewed sense of hope in knowing that their lives would get better. Tony, a 20-year-old male stated, I still have anxiety, but I learned how to deal with it. High school was only one small aspect of my life and I knew that in time, things would get better. I just had to coach myself through some of the stressful situations and work through them. My parents kept telling me that things would get better and I would start to feel better . . . And things around me did get better. I had hope in knowing that my anxiety would not ruin my life.
To summarize, everyday anxiety among late adolescents during high school was an embodied experience that affected their lived space at school and at home. At school, they experienced bullying, isolation, and the constant pressure to perform well. Life at home was experienced as both supportive and nonsupportive with pressure from parents. In time, these late adolescents felt better about their everyday anxiety and emphasized that life did get better.
Discussion
Findings from this study coincide with previous research on adolescent anxiety. Similar to the findings by Rew et al. (2012), the participants’ concerns during high school focused on education, relationships, and expectations from parents, teachers, and peers. As per studies by Pincus and Friedman (2004) and Stark et al. (1989), the participants reported that their everyday anxiety within the school setting was influenced by bullying, social isolation, and the constant pressure from parents and teachers to perform well. Similar to a prior study by Brandibas et al. (2004), anxiety within the school environment led to many of the adolescents avoiding activities that made them uncomfortable. The constant worry and fear among the adolescents in the study affected their lived space of school, which, in turn, negatively influenced their participation in activities and their lived relations with other students. Similar to prior studies by Dia and Bradshaw (2008) and Wilson et al. (2011), the adolescents’ worry and their inability to control their worrying lead to increased worrying and anxiety. Ultimately, many of the participants avoided attending high school, which led to long-term consequences such as a lack of socializing and decreased friendships. These long-term consequences have been identified in other studies (Fisher, Masia-Warner, & Klein, 2004; Saavedra et al., 2010).
The everyday anxiety of all the late adolescents in the study was affected by their life at home, which included their lived space and the lived relations with parents. This finding corresponds to the research by Freeman, King, Pickett, and Craig (2011) suggesting that socializing that takes place within the home environment is vital in the development of positive mental health in today’s youth. Life at home for participants in the study ranged from positive and supportive families to broken homes filled with hostility and fighting. Home environments that are hostile and full of change and unrest result in negative mental health effects (Freeman et al., 2011). A hostile home environment created unease for the adolescents in this study, thus increasing their experience of everyday anxiety. On the other hand, adolescents who were living in homes with supportive environments found it easier to deal with everyday anxiety. Prior studies have consisted of behavioral interventions (groups sessions, psycho-education, realistic thinking, and social skills) aimed at reducing anxiety (Berry & Hunt, 2009; Pincus & Friedman, 2004; Sung et al., 2006). However, all participants in this study reported everyday anxiety as affecting them physically, mentally, and emotionally. Everyday anxiety as an embodied experience has implications for nursing practice and future research.
Implications for Nursing Practice
Late adolescent everyday anxiety is directly affected by their lived experiences at school and at home. Registered nurses, nurse practitioners, and public health nurses are in positions where they can identify and help adolescents cope with their everyday anxiety. Registered nurses and nurse practitioners working in primary care are knowledgeable about adolescents and their developmental needs. Registered nurses need to holistically assess a late adolescent’s experiences with everyday anxiety (mind, body, spiritual, and environmental aspects such as school and family life) during routine primary health care visits or in schools. Nurse practitioners have the ability to assess each adolescent and his or her family members, determining areas of strength and weakness when dealing with everyday anxiety. Nurse practitioners are highly trained individuals who should utilize their full scope of practice and intervene with adolescents exhibiting everyday anxiety in primary care settings (Moldenhaver, 2004). For instance, nurse practitioners can provide holistic care for adolescents experiencing everyday anxiety by focusing on embodied healing interventions that integrate body, mind, emotion, spirit, and environment (Ray, 2009). Such holistic interventions include mindfulness, meditation, yoga, breathing, and relaxation, which can be utilized within the school and health care systems as well as at home with support from family members. In this study, late adolescents wanted to have choices in their care and did not want to be pressured into pharmacotherapy. Coping can be aided with pharmacotherapy if needed; however, first-line interventions should involve body/mind methods to recognize and address embodied anxiety. In addition, registered nurses and nurse practitioners are familiar with the network of resources within the community that can be accessible for adolescents and their families (Lemmon, Elisabeth, & Stafford, 2007). Registered nurses, nurse practitioners and public health nurses can educate family members about everyday anxiety. Teachers can identify potential areas of anxiety-provoking activities and ways to reduce anxiety within the classroom (Fisher et al., 2004). Public health nurses in the schools can work together with teachers as well as other educators, parents, and the community to promote overall mental well-being and emphasize that everyday anxiety is a normal reaction to life’s stressors. This strategy might also address the stigma and isolation associated with everyday anxiety.
Implications for Future Research
There is a need for further research into bullying and how it affects the embodied experience of late adolescent everyday anxiety, school performance, relationships with others, and future anxiety. Additional research is warranted to determine effective strategies to predict and decrease or eliminate bullying from perpetrators and the impact on the victims. Research is needed to explore late adolescents’ opinions and evaluations of the health care they received, evaluate resources available to help them to effectively cope with their everyday anxiety, and determine areas for improvement. Exploring alternative holistic treatments that can integrate body, mind, emotion, spirit, and environment is a potentially important area of research for the treatment of late adolescent everyday anxiety. Finally, the participants described how life got better after high school and noted some improvements in their everyday anxiety. Further research on what contributed specifically to their improvements would be useful.
Limitations
The study was a retrospective account as all of the participants (except for one) are no longer attending high school. Therefore, there may be some alterations in the participants’ memories of their experiences of everyday anxiety during high school. The small purposive sample from one geographic area does not allow the findings to be generalized to other adolescent populations who are experiencing everyday anxiety. The perspective of a diverse group of adolescents from different settings may vary and add a different understanding of everyday anxiety.
Conclusion
This study has enriched our understanding of everyday anxiety. Everyday anxiety will have an impact on most adolescents during high school. Further research on everyday anxiety is needed to ensure late adolescents successful transition into productive adult members of our society.
Footnotes
Diana R. Leone, RN, MScN is a Nurse Practitioner student at McMaster University in Hamilton, Ontario, Canada.
Susan L. Ray, RN, PhD, APN is an Associate Professor/Associate Scientist in the Arthur and Sonia Labatt School of Nursing, Faculty of Health Sciences at Western University in London, Ontario. Canada.
Marilyn Evans, RN, PhD is an Assistant Professor in the Arthur and Sonia Labatt School of Nursing, Faculty of Health Sciences at Western University in London, Ontario. Canada.