Students Anxiety Experiences in Higher Education Institutions

Students studying at higher education institutions face many challenges. Students who attempt to overcome these challenges may alter their behaviors. This may negatively affect their psychological state and cause them to feel anxiety. Anxiety is most prominent among college students. Many students face anxiety when they think they cannot achieve their academic or non-academic purposes; however, sometimes anxiety can encourage students to think more critically about how to achieve their goals. Students cope with anxiety in different ways, but some may struggle. This probably causes many symptoms that affect their mental health. Therefore, they should alleviate the anxiety to keep their mental health and persist in the institution.


Introduction
College students' mental health plays a very important role in their success and persistence at their institution [1]. When the students can manage their anxiety, they feel less pressure. If the students remain anxious, they may not follow through with their academic studies. Also, anxiety could complicate their physical and psychological states and persist after graduation, and it may negatively affect their capacity to work in the future [2]. Therefore, it is important to understand the factors that cause students' anxiety at higher education institutions.

Methods
To achieve the purposes of the study which focused to present the factors that cause students' anxiety in higher education institutions and find the solutions to this issue, a literature review was used to describe students' perception of anxiety feelings while they study in higher education institutions. Many studies that described students' perceptions from different countries were used to present this issue.

Data analysis
The researcher collected the researches that focus on students' anxiety and grouped them in different subcategories and explained each category based on the availability of recent researches that belong to the topic and the experience of the researcher. Although there were many factors that may cause students' anxiety, the researcher focused on some critical factors that presented in most higher education institutions in recent years.

Studying a new language
Studying a new language is a major factor that causes anxiety among many students, especially those who follow their studies in a non-native language. Most students in higher education institutions study English as a foreign language or as a second language. Some of them may learn English before college. However, they may not able to meet the high level of English proficiency required at the college level. They face anxiety because if they cannot pass successfully, they may not be able to graduate from the institution.
Tian [3] indicates Korean students face language anxiety when they must make presentations in class, and they lack language proficiency. Moreover, they feel anxiety because of their peers' negative feedback. Charoensukmongkol [4] also indicates Thai students face language anxiety because they lack proficiency in the English language. Tsai and Lee [5] found Taiwanese students have anxiety when reading English because they do not understand the English vocabulary, the topics, or the long and complicated text structures, and they fear they will make mistakes when answering questions.
Jawas [6] found Indonesian students also have English language anxiety because they lack proficiency in writing, and the instructors present them with class essay assignments that probably increase their anxiety because of the limited time in class to finish the assignment with the appropriate answer. Also, some Indonesian students have anxiety when giving a presentation. Some of them may not prepare well and do not like when someone asks them difficult questions about the presentation [7].
Abdala and Elnadeef [8] also indicate that Saudi Arabian students feel anxious about learning the English language specifically when they make mistakes in the class and lack writing proficiency. They are scared when they hear unwanted comments and jokes from their classmates while they are speaking. Some other students face anxiety in learning the Chinese language [9]. The Chinese language is not easy to learn, specifically in speaking and writing. Also, some Hispanic students have difficulties when studying Spanish, specifically in writing, spelling words, and using conjunctions [10].

The curriculum difficulty
Curriculum difficulties are also considered a factor that causes students' anxiety in most higher education institutions. Some students cannot understand the curriculum and struggle to answer questions in the classroom, do assignments, and write research papers or reports. Some students may hesitate to ask the instructors for help; therefore, they become anxious because they are unable to meet the course requirements. Some difficult curriculums include mathematics [11][12][13], biology [14,15], statistics [16], chemistry, physics, history [17], and law [18]. In addition, there are several medical specialization classes that cause students' anxiety, such as dental and medical [19], medical and engineering [20], dentistry and veterinary [21], and pharmacy [22].

The difficulty in exams
Some students face anxiety with midterm and final exams because they are not well prepared. Some students may not understand the exam questions and write the wrong answers as a result [17]. More importantly, sometimes there is not enough time to answer the exam questions. Some faculty members do not know the differences in the students' abilities, and they make exams that do not fit with some students' intelligence. As a result, students may fail the exams. Exam anxiety is widespread among college students [23,24] in different majors like math, history, geography, chemistry, physics, engineering, arts, and music. For example, some students specializing in music have anxiety in exams where they must use a musical instrument [25]. Also, some pharmacy students have anxiety about their clinical exams [22].
Some students also face anxiety about online exams because some faculty members make the exams with a time limit, and some students may need more time. Also, the computer may not work well or Internet services may shutdown while students are taking the online exam. As a result, some students may not prefer online exams.

Financial pressure
Financial anxiety is considered an issue many students face when studying at higher education intuitions because they are responsible for paying for their studies, especially those at private institutions. Some of them may be in debt. This financial pressure leads students to feel anxiety, which causes them psychological distress [26] that results in a lower grade point average (GPA). Some students who face difficulties in understanding difficult subjects depend on costly private instructors. Students also need money for daily expenses such as food and transportation. When students feel they do not have enough money, they may be anxious and ask friends for money, which negatively affects students' feelings, leading to stress and anxiety.

Culture shock
Many international students suffer from alienation and culture shock when they seek to continue studying in other countries. This shock causes them psychological crises such as anxiety because of the distance from their family and country, the difficulty of a new language and speaking with others, and the difficulty of adapting to the new culture, which requires patience.

Family responsibilities
Some university students have many family problems that cause them anxiety while they are studying. One of these problems is the illness of a family member, such as a parent, which requires the student to remain close to the patient. If the students are they have responsibility of the children and the husband. These problems affect the student academically because it hinders him in preparing well for tests, performing academic duties, and attending lectures, which causes him concern about how to balance his family and academic responsibilities.

Illness
Some students who suffer from a chronic illness have anxiety [27]. For example, a student who suffers diabetes is required to take daily insulin injections and go to Anxiety Disorders the health center, and some may experience dizziness while at the university campus. Diabetes may hinder a student if his health condition relapses, and he may be absent from the university. Other illnesses include cancer, anemia, heart problems, asthma, and obesity. These diseases may negatively affect the academic level of the students, which causes them anxiety.

Employment
Some students who attend higher education institutions work off campus part or full time. Some of them may not be able to attend classes, specifically if they work in the mornings and their classes are scheduled for the same time. Some of them face anxiety if they cannot manage their time. They may fail their courses because of their absences or fail exams because they do not prepare well. As a result, they receive a lower GPA and an academic warning.

Discrimination
Discrimination is a concern that many students face at higher education institutions. The institutions gather students and staff from different backgrounds, nationalities, ethnicities, religions, colors, cultures, and levels of intelligence. Some students feel anxiety because of unfair treatment from classmates, friends, and staff and faculty members. When the students feel they are not welcome and they are treated badly, this causes them to feel anxiety [28,29].

Disabilities
Some disabled students enter higher education institutions to further their studies, despite the challenges they face. Some disabled students have anxiety because they are unable to major in some specializations they may need. Some specializations such as geology and biology need students to participate in course activities using labs and instruments, which is difficult for some disabled students. Also, they may not be able to socialize with other students and may prefer isolation. Some students are visually impaired and require specific resources like certain textbooks, handouts, and software [30]. However, these resources are not available for some courses. Also, some students may have psychiatric disabilities [31] and need special attention from the mental health center to help them succeed academically. Some students who have autism spectrum disorder have anxiety when trying to achieve success in their academic studies [32].

Anxiety symptoms
When students have anxiety, it affects their mind and body and causes several symptoms: cognitive, physical, and emotional.

Cognitive symptoms
Many students could experience symptoms along with their feelings of anxiety. They may have many negative and painful experiences, such as insomnia and other sleep disorders. Anxiety also negatively affects students' memories. They may become unable to think correctly and make decisions; therefore they cannot participate in classroom discussions and cannot share their opinions and ideas with other classmates and faculty members. Some of them feel sadness, fear, and panic. As a result, their academic achievements are negatively affected.

Physical symptoms
Students with anxiety can experience significant pain with symptoms like breathing problems, stomachaches, headaches, joint and muscle pain, and fatigue. These symptoms could make them unable to come to the university. Some students may fear from the faculty, so they upsent from the institution. Some students become fatigued when they have a lot of academic work to do on campus and feel anxious because they do not know how to manage this work. This academic anxiety badly affects students' health; however, they should cope with anxiety. Some students have sensitive behaviors, which play a role in their tendency to become overwhelmed with anxiety. This needs change for students to cope with academic life.

Emotional symptoms
Some students who suffer from anxiety experience painful emotional symptoms such as depression, sadness, nervousness, anger, and loneliness. Students may feel unhappy about coming to a university or become very nervous around people, such as friends and peers. Others feel worried and sad when they cannot overcome the challenges they face, such as having a low GPA. Some of them like to be alone when they have stressful feelings, which can lead to depression. Sometimes, these students may have negative thoughts about withdrawing from college, especially when their friends are successful and have good GPAs. Some students may feel tired from studying, the tough curriculum, and attending the university. They may have expected to be happy with university life but instead found it to be the opposite of what they wanted.

Alleviating students' anxiety
Mental health problems are a social phenomenon that requires attention in many societies [33]. Anxiety is an aspect of a college student's mental health. Attention must be paid to the means that help prevent students from falling into anxiety and reducing its severity and psychological impact on the students continuing their studies.

Improving relationships between faculty members and students
Having human relationships between faculty members and students is very important. Communication between these groups plays an important role in reducing students' anxiety. The faculty members should ask students if they need help to understand the curriculum, do assignments, and write reports. The faculty can design class activities related to the curriculum to make sure the students understand the content. For example, in teaching a language, the faculty should encourage group work in class to help students participate in communication to improve their speaking and their relationships with classmates to reduce the anxiety. Also, video games online can improve communication among students, increase students' confidence, and reduce their anxiety [34]. Collaborative work among students can also reduce students' anxiety, and they should be encouraged to use the strategies they prefer in learning [6].
The faculty members can encourage students to answer questions, whether they are right or wrong, to reduce students' fear. They should provide students with steps to do the assignments, write reports, and create projects. The faculty members should also understand that students differ in abilities and intelligence when they design exam questions. The exams should meet different students' abilities to reduce their anxiety. Hull et al. [35] indicate the importance of changing evaluation tools and improving students' self-efficacy.
The faculty members have important roles in guiding students and giving them advice related to academic decisions, such as selecting a college or selecting a major, and helping them manage their time for studying multiple curriculums. In helping them deal with anxiety, adapt to the challenges, and improve their thinking, faculty members can reduce anxiety's psychological side effects on students' bodies and minds.

Using mental health services
Many institutions provide students with mental health workers to help them cope with their negative feelings while they pursue their studies. To provide students with efficient mental services, the institutions should hire workers who specialize in psychology and counseling. This will provide students with effective strategies to reduce their anxiety. These mental health workers should be available to meet students on campus and, most importantly, give students a trusted and secure setting in which to improve their self-confidence when they seek help. They should provide students with a socialized atmosphere to reduce their isolation and fear, specifically students with psychiatric disabilities and autism spectrum disorder. These students need to manage their social emotions to adapt to university life [32]. Online social networks should be improved to help them socially [36].
Also, it's important to provide international students with mental health workers who can deal with their culture shock, speak different languages to meet various students' needs, and provide them with social support and a friendly relationship. Different social and cultural activities on campus can help students communicate with others and reduce their anxiety as well. Shelton, Wang, and Zhu [37] indicate that cultural orientation is an appropriate way to keep students mentally healthy.

Improving academic services
To reduce students' academic anxiety, institutions should provide students with effective academic services like a writing center, which helps students write in many subjects and improves their efficiency in using vocabulary and grammar. Tutorial services are also important in helping students reduce their anxiety. The tutorial should be provided by an effective staff specializing in the curriculum to help students understand the content of the courses, specifically in language courses, mathematics, statistics, and biology.
Improving library services can help students do research and experiments. According to Grandy [38], some adult students have library anxiety because they are unable to use the library services. Therefore, these students should be provided with information literacy courses to reduce their anxiety about using library resources, technology resources, and searching strategies.

Physical exercise and relaxation activities
Many students who suffer from anxiety can manage their negative feelings through exercises like walking, swimming, and playing tennis. Some students join Students Anxiety Experiences in Higher Education Institutions DOI: http://dx.doi.org /10.5772/intechopen.92079 sports clubs, which results in an improvement in their positivity and happiness. Taking part in physical activities can greatly reduce the negative psychological health impacts on a student's body and mood [17], reduce mental difficulties, and improve their health well-being [39]. Other students may prefer to reduce their anxiety by reading books about mental health and dealing with anxiety to be aware of how they can manage their symptoms. Some of them may also read novels and magazines for relaxation [17].

Discussion
Students at higher education institutions face many kinds of challenges that affect negatively their psychology feeling, causing them anxiety. Its effects vary among students in how to deal with it, overcome its symptoms, and find solutions. The study found that the most important factor that causes anxiety is related to academic study. For example, many students who study a new language face challenges in understanding language words, speaking, and writing. This issue was found in many students in different countries such as Korea, Thailand, Indonesia, China, and Saudi Arabia, which reflect that this issue is widespread internationally among higher education institutions. This finding needs a special issue from the faculty members to dedicate efforts in helping students understand a new language without the feeling of anxiety.
The finding also highlights that students in different colleges and specialization face anxiety. This finding may reflect that some students may have low academic competency to study in a specific specialization and not qualify to study high level of curriculum contents. However, some faculty members may not spend adequate time to explain to students the curriculums' contents, which may affect negatively students' feeling in searching and understanding. As it known that students vary in competencies, therefore the faculty members should focus in insuring that students understand the curriculum and how doing the assignments .
In addition, most students in higher education institutions face anxiety of midterm and final exams in most specialization. This issue needs faculty members' attention to focus on preparing students for exam and reduce their anxiety. As it is known, students attend the university or college to get knowledge and improve their abilities, not to feel anxiety and have a psychological sickness.
Besides academic factors, some students feel anxiety because of financial pressure and not being able to pay the tuitions and fees. This issue is widely spread among students specifically who study in a private institution. Actually the institution should consider the students' financial level before admitting them in the institution to insure their ability to pay to reduce their anxiety.
Some students feel anxiety because of illness and not being able to attend class daily and doing assignments and preparing for exams. The medical staff in the institution should consider students with illness and disabilities and follow their health situations to insure their capability to follow their study and provide them with support services to reduce their anxiety. Most importantly some students hesitate to inform the support staff with their illness or disability situation; as a result they may not able to deal with the problems that they might face, and as a result they feel anxiety.
Because the anxiety have several negative cognitive, physical, and emotional symptoms which negatively affect students' mental health. Several solutions were suggested to alleviate students' anxiety through developing human relationship between students and faculty members, which is an important factor in helping students reduce their anxiety feelings. It is important that faculty members recognize Author details Nabila Y. AlKandari Kuwait University, Kuwait *Address all correspondence to: nabilah.alkandari@ku.edu.kw the importance of helping students in gaining knowledge and understanding curriculum contents to help them become qualified graduates in the work market with well body and mental health. As several researchers indicated, the negative effects of anxiety could have a continuous side effect on the students when they graduate and join the workforce. The workforce needs healthy and qualified graduates who can work without anxiety and stress.

Conclusion
Most students studying at higher education institutions face many challenges that give them a negative feeling and lead them to have anxiety. The most important factor that affects students is the academic challenges which are related to their persistence or retention in the institutions. Some of these academic factors include difficulty of studying new language, midterm and final exams, and curriculum. Some other students also face anxiety related to different reasons such as being ill or disabled students. Also some students feel discrimination which affects them negatively. International students also face culture shock anxiety which affects their persistence in the institutions. Students should learn managing this feeling to prevent their mental health from unwanted symptoms which may negatively affect their psychological behaviors. Also, students should understand how to improve their thinking and mind to adapt to the different challenges they face in their academic life. More importantly the university and college leadership should consider the importance of providing students with academic environment that encourage students' learning and persistence at the institution and protect them from an unwanted anxiety feeling which probably may change students' behaviors and attitudes negatively after graduation.
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