Dispositional mindfulness and employment status as predictors of resilience in third year nursing students: a quantitative study

A cross-sectional study of resilience and well-being among nursing students in Saudi Arabia

Objectives

Promoting resilience and embracing healthy coping strategies can effectively assist nursing students in managing stress and enhancing their welfare. Nonetheless, a comprehensive understanding of the factors influencing their well-being and resilience, pivotal for both academic accomplishments and future career longevity, remains incomplete.

Methods

A cross-sectional descriptive correlational design was adopted for this study. Participants comprised students enrolled in pre-registration nursing programs at both undergraduate and graduate levels. The World Health Organization-5 Well-Being Index and the 10-item Connor-Davidson Resilience Scale were utilized to assess psychological well-being and resilience, respectively.

Results

The study involved 175 university nursing students selected through convenience sampling. On the 10-item Connor-Davidson Resilience Scale, the average score was 25.5, with undergraduate and graduate students scoring an average of 25.4 and 26.3, respectively. Nevertheless, the two groups had no statistically significant difference (p = 0.526). Regarding perceived well-being, the average World Health Organization-5 score was 16.1, with no noticeable distinction between undergraduates and postgraduates (p = 0.858). Notably, bivariate analysis revealed a moderate positive correlation between self-reported resilience and perceived well-being (rp = 0.281, p = 0.001). Moreover, senior students exhibited significantly higher scores on the perceived well-being scale than junior students (17.0 vs 15.1, p = 0.010). Multivariable regression analysis also identified that self-reported resilience represents a consistent means of predicting perceived well-being (regression coefficient B = 0.22, p < 0.001).

Conclusions

The outcomes indicate that university-based nursing students who exhibit higher levels of resilience have more positive perceptions of their well-being. Moreover, postgraduate students exhibit more significant resilience levels than undergraduate students.

Prevalence and levels of burnout in nursing students: A systematic review with meta-analysis

AIM

The aim of this study was to analyze burnout levels and prevalence in nursing students and to estimate prevalence levels with meta-analyses.

BACKGROUND

Nurses are one of the healthcare professionals most affect by burnout, but nursing students, during their studies, can also suffer burnout.

DESIGN

a systematic review with meta-analysis was performed.

METHODS

The search equation used in Pubmed, CINAHL and Scopus databases was "burnout AND nursing students". Quantitative primary studies including information about burnout, emotional exhaustion, depersonalization, or personal accomplishment in nursing students were included. Four meta-analysis were performed.

RESULTS

the sample was of n = 34 studies, with n = 15 studies being included in the meta-analysis with n = 2744 nursing students. Burnout prevalence was 19% (95% CI 11-28%). Regarding burnout dimensions, the most affected was high emotional exhaustion with a prevalence of 41%(95% CI 23-61%; n = 2222) followed by 27% low personal accomplishment(95% CI 9-49%; n = 2096), 25% high depersonalization (95% CI 15-36%; n = 2096).

CONCLUSIONS

Prevalence of burnout and its dimensions vary from 19% to 41%, being emotional exhaustion the main problem in nursing students. This problem may affect their future as nursing professionals, and it would be of important to prevent and to treat burnout at university levels.

Factors related to the appearance and development of burnout in nursing students: a systematic review and meta-analysis

Introduction

Burnout may be suffered not only by experienced nurses, but also by those in training. The university environment can be highly stressful for student nurses, who are exposed to various stress-producing situations.

Aim

The aim of this study is to identify and analyse the main risk factors for burnout among nursing students.

Methods

A systematic review with meta-analysis was performed. The search equation used was "Burnout AND Nursing students". Quantitative primary studies on burnout in nursing students, and related risk factors published in English or Spanish and with no restriction by year of publication were included.

Results

A sample of n = 33 studies were included. Three variables are identified can influence burnout in nursing students: academic, interpersonal, environmental and/or social factors. The meta-analyses, with the higher sample of n = 418 nursing students, show that some personality factors, empathy, and resilience are correlated with emotional exhaustion, depersonalization and personal accomplishment.

Conclusion

The personality factors that can influence the development of burnout in nursing students, such as resilience and empathy, among others, must be taken into account when preventing the appearance and treating burnout. Professors should teach nursing students to prevent and recognize the most frequent symptoms of burnout syndrome.

Stress and Resilience of Nursing Students in Clinical Training During the COVID-19 Pandemic: Palestinian Perspective

Introduction

Stress reduces nursing students' capacity to think critically, impedes decision-making, and eventually lowers academic performance and limits success. The circumstances surrounding the COVID-19 outbreak drove students into new virtual learning settings, adding stress to their academic responsibilities.

Objectives

The purpose of this study was to assess the perceived stress and resilience among nursing students in clinical training during the COVID-19 pandemic.

Method

A cross-sectional study was conducted on 315 students studying nursing. Data collection utilized the Perceived Stress Scale and the Connor-Davidson Resilience Scale.

Results

The analysis revealed that the stress score mean was 75.2 ± 6.6 and the resilience score mean was 26.0 ± 3.4. Also, there was a weak negative association between nursing students' stress and their resilience (p < 0.05). Additionally, the results indicated statistically significant differences between stress and gender, study year level, and age (p < 0.05).

Conclusion

Stress was high and resilience was moderate during the COVID-19 pandemic among nursing students.

Psychological experience among internship nurses at different internship stages: A qualitative study

AIM

Some studies have found that clinical practice has caused great pressure and negative psychological experience to nursing students. Therefore, this study aimed to identify psychological experience at different internship stages among internship nurses.

DESIGN

A qualitative study.

METHODS

In this qualitative study, one-to-one in-depth interviews and mixed data analysis strategies were conducted among internship nurses from May 2018 to February 2019.

RESULTS

The pressure of the initial stage was operational pressure (80.0%), intermediate stage was nurse-patient communication (50.0%), and last stage was employment pressure (70.6%). Nursing students mainly expected to improve their operational and communication skills, and to acquire clinical experience, thinking ability and frontier knowledge. 62.5% students said ambivalent on "let us practice with being monitored," especially in the last stage (88.2%). Clinical nursing teaching should pay attention to this dynamic experience and their factors and take corresponding measures to improve the quality of internship.

Investigating the professional identity and resilience in nursing students during the COVID-19 pandemic

BACKGROUND

Professional identity includes the values and beliefs of a nurse that guide her thinking, action, and interaction with patients. The stressful conditions of the COVID-19 pandemic may have affected nursing students' resilience and attitudes toward their profession. Therefore, the aim of this study was to investigate the professional identity and resilience in nursing students during the COVID-19 pandemic.

MATERIALS AND METHODS

This cross-sectional descriptive study was performed in November and December 2020 with the participation of all nursing students of Babol University of Medical Sciences who spent at least one semester of internship in a hospital during the COVID-19 pandemic. Data were collected using demographic questionnaire, Connor-Davidson resilience scale, and nursing students' professional identity scale. Data analysis was performed using independent t-test, ANOVA, and correlation tests at a significance level of 0.05.

RESULTS

Nursing students in the 3^rd, 5^th, and 7^th semesters have spent a minimum of 13 and a maximum of 151 days of internship during the pandemic period. The mean score of professional identity of nursing students was 61.86 ± 9.34 and their mean resilience score was 32.08 ± 13.54. The resilience score of 92% of students was below 50. Professional identity was significantly stronger, and resilience was considerably higher in students who were satisfied with their profession and lived with their families (P < 0.05). In other words, students with higher professional identity scores had higher resilience (r = 0.39, P = 0.000).

CONCLUSION

Despite a good professional identity score, the resilience of nursing students during the COVID-19 pandemic is low. Therefore, professors and the clinical education system should provide more support for students in such stressful times as the COVID-19 pandemic period.

A Transformative Learning Experience for Senior Nursing Students

BACKGROUND

Research suggests that clinical practicums in hospital-based settings are important, even if condensed, to provide students with the opportunity for real-world learning experiences. Rational dialogue makes learning meaningful and empowers students to learn by reflecting on experiences.

PROBLEM

The COVID-19 pandemic minimized availability of traditional one-to-one mentorship practicums.

APPROACH

This article describes the use of critical reflection on experiences in an undergraduate senior mentorship course to assess student learning through the thematic analysis of writing assignments. Guided by Mezirow's transformative learning theory, students completed a traditional group clinical practice, written reflective journals and virtual seminars focused on role development, and reflection on concurrent learning in clinical and simulation experiences.

OUTCOMES

Transformative learning was evident in their writing. Student journals demonstrated themes of responding to change, discovering resilience, developing confidence, finding gratitude, embracing advocacy, and transforming and becoming.

CONCLUSIONS

Through critical reflection, students recognized the opportunities mentorship afforded them, despite challenges.

Associations between academic burnout, resilience and life satisfaction among medical students: a three-wave longitudinal study

BACKGROUND

Research shows that there are connections among academic burnout, resilience, and life satisfaction in medical students. However, no study has yet examined the temporal relationships between academic burnout, resilience, and life satisfaction among medical students. This longitudinal study aimed to examine the temporal associations between academic burnout, resilience, and life satisfaction and to explore the possible mediating role of resilience in the relationship between academic burnout and life satisfaction among medical students.

METHODS

This is a three-wave longitudinal study covering the preclinical education period of 20 months. From October 2018 to June 2020, a total of 190 students majoring in clinical medicine filled out the Chinese College Student Academic Burnout Inventory (CCSABI), the Connor-Davidson Resilience Scale (CD-RISC) and the Satisfaction With Life Scale (SWLS) three times. Cross-lagged models were constructed to examine the temporal relationships between academic burnout, resilience, and life satisfaction and longitudinal mediation models were constructed to explore the possible mediating role of resilience in the association of academic burnout with life satisfaction.

RESULTS

Among medical students, resilience uni-directionally and positively predicted life satisfaction, while academic burnout uni-directionally and negatively predicted life satisfaction. However, the temporal association between resilience and academic burnout was negative and somewhat bidirectional. Resilience had a significant mediating effect on the relationship between academic burnout and life satisfaction in medical students.

CONCLUSIONS

Medical educators need to identify and take effective measures to combat academic burnout problems which can lead to reduced life satisfaction among medical students. Resilience-based interventions may be promising in buffering the negative impacts of academic burnout and improving life satisfaction. It is recommended that effective resilience-promotion interventions be developed and implemented in medical education to help enhance medical students' psychological well-being.

The role of mindfulness and attachment security in facilitating resilience

Background

In recent years, there has been growing interest in exploring ways to facilitate positive psychological dispositions, including resilience. The goal of the present study was to explore the possibility that trait mindfulness facilitates attachment security and thus enhances resilience.

Methods

We conducted two studies based on cross-sectional surveys. In Study 1, data of 207 students studying in Japan was collected. In Study 2, we used a different sample of 203 participants and different measurements to replicate the findings of Study 1.

Results

The results of Study 1 revealed that mindfulness positively predicted resilience, while attachment anxiety and avoidance were mediators between mindfulness and resilience. The results of Study 2 showed that mindfulness positively predicted resilience, and the mediating effect of attachment avoidance was significant, but the mediating effect of attachment anxiety was not significant.

Conclusions

It is possible to facilitate attachment security through cultivating trait mindfulness, and in this way, resilience could be enhanced. The effect of different components of mindfulness on attachment and resilience requires further studies.

The association between dispositional mindfulness and empathy among undergraduate nursing students: A multicenter cross-sectional study

The aim of this study was to explore the role of gender, age, and academic year in shaping dispositional mindfulness (DM) and the association between DM facets and empathy dimensions in a sample of undergraduate nursing students. In a multicenter cross-sectional study design, the Five Facet Mindfulness Questionnaire (FFMQ), the Interpersonal Reactivity Index (IRI), and socio-demographic questions were administrated to a convenience sample of Italian nursing students. 622 nursing students (82.2% female) participated in the study (response rate = 86.15%). Females had higher levels of Acting with Awareness (p < .001, d = .54) and lower levels of Non-reacting (p < .001, d = .52) facets of DM than males. Older students displayed higher scores on the Observing (r = .112, p = .005) and on the Non-reacting (r = .187, p < .001) FFMQ subscales than younger ones. No statistically significant differences in DM levels between the three academic years were found (ps > .202). After controlling for socio-demographic factors, DM facets were generally positively related to Perspective Taking (βs from .131 to .208, ps < .007) and Empathic Concern (βs from −.156 to .189, ps < .001), whereas negatively related to Personal Distress (βs from −.141 to −.261, ps < .001). Nursing students with higher levels of DM were more able to consider others’ cognitive perspective and to feel compassion, and were less emotionally distressed when facing tense interpersonal situations. Tailored mindfulness interventions might be useful to foster functional empathy within nursing undergraduate programs.

The effect of resilience on the relationship between perceived stress and change in alcohol consumption during the COVID-19 pandemic in Queensland, Australia

The COVID-19 pandemic has led to increased levels of stress and alcohol consumption. This study examined the effect of resilience on the relationship between stress and changes in alcohol consumption in the context of the COVID-19 pandemic in early 2020. A cross-sectional survey of 502 adults in Queensland, Australia (mean age = 45.68 (16.61)), found 23.9% of individuals had increased their alcohol consumption since the start of the pandemic. Regression modelling demonstrated a significant association between perceived stress and change in alcohol consumption. The study also revealed resilience was a moderating factor, where high levels of resilience buffered against increases in alcohol consumption associated with stress during the COVID-19 pandemic.

A Multicenter Study About Resilience of Nursing Students and Faculty in Online Courses

BACKGROUND

Resilience is the process of adapting well in adverse situations. Due to the challenges of teaching in online programs and the adaptations needed by students, it is important that faculty and students maintain a high level of resilience.

PURPOSE

The purpose of this study was to assess the resilience level of undergraduate and graduate nursing students and faculty who interact in an online environment and to determine factors that impact resilience.

METHODS

This study employed a descriptive cross-sectional study design using a convenience sample of undergraduate and graduate students and faculty at six accredited universities in the United States. Faculty and student resilience were measured using the Connor Davidson 10 Resilience scale instrument.

RESULTS

The sample included 92 faculty who taught at least one online course and 200 students who were enrolled in at least one online course. There was no difference in faculty or student resilience by generation or program. Overall resilience scores were at the moderate level for both students and faculty.

CONCLUSION

Resilience has multiple benefits for both students and faculty, and is a critical concept for focus in nursing education at all levels.

Posttraumatic growth and positive determinants in nursing students after COVID-19 alarm status: A descriptive cross-sectional study

PURPOSE

To determine the relationship between posttraumatic growth (PTG), psychological flexibility, and psychological resilience of nursing students after the COVID-19 alarm status.

DESIGN AND METHODS

This descriptive cross-sectional study was conducted with nursing students (N = 292) studying at a nursing school of a university. The data collection instruments included a form on descriptive variables, and the PTG, psychological flexibility, and psychological resilience scales. Descriptive statistics, independent-samples t test, ANOVA, correlation, simple, and hierarchical linear regression analyses were used to analyze the data.

FINDINGS

The mean scores regarding psychological flexibility, psychological resilience, and PTG were 27.56 ± 11.06, 18.10 ± 5.75, and 63.49 ± 20.64, respectively. While psychological flexibility explained 36.7% of the total variance in psychological resilience, the predictive effect of seven descriptive variables, including psychological flexibility and psychological resilience, on PTG was determined as 13.4%.

PRACTICE IMPLICATIONS

PTG, psychological flexibility, and psychological resilience may help nursing students prepare for their transition to the profession.

Undergraduate nursing students' resilience, challenges, and supports during corona virus pandemic

The coronavirus global pandemic interrupted teaching at Australian universities. Face-to-face teaching was replaced by online delivery. This presented challenges for nursing programmes due to the hands-on teaching requirements and clinical placements. Questions were raised around students' resilience and stress in the face of adversity. This study explored undergraduate nursing students' resilience, challenges experienced, and supports utilized during the pandemic. Convenience sampling recruited students from one nursing programme (n = 340). Quantitative and qualitative data were collected. The Connor-Davidson Resilience Scale (CD-RISC-25) examined resilience scores through non-parametric analysis. Narrative responses were analysed using inductive thematic analysis. 121 surveys (40.3%) were completed. Most participants were from second year (n = 77, 63.6%). The difference in median resilience scores among employed participants was statistically significant (P = 0.029) and higher than the unemployed. The median scores of students working in nursing-related roles were higher than others. Median resilience score across all year levels was 70 (IQR = 62-80), in the lowest score range. Major themes identified were fear of the virus, isolation, and mental health problems. The coping strategies identified were developing daily routines, staying connected, and establishing self-help techniques. This research has implications to optimize students' learning experience, enhance resilience, and promote mental health and well-being.

Modifiable Factors Influencing Resilience among Medical Interns

Resilience among the medical interns is essential and is protective against the state of burnout. However, it is not thoroughly investigated among medical interns. Is there any behavioural and modifiable factors influencing resilience? The objective of this study is to determine the level of resilience among medical interns in Malaysia and its associated factors. This nationwide cross-sectional study recruited medical interns from 17 randomly selected Malaysian hospitals accredited for medical intern training. All medical interns who reported to the selected hospitals from January to April 2020 were invited to answer an online questionnaire. The questionnaire incorporated Connor-Davidson Resilience Scale-10 (CD-RISC-10) for resilience, USMEQ-i to measure emotional quotient, Brief-Cope to assess coping styles, Preparedness for Hospital Practice Questionnaire (PHPQ test) to assess internship preparedness and questions related to sociodemographic, undergraduate training and interest to become a doctor.<strong> </strong>524 from 870 medical interns (60.2%) responded. Mean resilience score was 28.6 (SD = 6.33). Significant factors associated with resilience include active involvement in sports (p = 0.002), high EQ (p&lt;0.001), interest to become a doctor (p&lt;0.001), coping using humour (p&lt;0.001), less coping by venting (p&lt;0.001) and no failures in any clinical posting (p = 0.012). The regression model was substantiated by adjusted R2 of 62.8%. Factors affecting resilience among medical interns include modifiable factors such as coping styles and involvement in sports. The findings could guide targeted intervention to promote during medical schools or internship preparation programmes to increase resilience among medical interns.

Quality of Life, Resilience, and Related Factors of Nursing Students During the COVID-19 Pandemic

BACKGROUND

COVID-19 and the associated measures to mitigate the spread of the virus have significantly disrupted nursing education.

PURPOSE

The purpose of this study was to examine the relationship between quality of life (QoL), resilience, and associated factors among nursing students during the unprecedented COVID-19 pandemic and subsequent social distancing requirements.

METHODS

A cross-sectional study using an anonymous survey with nursing students (n = 152) was conducted at a public university in rural Appalachia in April 2020. Instruments included World Health Organization Quality of Life-BREF, Connor Davidson Resilience Scale, demographics and school-related questionnaires, and an open-ended question. Data were analyzed using descriptive, bivariate, and multiple linear regression analyses.

RESULTS

Resilience, having online experience, and being well prepared for online learning were associated with each QoL domain. Remarkably, 21% to 54% of nursing student QoL scores indicated poor QoL.

CONCLUSIONS

Cultivating resilience among nursing students may improve QoL, help with academic success, and prepare students to sustain the demands associated with the nursing profession.

The Effects of a Novel Mindfulness-based Intervention on Nurses' State Mindfulness and Patient Satisfaction in the Emergency Department

INTRODUCTION

The objective of this study was to examine the effect of a novel mindfulness-based time-out intervention on state of mindfulness among emergency nurses and, accordingly, on patient satisfaction.

METHODS

A pre-post intervention design among nurses in the emergency department was used with a between-subjects factor of patients who were nested within each nurse. The study was conducted between January 2017 and June 2018 among 48 nurses in the emergency department of a public tertiary academic hospital. For each nurse, a consecutive sample of 20 patients who attended the emergency department was recruited (n = 1920 patients; 960 in each phase). The mindfulness-based time-out intervention was based on theoretical mindfulness principles and carried out every 4 hours with direct communication to the patient at their bedside. Nurses' sociodemographic and professional characteristics and trait mindfulness were collected preintervention. Pre- and postintervention, data was collected on patients' sociodemographic and satisfaction, nurses' state mindfulness, and ED workload.

RESULTS

An increase in nurses' state mindfulness and patients' satisfaction was found after the mindfulness-based time-out intervention compared with before the intervention (4.35 [SD = 0.64] vs 4.03 [0.82], P < .001 and 4.03 [0.41] vs 3.16 [0.44], P < .001, respectively). A positive correlation was found between patients' satisfaction and nurses' state mindfulness (r = 0.29, P < .001). The findings also demonstrated that state mindfulness was higher among nurses, characterized by high trait mindfulness, after the mindfulness-based time-out intervention implementation.

DISCUSSION

By adapting mindfulness principles to the dynamic environment of the emergency department, we showed that the mindfulness-based time-out intervention was associated with a significant improvement in state mindfulness and patient satisfaction. The findings elucidate the interrelation among several conceptualizations of mindfulness that are increasingly reported in the literature, namely trait and state mindfulness, and interventions to promote mindfulness.

Mindfulness, Interoception, and Olfaction: A Network Approach

The fine-tuned interplay between the brain and the body underlies the adaptive ability to respond appropriately in the changing environment. Mindfulness Disposition (MD) has been associated with efficient emotional functioning because of a better ability to feel engaged by information from the body and to notice subtle changes. This interoceptive ability is considered to shape the ability to respond to external stimuli, especially olfaction. However, few studies have evaluated the relationships between interoception and exteroception according to MD. We conducted an exploratory study among 76 healthy subjects for first investigating whether MD is associated with better exteroception and second for describing the causal interactions network between mindfulness, interoception, emotion, and subjective and objective olfaction assessments. Results found that a high level of MD defined by clustering exhibited best scores in positive emotions, interoception, and extra sensors’ acuity. The causal network approach showed that the interactions between the interoception subscales differed according to the MD profiles. Moreover, interoception awareness is strongly connected with both the MD and the hedonic value of odors. Then, differences according to MD might provide arguments for a more mindful attention style toward interoceptive cues in relation to available exteroceptive information. This interaction might underlie positive health.

Resilience-building module for undergraduate nursing students: A mixed-methods evaluation

In nursing students, resilience is recognised as a critical quality that will enable them to face and solve the challenges encountered in their studies and future careers. This mixed-methods study aimed to develop a resilience-building module for university nursing students and evaluate its effects on resilience, well-being and mindfulness. We recruited a convenience sample of 195 nursing students and delivered a resilience-building module comprising three 90-minute workshops on the following topics: resilience and emotion regulation, stress management and mindfulness, and burnout and depression. The participants' views and perceptions of the module were explored using pre-test and post-test questionnaires and focus group interviews. No significant changes in outcomes were observed from the pre-test to the post-test. However, a multivariable linear regression analysis indicated that mindfulness was significantly associated with resilience. A qualitative data analysis revealed that the resilience-building module evoked the participants' awareness of resilience and was considered an enjoyable learning experience. In conclusion, although the quantitative results demonstrated no significant changes in outcomes after the module, the qualitative results suggested that the resilience-building module could have beneficial effects if included in the undergraduate nursing curricula. Finally, better mindfulness was identified as important for enhancing resilience among undergraduate nursing students.

Mind Over Matter: Mindfulness, Income, Resilience, and Life Quality of Vocational High School Students in China

Many social welfare programs focus on the provision of cash assistance and cash transfers to improve the quality of life (QoL) of those living in low-income households. While there is literature to support a positive relationship between income and QoL, studies have shown that QoL is impacted by non-income-related factors. This study examined the effects of income and mindfulness on QoL through a mediator, resilience, and attempts to answer the question of how important income is to QoL, relative to a non-income-based determinant, mindfulness. Using a sample of 905 emerging adults from the senior class of a secondary vocational high school based in an impoverished county of China, we studied two key determinants of QoL, income and mindfulness, as well as respective pathways, during a particularly critical stage of life. The results indicated that mindfulness had strong direct and indirect effects on QoL via resilience, while income had only limited indirect effects on QoL via resilience. Policy implications were discussed.

Critical thinking skills in intensive care and medical-surgical nurses and their explaining factors

Critical thinking affects patient safety in critical situations. Nurses, in particular, intensive care unit (ICU) nurses, need to develop their critical thinking skills. The present article seeks to compare the level of critical thinking in medical-surgical and ICU nurses and investigate the factors explaining it. A cross-sectional study was conducted on 120 medical-surgical and ICU nurses (60 per group). Data were collected using the California Critical Thinking Skills Test and analyzed in SPSS-16 using independent samples t-test, ANOVA, and the regression analysis. The mean critical thinking score was 8.68 ± 2.84 in the ICU nurses and 9.12 ± 2.99 in the medical-surgical nurses. No significant differences were found between the two groups in terms of the critical thinking score and the scores of its domains. The results of the regression analysis showed that demographic variables explain only 8% of the variations in critical thinking score, as only gender explains nurses' critical thinking score. The results revealed poor critical thinking scores in the nurses working in medical-surgical wards. Investigating the reasons for the poor scores obtained and using educational strategies such as PBL, conceptual map, participation in interdisciplinary rounds, the development of clinical guidelines and participation in continuing education conferences are recommended for developing critical thinking skills in nurses.

Variability of Burnout and Stress Measures in Pediatric Residents: An Exploratory Single-Center Study From the Pediatric Resident Burnout-Resilience Study Consortium

Residency is a high-risk period for physician burnout. We aimed to determine the short-term stability of factors associated with burnout, application of these data to previous conceptual models, and the relationship of these factors over 3 months. Physician wellness questionnaire results were analyzed at 2 time points 3 months apart. Associations among variables within and across time points were analyzed. Logistic regression was used to predict burnout and compassionate care. A total of 74% of residents completed surveys. Over 3 months, burnout ( P = .005) and empathy ( P = .04) worsened. The most significant cross-sectional relationship was between stress and emotional exhaustion (time 1 r = 0.61, time 2 r = 0.68). Resilience was predictive of increased compassionate care and decreased burnout ( P < .05). Mindfulness was predictive of decreased burnout ( P < .05). Mitigating stress and fostering mindfulness and resilience longitudinally may be key areas of focus for improved wellness in pediatric residents. Larger studies are needed to better develop targeted wellness interventions.

Mindfulness in allied health and social care professional education: a scoping review

Background: Investigations into the use of mindfulness with allied health and social care students, many of whom ultimately work in rehabilitation settings, is in the nascent stages and no systematic mapping of the literature has occurred. The purpose of this scoping review was to identify, summarise, and describe the current state of knowledge on mindfulness in allied health and social care professional education.Methods: Arksey and O'Malley's scoping review methodology was adopted. Five data bases were searched; inclusion and exclusion criteria were applied; and 50 papers were identified for inclusion in the study.Results: Quantitative studies depicted mindfulness interventions as contributing to: improved capacities for mindfulness; decreases in stress, anxiety, and depression; improvements in academic skills, quality of life and well-being, and empathy; improved physiological measures and emotional regulation; and mixed effects on burn-out. Qualitative studies highlighted: 1) mindfulness and self-care, 2) mindfulness within professional practice placements, 3) mindfulness in the classroom, and 4) the cultivation of mindful qualities.Conclusions: The study has important implications for the education of future rehabilitation professions and suggests that learning about mindfulness may be useful in assisting students to: manage academic stress, anxiety, and depression; cultivate a physical and mental state of calm; be more present and empathetic with clients; and be more focused and attentive in professional practice settings.Implications for rehabilitationFurther exploration of mindfulness as a promising educational intervention for the professional preparation of future rehabilitation practitioners in allied health and social care fields is recommended.Education and research about mindfulness and its potential opportunities for students in terms of the mediation of stress, anxiety, depression, and the cultivation of empathy, academic skills, quality of life, and resilience are recommended.Education and research about mindfulness and its potential for the cultivation of beneficial qualities of mind such as attention, self-awareness, compassion, non-judgment, and acceptance are recommended.Education and research about mindfulness as a potential means to develop capacities related to self-care, professional practice placements, and classroom performance in students is recommended.

Resilience in Baccalaureate Nursing Students: An Exploration

The purpose of the current study was to explore resilience in senior-level baccalaureate nursing students. Twenty-seven participants completed an online questionnaire assessing three stressors that pertained to marriage or divorce, death or loss of family members or close friends, and extreme financial hardship in the past 1 year. Resilience was measured using the 25-item Connor-Davidson Resilience Scale (CD-RISC-25) and one open-ended question about the experience of resilience. Mean CD-RISC-25 score was 73.26 (SD = 10.7; range = 45 to 96); only 33.3% of the sample was considered resilient (score >80). Qualitative data described academic stressors and support resources for resilience. Study findings underscore the relevance of resilience in nursing students. Nurse educators must help nursing students develop resilience to better prepare them for academic success and ensure a smooth transition into their professional nursing role. [Journal of Psychosocial Nursing and Mental Health Services, 56(7), 46-55.].

Does building resilience in undergraduate nursing students happen through clinical placements? A qualitative study

BACKGROUND

The shortage of nurses has become a global phenomenon, and methods of decreasing the attrition rate of nurses have been explored. Resilience was one of the important factors that increased the retention rate of nurses who stayed in this highly stressful profession.

OBJECTIVES

To understand how undergraduate nursing students perceive and experience their clinical placements and to identify the factors that helped them build resilience.

DESIGN

A qualitative design utilizing focus group interviews was adopted for this study.

PARTICIPANTS

Nineteen third- and fourth-year undergraduate nursing students in a Bachelor of Nursing program participated in this study.

SETTING

This study was conducted at a local university in Singapore.

METHOD

Four audio-taped focus group interviews were conducted.

RESULTS

Students reported that they were stressed while facing challenges head-on during their first clinical placements, mainly due to a lack of peer and clinical support. Gradually, students built resilience overtime and were able to adapt to the ward culture through peer support and reframing coping strategies.

CONCLUSION

Nursing students gradually built resilience after accumulating experiences from their clinical placements. Although they eventually adapted well, peer, clinical, and informational support during clinical placements were lacking. Resilience programs that teach positive coping strategies and mindfulness training could be implemented in the undergraduate nursing curriculum.

Investigating the psychological resilience, self-confidence and problem-solving skills of midwife candidates

BACKGROUND

The high level of psychological resilience, self-confidence and problem solving skills of midwife candidates play an important role in increasing the quality of health care and in fulfilling their responsibilities towards patients.

OBJECTIVES

This study was conducted to investigate the psychological resilience, self-confidence and problem-solving skills of midwife candidates.

DESIGN

It is a convenience descriptive quantitative study.

SETTINGS

Students who study at Health Sciences Faculty in Turkey's Central Anatolia Region.

PARTICIPANTS

Midwife candidates (N = 270).

METHODS

In collection of data, the Personal Information Form, Psychological Resilience Scale for Adults (PRSA), Self-Confidence Scale (SCS), and Problem Solving Inventory (PSI) were used.

RESULTS

There was a negatively moderate-level significant relationship between the Problem Solving Inventory scores and the Psychological Resilience Scale for Adults scores (r = -0.619; p = 0.000), and between Self-Confidence Scale scores (r = -0.524; p = 0.000). There was a positively moderate-level significant relationship between the Psychological Resilience Scale for Adults scores and the Self-Confidence Scale scores (r = 0.583; p = 0.000). There was a statistically significant difference (p < 0.05) between the Problem Solving Inventory and the Psychological Resilience Scale for Adults scores according to getting support in a difficult situation.

CONCLUSIONS

As psychological resilience and self-confidence levels increase, problem-solving skills increase; additionally, as self-confidence increases, psychological resilience increases too. Psychological resilience, self-confidence, and problem-solving skills of midwife candidates in their first-year of studies are higher than those who are in their fourth year. Self-confidence and psychological resilience of midwife candidates aged between 17 and 21, self-confidence and problem solving skills of residents of city centers, psychological resilience of those who perceive their monthly income as sufficient are high. Psychological resilience and problem-solving skills for midwife candidates who receive social support are also high. The fact that levels of self-confidence, problem-solving skills and psychological resilience of fourth-year students are found to be low presents a situation that should be taken into consideration.

Resilience and well-being of university nursing students in Hong Kong: a cross-sectional study

BACKGROUND

University nursing students experience higher levels of academic stress than those of other disciplines. Academic stress leads to psychological distress and has detrimental effects on well-being. The ability to overcome such adversity and learn to be stronger from the experience is regarded as resilience. Resilience is found to have an impact on learning experience, academic performance, course completion and, in the longer term, professional practice. Resilience and positive coping strategies can resist stress and improve personal well-being. However, the relationship between resilience and well-being remains unexplored in nursing students, which are significant attributes to their academic success and future career persistence.

METHODS

The study was a cross-sectional descriptive correlational design. Inclusion criteria for recruitment was students studying pre-registration nursing programmes at both undergraduate and postgraduate levels. The 10-item Connor-Davidson Resilience Scale (CD-RISC-10) and World Health Organisation-5 Well-Being Index (WHO-5) were used to measure resilience and psychological well-being respectively.

RESULTS

A convenience sample of 678 university nursing students was recruited from a university. The mean score of CD-RISC-10 was 24.0. When comparing the resilience levels of undergraduate and postgraduate students, the total scores were found to be 23.8 and 24.9 respectively. There was a statistically significant difference between the groups (p = .020). With regard to perceived well-being, the mean score of WHO-5 was 15.5. There was no significant difference between undergraduates and postgraduates (p = .131). Bivariate analysis showed that self-reported resilience had a medium, positive correlation with perceived well-being (r = .378, p = .000), and senior students had significantly higher level of perceived well-being than junior students (16.0 vs 15.1, p = .003). Multivariable regression analysis on perceived well-being indicated that self-reported resilience emerged as a significant predictor of perceived well-being (regression coefficient B = 0.259; p < .001).

CONCLUSIONS

The results demonstrate that nursing students with a high level of resilience have better perceived well-being, and the level of resilience of postgraduates was significantly higher than that of undergraduates. Therefore, educational strategies should be developed in the nursing curriculum and a supportive learning environment should be created to foster resilience in the students.