Academic stress, COVID-19 anxiety, and quality of life among nursing students: The mediating role of resilience

Lifestyles and academic stress among health sciences students at the National University of Chimborazo, Ecuador: a longitudinal study

Background

The significant changes experienced by university students in their training are inherent to educational processes. Social isolation caused by the COVID-19 pandemic, online education and the reopening of higher-education institutions produced substantial variations in the lifestyle of university students in health sciences and generated academic stress and perceived stress. This study was conducted at the National University of Chimborazo (UNACH), a public institution located in Riobamba, central Ecuador, the diverse student's population provided an ideal setting for examining the interplay between academic and perceived stress, lifestyle factors, and learning modalities. The research focused on health sciences students across six academic programs. The university's geographical position and demographic characteristics offered a representative sample for investigating these factors within the context changing.

Aim

To compare academic and perceived stress and university students' lifestyles at two different periods: (1) during the mandatory social confinement caused by the COVID-19 pandemic with an online learning modality (T1); (2) in the post-pandemic period with a return to face-to-face activities (T2).

Design

An observational, analytical, quantitative, and longitudinal study.

Participants

Students from six programs (Nursing, Physiotherapy, Clinical Laboratory, Medicine, Dentistry, and Clinical Psychology) from the Faculty of Health of the National University of Chimborazo-Ecuador (n = 2,237) participated voluntarily, the students had one mean age of M = 21.31 (SD = 2.36) at T1 and M = 22.94 (SD = 2.40) at T2. Non-probability convenience sampling was employed due to the accessibility of the student population and the importance of including the maximum number of relevant individuals within the study population.

Methods

The following instruments were used: Nola Pender's Lifestyle Profile Questionnaire, Cognitive Systemic Inventory for the study of academic stress, and Cohen's Perceived Stress Scale.

Results

In T1 and T2, students reported high levels of stress, and increased unhealthy lifestyle increased with the return to classrooms. Additionally, upon returning to face-to-face activities (T2), the mean score applied to the responses of Nola Pender's Lifestyle Profile Questionnaire decreased from M = 113.34 (SD = 23.02) to M = 107.2 (SD = 29.70; p < 0.001). There was significant difference (p < 0.001) in academic stress in T1 [M = 66.25 (SD = 15.66)] and T2 [M = 64.00 (SD = 17.91)].

Conclusions

Upon returning to university classrooms (T2), the number of students who reported an "unhealthy" lifestyle increased. Academic stress was high in T1 and T2 and was reported higher in online activities during social isolation.

Mediating effects of insomnia and resilience on COVID-19-related post-traumatic stress disorder and quality of life in adolescents

The coronavirus disease-2019 (COVID-19) pandemic has impaired the quality of life (QoL) for many due to its extensive impacts. However, few studies have addressed the specific impact of COVID-19 on the mental health of adolescents, particularly post-traumatic stress disorder (PTSD). This study considered the impact of COVID-19-related PTSD on the QoL of adolescents in China, the mediating effects of insomnia, and the moderating effects of resilience. Participants included 50,666 adolescents aged 12-18 years selected using a comprehensive sampling method. We performed data collection from January 8th to January 18th, 2023, using the Children's Revised Impact of Event Scale, Pittsburgh Sleep Quality Index, Ten-item Connor-Davidson Resilience Scale, and Screening for and Promotion of Health-related QoL in Children and Adolescents Questionnaire for data collection. Male adolescents exhibited significantly lower levels of PTSD and insomnia compared to females and scored significantly higher in psychological resilience and overall QoL. Insomnia played a mediating role between PTSD and QoL. Psychological resilience moderated the impact of COVID-19-related stress on adolescents' QoL through its influence on insomnia. PTSD resulting from the COVID-19 pandemic affects the QoL of adolescents through the presence of insomnia. Psychological resilience plays a moderating role in this process. Cultivating psychological resilience in adolescents can effectively enhance their ability to cope with the impacts of sudden public events.

Stress, mental health, and protective factors in nursing students: An observational study

BACKGROUND

Nursing students suffer high levels of stress, especially in the first year.

OBJECTIVES

to compare academic stress at the beginning and end of nursing studies; to analyse the relationships between academic stress, mental health, and protective factors; and to examine whether resilience mitigates the effect of academic stress on psychological well-being.

DESIGN

A cross-sectional study.

SETTING AND PARTICIPANTS

Sample was 370 first- and fourth-year nursing students from Spain (University of Castilla-La Mancha, University of Cantabria, and University of Sevilla).

VARIABLES AND DATA COLLECTION

We assessed academic and clinical stress, coping skills, anxiety, depression, psychological well-being, and resilience were measured.

DATA ANALYSIS

We performed a descriptive analysis of the study sample, as well as correlation and hierarchical regression models. Additionally, mediation models were estimated.

RESULTS

First-year students presented higher academic stress than fourth-year students. Clinical stress, anxiety, depression, and emotional coping predicted academic stress, while academic stress, depression, and coping skills predicted psychological well-being. Mediation models showed a significant path between academic stress, resilience, depression, and psychological well-being.

CONCLUSION

Academic stress has a detrimental effect on the mental health. Coping strategies and resilience may be protective factors that should be encouraged in interventions designed to improve psychological well-being.

Grit, resilience and growth-mindset interventions in health professional students: A systematic review and meta-analysis

OBJECTIVES

Grit, resilience and a growth-mindset influence students' ability to positively adapt to the challenges of health professional training. However, it is unclear if interventions can improve these traits. This systematic review aimed to explore if interventions can improve these traits in health professional students (primary) and their impact on academic and/or wellbeing outcomes (secondary).

METHODS

A comprehensive search of CINAHL, MEDLINE, Eric and Embase was conducted from inception until 15 March 2023. Randomised or non-randomised controlled trials and single-group intervention studies that aimed to improve health professional students' resilience, grit and/or growth-mindset were eligible for inclusion. Two reviewers independently screened studies for inclusion and evaluated quality using the Mixed Methods Appraisal Tool. Post-intervention data from randomised and non-randomised control trials were pooled using a random-effects model to calculate standardised mean differences (SMD) and 95% confidence intervals (CIs).

RESULTS

Resilience interventions improved resilience by a moderate amount in 13 studies with 990 participants (pooled SMD 0.74, 95%CI 0.03 to 1.46) and a large amount when interventions were greater than one session duration in 10 trials with 740 participants (pooled SMD 0.97, 95%CI 0.08 to 1.85). Grit and growth-mindset interventions improved grit (pooled SMD 0.48, 95%CI -0.05 to 1.00, n = 2) and growth-mindset (pooled SMD 0.25, 95%CI -0.18 to 0.68, n = 2) by a small amount. Resilience interventions decreased perceived stress by a small amount (pooled SMD -0.38, 95%CI -0.62 to -0.14, n = 5).

CONCLUSIONS

Resilience interventions improve resilience and decrease perceived stress in health professional students. Preliminary evidence suggests grit and growth-mindset interventions may also benefit health professional students. Interventions may be most effective when they are longer than one session and targeted to students with low baseline levels of resilience and grit.

Improving the academic resilience of hospital nursing interns through a hybrid multi-criteria decision analysis model

Purpose: To identify the main variables affecting the academic adaptability of hospital nursing interns and key areas for improvement in preparing for future unpredictable epidemics. Methods: The importance of academic resilience-related variables for all nursing interns was analyzed using the random forest method, and key variables were further identified. An importance-performance analysis was used to identify the key improvement gaps regarding the academic resilience of nursing interns in the case hospital. Results: The random forest showed that five items related to cooperation, motivation, confidence, communication, and difficulty with coping were the main variables impacting the academic resilience of nursing interns. Moreover, the importance-performance analysis revealed that three items regarding options examination, communication, and confidence were the key improvement areas for participating nursing interns in the case hospital. Conclusions: For the prevention and control of future unpredictable pandemics, hospital nursing departments can strengthen the link between interns, nurses, and physicians and promote their cooperation and communication during clinical practice. At the same time, an application can be created considering the results of this study and combined with machine learning methods for more in-depth research. These will improve the academic resilience of nursing interns during the routine management of pandemics within hospitals.

The way to relieve college students' academic stress: the influence mechanism of sports interest and sports atmosphere

BACKGROUND AND RESEARCH OBJECTIVES

Given the enduring popularity of higher education, there has been considerable attention on the correlation between college students' engagement in sports and their academic stress levels. This study seeks to delve deeply into how university physical education fosters academic performance by influencing students' sports interests, particularly in enhancing their psychological resilience to mitigate academic pressure. Through this investigation, the aim is to offer both theoretical underpinnings and empirical evidence to support the holistic enhancement of higher education.

RESEARCH METHODS

Initially, this study undertakes an analysis of the fundamental relationship between college students' physical activities and their experience of academic stress. Subsequently, utilizing a structural equation model, specific research models and hypotheses are formulated. These are then examined in detail through the questionnaire method to elucidate the mechanism by which college sports interests alleviate academic stress.

RESEARCH FINDINGS

The study reveals a significant positive correlation between psychological resilience and academic stress, indicating that a robust psychological resilience can effectively diminish academic pressure. Furthermore, both the sports atmosphere and sports interest are found to exert a notable positive impact on academic stress, mediated by the variable of psychological toughness. This underscores the pivotal role of physical education in fostering positive psychological traits and enhancing academic achievement.

CONCLUSION

This study underscores the central importance of cultivating and nurturing college students' sports interests, as well as fostering a conducive sports atmosphere, in fortifying psychological resilience and mitigating academic pressure. By offering novel perspectives and strategies for alleviating the academic stress faced by college students, this study contributes valuable theoretical insights and practical experiences to the broader development of higher education.

Exploring post-COVID-19 health effects and features with advanced machine learning techniques

COVID-19 is an infectious respiratory disease that has had a significant impact, resulting in a range of outcomes including recovery, continued health issues, and the loss of life. Among those who have recovered, many experience negative health effects, particularly influenced by demographic factors such as gender and age, as well as physiological and neurological factors like sleep patterns, emotional states, anxiety, and memory. This research aims to explore various health factors affecting different demographic profiles and establish significant correlations among physiological and neurological factors in the post-COVID-19 state. To achieve these objectives, we have identified the post-COVID-19 health factors and based on these factors survey data were collected from COVID-recovered patients in Bangladesh. Employing diverse machine learning algorithms, we utilised the best prediction model for post-COVID-19 factors. Initial findings from statistical analysis were further validated using Chi-square to demonstrate significant relationships among these elements. Additionally, Pearson's coefficient was utilized to indicate positive or negative associations among various physiological and neurological factors in the post-COVID-19 state. Finally, we determined the most effective machine learning model and identified key features using analytical methods such as the Gini Index, Feature Coefficients, Information Gain, and SHAP Value Assessment. And found that the Decision Tree model excelled in identifying crucial features while predicting the extent of post-COVID-19 impact.

The Day After: The Longitudinal Effect of COVID-19 Lockdown on Quality of Life of University Students and the Moderator Role of Mindfulness

Background: The COVID-19 lockdown has been a major stressor for the general population, posing a considerable threat to quality of life (QoL), particularly among university students. Existing research highlights the protective role of dispositional mindfulness (DM) in mitigating stressors; however, its influence on moderating the impact of COVID-19 on QoL remains unknown. We used a longitudinal design to assess the QoL of undergraduate students before and after the COVID-19 lockdown, while also examining the potential moderating effect of DM on this impact. Methods: One hundred eleven Spanish undergraduate students were recruited in 2019, and 103 were followed-up in 2020. Instruments comprised a demographic questionnaire, the World Health Organization Quality of Life BREF (WHOQOL-BREF) inventory to assess QoL, and the Five Facets Mindfulness Questionnaire (FFMQ) to assess DM. Results: Analyses revealed statistically significant differences between the two time points in WHOQOL-BREF: Psychological, Social Relationships, and Environmental. Moderation analyses revealed that the impact of COVID-19 on WHOQOL-BREF Psychological scores was moderated by FFMQ-Observe and FFMQ-Non-judging. Conclusions: The COVID-19 lockdown resulted in a reduction of QoL among undergraduate students, yet this impact was moderated by DM. Specifically, present moment attention to experience (observe) and non-judgmental awareness attenuated the impact of COVID-19 on psychological well-being. Future research should focus on evaluating the protective role of preventive interventions designed to increase DM among undergraduate students.

Reliability and validity of a Japanese version of the Brunnsviken Brief Quality of Life Scale

Aim

The Brunnsviken Brief Quality of Life Scale (BBQ) is a popular quality of life measure, indexing satisfaction with and importance of six empirically selected life domains. Whether these domains hold cross-cultural validity remains largely unexplored. The current study developed and psychometrically validated a Japanese version of the BBQ (BBQ-J).

Methods

Data were collected from 637 Japanese individuals aged between 20 and 87 years. We used t-tests, Pearson product-rate correlation coefficients, a reliability analysis, a confirmatory factor analysis, and an exploratory factor analysis to analyze the data, with 637 participants in all analyses.

Results

There were no statistically significant gender differences on the BBQ-J. Confirmatory factor analysis of the BBQ-J revealed a 1-factor structure with six items. Convergent validity was confirmed by its association with life satisfaction, and negative convergent validity was confirmed by its negative correlation with depressive symptoms. Cronbach's alpha of the BBQ-J showed high internal consistency.

Conclusion

Similar to the original version, the Japanese version of the BBQ is a valid and reliable self-administered measure of subjective quality of life for use in clinical and research settings.

The mediating effect of resilience and COVID-19 anxiety on the relationship between social support and insomnia among healthcare workers: a cross-sectional study

Background

Insomnia in healthcare workers has become a topic of concern in the health system. The high infectivity and longevity of the COVID-19 pandemic have resulted in great pressure and a high incidence of insomnia among healthcare workers. Insomnia among healthcare workers has a negative impact on high-quality healthcare services in addition to their health. Thus, it's necessary to explore insomnia's underlying mechanisms.

Object

The present research's aims were threefold: explored the association between social support, resilience, COVID-19 anxiety, and insomnia among healthcare workers during the pandemic, elucidated the underlying mechanism of insomnia, and offered recommendations for improving the health of these workers.

Materials and methods

A cross-sectional design was adopted. From May 20 to 30, 2022, 1038 healthcare workers were selected to fill out the Oslo 3-item Social Support Scale, the eight-item Athens Insomnia Scale, the Coronavirus Anxiety Scale, and the Brief Resilience Scale. Descriptive statistics and correlations were analyzed by SPSS 25.0. Mediation analysis was conducted by Mplus 8.3 using 5000 bootstrap samples.

Results

Of the participating 1038 healthcare workers, the prevalence of insomnia was 41.62% (432/1038). Significant associations were found involving insomnia, resilience, COVID-19 anxiety, and social support. Insomnia was directly affected by social support. Moreover, three indirect pathways explain how social support affected insomnia: resilience's mediating role, COVID-19 anxiety's mediating role, and the chain-mediation role of resilience and COVID-19 anxiety.

Conclusion

The results validated our hypotheses and supported the opinion of Spielman et al. 's three-factor model of insomnia. Social support of healthcare workers has an indirect impact on insomnia in addition to its direct one via independent and chain-mediation effects of resilience and COVID-19 anxiety.

Enhancing nurses' perceptions of having a place to reduce turnover intentions

AIM

To investigate whether education, tenure, being an advanced practice nurse, skill level, and time pressure impact perceptions of "having a place" and, further, turnover intentions.

BACKGROUND

Nursing shortages persist worldwide. Nurses' turnover intentions are negatively related to their perceptions of "having a place" (i.e., the feeling that the nursing workplace is their territory). However, the sources of nurses' perceptions of the perception of "having a place" remain unknown.

METHODS

Our research employed a cross-sectional and correlational design. This research was conducted at a large-scale hospital in northern Taiwan from December 2021 to January 2022. We used personnel data pertaining to 430 nurses as well as scales for time pressure, "having a place" and turnover intentions to assess nurses' intention to leave their place of employment. The inclusion criteria focused on full-time nurses who worked for the hospital under investigation. Most of our participants were women. The STROBE statement was used as the EQUATOR checklist (supplemental file).

RESULTS

"Having a place" was positively related to educational level, tenure, and skill level, while being an advanced practice nurse was negatively associated with perceptions of "having a place," which in turn were negatively related to turnover intention among nurses.

CONCLUSION

Our study is the first to examine the antecedents of nurses' perceptions of "having a place," which include education, tenure, and skill level.

IMPLICATIONS FOR NURSING POLICY

Nursing policymakers could encourage nurses to pursue higher degrees and update their nursing skills while instilling perceptions of "having a place" in nurses with a brief tenure and advanced practice nurses.

Is It Feasible to Reduce Academic Stress in Net-Zero Energy Buildings? Reaction from ChatGPT

We may lessen the detrimental effects of global warming on human thought processes by reducing greenhouse gas emissions, encouraging sustainability, and giving adaption measures top priority. The purpose of the letter is to draw attention to the necessity of net-zero energy buildings (NZEB) in academic institutions in order to reduce academic stress, promote well-being, and improve cognitive functions. While some levels of stress might be advantageous, excessive and mismanaged stress can be detrimental to students' well-being. To foster a healthy academic atmosphere, it is essential to offer resources, support networks, and stress-reduction techniques. As human authors, we thoroughly edited ChatGPT's responses to create this letter.

Relationship between Subjective Health, the Engel Coefficient, Employment, Personal Assets, and Quality of Life for Korean People with Disabilities

The aim of this research is to examine the effect of subjective health on the quality of life of Korean people with disabilities. The second goal of this study is to examine the effect of the Engel coefficient on quality of life. Additionally, this study is conducted to inspect the effect of employment and personal assets on quality of life. Further, in this work, the moderating effect of personal assets on the association between employment and quality of life for people with a disability is explored. The Panel Survey of Employment for the Disabled served as the source of data. The study period ranges from 2016 to 2018. To test the research hypotheses, this study adopted econometric analyses, namely, ordinary least squares, fixed effect, and random effect models. The results revealed that the quality of life for people with disabilities is positively influenced by subjective health, employment, and personal assets. In contrast, the Engel coefficient exerts a negative impact on quality of life. Plus, the finding indicates that personal assets negatively moderate the relationship between employment and quality of life for people with disabilities. This research is aimed at presenting policy implications for the welfare of people with disabilities.

Moral courage, burnout, professional competence, and compassion fatigue among nurses

BACKGROUND

Moral courage is the ability to defend and practice ethical and moral action when faced with a challenge, even if it means rejecting pressure to act otherwise. However, moral courage remains an unexplored concept among middle eastern nurses.

AIM

This study investigated the mediating role of moral courage in the relationship between burnout, professional competence, and compassion fatigue among Saudi Arabian nurses.

RESEARCH DESIGN

Correlational, cross-sectional design following the STROBE guidelines.

PARTICIPANTS AND RESEARCH CONTEXT

Convenience sampling was used to recruit nurses (n = 684) for four government hospitals in Saudi Arabia. Four validated self-report questionnaires (Nurses' Moral Courage Scale, Nurse Professional Competence Scale-Short Form, Maslach Burnout Inventory, and Nurses Compassion Fatigue Inventory) were used to collect data between May to September 2022. Spearman rho and structural equation modeling analyses were employed to analyze the data.

ETHICAL CONSIDERATIONS

The ethics review committee of a government university in Ha'il region, Saudi Arabia, approval this study (Protocol no.: H-2021-012; Approved: 08/022,021). Participants were fully explained the study aims, and consent was voluntarily secured.

RESULTS

The emerging model showed that burnout had a direct and positive influence on compassion fatigue, while professional competence had a direct, negative effect on compassion fatigue. Moral courage had a small and direct but negative influence on compassion fatigue. Mediation analyses also indicated that moral courage significantly mediated the indirect effects of burnout and professional competence on compassion fatigue.

CONCLUSION

Moral courage can be a crucial aspect in preserving the psychological and mental health of nurses, particularly under stressful conditions. Therefore, it is advantageous from an organizational and leadership standpoint to implement measures such as programs and interventions to foster moral courage among nurses.

The impact of COVID-19 on stress and resilience in undergraduate nursing students: A scoping review

BACKGROUND

Being a nursing student can be a stressful experience, faced with considerable academic and clinical demands. It has been suggested that the Coronavirus Disease 2019 (COVID-19) may have further exacerbated the pressure nursing students face. It has been posited that resilience, a complex psychological concept, may help nursing students overcome stressful situations.

AIMS

The aim of this scoping review was to examine the relationship between resilience and stress in nursing students during the COVID-19 pandemic.

METHODS

Relevant publications were identified by a comprehensive search of the literature from January 2019 to September 2022 to capture relevant publications during the COVID-19 global pandemic period from the following databases: CINAHL, Medline Complete, APA PsycInfo, Ovid EmCare and Web of Science. Fifteen studies met our inclusion criteria and were included in the review using Arskey & O'Malley's (2005) methodological framework for scoping reviews.

RESULTS

Our findings suggest that nursing students from all around the world have experienced high levels of stress during the COVID-19 pandemic. Almost unanimously, resilience was identified as a key protective factor against stress and the development of psychological morbidity. Those nursing students with higher levels of resilience were deemed more likely to stay on track with their studies, despite COVID-related challenges.

CONCLUSION

In conclusion, this scoping review adds to the well-established argument to incorporate resilience-building activities in undergraduate nursing curricula. Developing levels of resilience has the potential to empower nursing students for academic and clinical success, whilst facing the challenges of an ever-changing world.

Nursing students' perceived stress, social support, self-efficacy, resilience, mindfulness and psychological well-being: A structural equation model

Nursing students' stress, protective factors (e.g. resilience, social support, mindfulness and self-efficacy) and psychological well-being (PWB) have been well reported in the literature. However, the interactions of these variables were scarcely examined in the latter part of the COVID-19 pandemic and in the context of a developing country. This cross-sectional correlational study complying with STROBE guidelines tested a hypothetical model of the interrelationships of nursing students' stress, protective factors and PWB using structural equation modelling (SEM). Nursing students (n = 776) from five nursing schools in the Philippines were conveniently recruited from September 2022 to January 2023. Six validated self-report scales (Perceived Stress Scale, Multi-dimensional Scale of Perceived Social Support, Generalized Self-Efficacy Scale, Connor-Davidson Resilience Scale, Mindful Attention Awareness Scale, and Psychological Wellbeing Scale) were used to collect data. SEM, mediation analyses and path analyses were used for data analysis. The emerging model demonstrated acceptable model fit parameters. Stress negatively impacted protective factors, while all the protective factors positively influenced PWB. Social support mediated the influence of stress on resilience, mindfulness and PWB. Resilience is a significant mediator of stress, self-efficacy, social support and PWB. Mindfulness mediated the influence of stress, social support and self-efficacy on PWB. Finally, self-efficacy had a mediating role between resilience and mindfulness. Nursing institutions and nurse educators can use the proposed model as their basis for empirical and theoretical evidence in creating programmes that will strengthen nursing students' protective factors, thus reducing stress while improving PWB and learning outcomes.

Comparison between virtual and hybrid education for psychological factors and academic stress in freshman nursing students: a case-control study

BACKGROUND

The coronavirus 2019 (COVID-19) pandemic has prompted several changes in the learning methods of students. The purpose of this study was to establish whether a relationship between levels of resilience, self-esteem, anxiety, depression, and academic stress in both hybrid and virtual learning education exist.

METHODS

A descriptive and observational case-control study was carried out in universities that offer nursing designation. A total sample of 140 freshman nursing students was recruited. Concretely, 70 participants were recruited from an university receiving hybrid education and 70 participants were recruited from another university receiving virtual learning education. Nursing students self-reported the following questionnaires: the Rosenberg Self-Esteem scale, the 10 CD-Risk Connor-Davidson Risk Resilience Scale, the Beck Anxiety Inventory, the Beck Depression Inventory and the Academic Stress Coping Scale.

RESULTS

Significant differences (P = 0.001) showed higher depression levels for students who received virtual education versus received hybrid education. Differences in Rosenberg test for self-esteem and Beck Anxiety Inventory for anxiety (P > 0.05) were not found.

CONCLUSION

Students who received online education presented higher depression levels which could be due to they had not face-to-face relationships with teachers or classmates, whereas the hybrid education group received a different type of direct interaction with teachers and peers.

Perceived Self-Efficacy, Preventive Health Behaviors and Quality of Life Among Nursing Students in Nakhon Si Thammarat Province, Thailand During the COVID-19 Pandemic

Purpose

COVID-19 is a threat to health worldwide. For nursing students, it affects the physical, mental, social, and family economy. This research aimed to study the relationship between perceived self-efficacy, preventive health behaviors in COVID-19, and quality of life among nursing students during the COVID-19 pandemic.

Samples and Methods

This study was descriptive research. The samples included 273 nursing students by simple random sampling. The data was collected using a questionnaire about perceived self-efficacy, preventive health behaviors, and quality of life. The data were analyzed by descriptive statistics, chi-square, and binary logistic regression statistics.

Results

The mean score of perceived self-efficacy and preventive health behaviors against COVID-19 were high (M = 71.47, S.D. = 8.46; M = 69.10, S.D.= 8.72; respectively). The mean score of quality of life was also high (M = 97.69, S.D.=13.62). In addition, it was found that perceived self-efficacy and preventive health behaviors were significantly related to quality of life among nursing students (p < 0.001). Confirmation with binary logistic regression found that perceived self-efficacy and preventive health behaviors were significantly related to the quality of life (OR = 2.87; 95% CI: 1.415.-5.85; OR = 3.39; 95% CI: 1.43-8.03; respectively) (p < 0.01). To clarify, the group with high perceived self-efficacy tended to have 2.87 times good quality of life than the group with low-moderate perceived self-efficacy. The group with high preventive health behaviors tended to have a 3.39 times good quality of life than the group with low-moderate preventive health behaviors.

Conclusion

Well-perceived self-efficacy and preventive health behaviors against COVID-19 among nursing students were related to good quality of life. Therefore, their perceived self-efficacy should be promoted to build their confidence in the adjustment of preventive behaviors to be safe from COVID-19. This will lead to good quality of life among nursing students.

Early impact of COVID-19 social distancing on social determinants of health and their effects on mental health and quality of life of Korean undergraduate students

Introduction

This study aimed to investigate the association between social determinants of health and perception of COVID-19 social distancing/mental health/quality of life during COVID-19 social distancing in Korean undergraduate students using online survey data augmented with natural language processing.

Methods

An online cross-sectional survey including sociodemographic characteristics, students' perceptions of COVID-19 social distancing, and social determinants of health was conducted between July and November in 2020. We conducted logistic regression analysis to investigate the relationship between social determinants of health (independent variables) and perceptions of COVID-19 social distancing, mental health, and quality of life (dependent variables). This association was augmented using sentiment analysis and word clouds by visualizing open-ended comments on COVID-19 social-distancing policies.

Results

Data were collected from 1,276 undergraduate students. Participants who experienced negative impacts on their social-networking activities due to COVID-19 social distancing were at significantly higher odds to perceive COVID-19 social distancing as not being beneficial [odds ratio (OR) = 1.948, 95% confidence interval (CI) 1.254-3.027], to have increased stress levels (OR = 1.619, 95% CI 1.051-2.496), and to experience decreased quality of life over 5 weeks (OR = 2.230, 95% CI 1.448-3.434) against those who answered neutrally. In contrast, Participants who reported positive perceptions of social-networking activities during the COVID-19 pandemic had lower odds of feeling depressed or anxious (OR = 0.498, 95% CI 0.278-0.894) and reporting a low quality of life over 5 weeks (OR = 0.461, 95% CI 0.252-0.842) compared to those who reported neutral perceptions. Furthermore, the results of the word cloud and sentiment analyses showed that most students perceived social distancing negatively.

Conclusions

The government's social-distancing policy to prevent the spread of COVID-19 may have had a negative impact, particularly on undergraduate students' social-networking activities. This highlights the need for greater social support for this population, including access to psychotherapeutic resources, and improvements in policies to prevent infectious diseases while still maintaining social connections.

Mediating effect of resilience and fear of COVID-19 on the relationship between social support and post-traumatic stress disorder among campus-quarantined nursing students: a cross-sectional study

BACKGROUND

The emergency of Omicron variants, spreading in China and worldwide, has sparked a new wave of the coronavirus disease 2019 (COVID-19) pandemic. The high infectivity and persistence of the pandemic may trigger some degrees of post-traumatic stress disorder (PTSD) for nursing students experiencing indirect trauma exposure to the epidemic, which hinders the role transition from students to qualified nurses and exacerbates the health workforce shortage. Thus, it's well worth an exploration to understand PTSD and its underlying mechanism. Specifically, PTSD, social support, resilience, and fear of COVID-19 were selected after widely literature review. This study aimed to investigate the relationship between social support and PTSD among nursing students during COVID-19, to address the mediating role of resilience and fear of COVID-19 between social support and PTSD, and to provide practical guidance for nursing students' psychological intervention.

METHODS

From April 26 to April 30, 2022, 966 nursing students from Wannan Medical College were selected by the multistage sampling method to fill the Primary Care PTSD Screen for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Brief Resilience Scale, Fear of COVID-19 Scale, and Oslo 3 Items Social Support Scale. Data were analyzed by descriptive statistics, spearman's correlation analysis, regression analysis, and path analysis.

RESULTS

15.42% of nursing students had PTSD. There were significant correlations between social support, resilience, fear of COVID-19, and PTSD (r =-0.291 ~ 0.353, P <0.001). Social support had a direct negative effect on PTSD (β =-0.216; 95% confidence interval, CI: -0.309~-0.117), accounting for 72.48% of the total effect. Analysis of mediating effects revealed that social support influenced PTSD through three indirect pathways: the mediated effect of resilience was statistically significant (β =-0.053; 95% CI: -0.077~-0.031), accounting for 17.79% of the total effect; the mediated effect of fear of COVID-19 was statistically significant (β =-0.016; 95% CI: -0.031~-0.003), accounting for 5.37% of the total effect; the chain mediating effect of resilience and fear of COVID-19 was statistically significant (β =-0.013; 95% CI: -0.022~-0.006), accounting for 4.36% of the total effect.

CONCLUSION

The social support of nursing students not only directly affects PTSD, but also indirectly affects PTSD through the separate and chain mediating effect of resilience and fear of COVID-19. The compound strategies targeted at boosting perceived social support, fostering resilience, and controlling fear of COVID-19 are warranted for reducing PTSD.

Resilience and academic motivation's mediation effects in nursing students' academic stress and self-directed learning: A multicenter cross-sectional study

AIMS

To investigate the mediating role of resilience and academic motivation between academic stress and self-directed learning.

BACKGROUND

Academic stress in nursing students is a well-reported concept that affects resilience, academic motivation and self-directed learning. However, there is a dearth of studies investigating the mediating role of resilience and academic motivation between academic stress and self-directed learning.

DESIGN

Cross-sectional study and mediation analysis.

METHODS

Nursing students (n = 718) were recruited from five nursing schools via convenience sampling. Four self-report scales (Perception of Academic Stress Scale, Connor and Davidson Resilience Scale, Short Academic Motivation Scale and Self-directed Learning Instrument) were used to collect data from August to December 2022. Pearson's r, bivariate analysis and multistage regression analyses were employed to analyze the data.

RESULTS

Academic stress negatively influences nursing students' resilience, academic motivation and self-directed learning. Resilience and academic motivation have a positive impact on self-directed learning. Resilience and academic motivation mediate the relationship between academic stress and self-directed learning, as evidenced by a reduction in the negative impacts of academic stress on nursing students.

CONCLUSION

Resilience and academic motivation, as mediators, reduce the effects of academic stress on self-directed learning. Nursing educators and administrators should promote programs that strengthen resilience and academic motivation. Thus, improving educational and clinical performance.

The academic stress and subjective well-being of graduate nursing students: The mediating role of resilience

AIM

To investigate the levels of subjective well-being in graduate nursing students, explore the impact of academic stress and resilience on subjective well-being, and examine the mediation effect of resilience on the relationship between academic stress and subjective well-being among graduate nursing students.

BACKGROUND

Few studies explore the impact of academic stress and resilience on subjective well-being among graduate nursing students. Understanding the status of subjective well-being and associated factors in graduate nursing students will enable the development of tailored interventions to improve their well-being and academic achievements during graduation education.

DESIGN

A cross-sectional design.

METHODS

Graduate nursing students were recruited by social media between April 2021 and October 2021, in China. Subjective well-being was measured using the General Well-Being Schedule, resilience by the Connor-Davidson Resilience Scale, and academic stress through the Questionnaire of Assessing Academic Stress for graduate nursing students. Structural equation modelling was used to test the relationship among academic stress, resilience and subjective well-being.

FINDINGS

The mean score of subjective well-being for graduate nursing students was 76.37. The proposed model revealed a satisfied fit with the data. Academic stress and resilience were significantly related to subjective well-being in graduate nursing students. Resilience partially mediated the relationship between academic stress and subjective well-being, and the mediation effect accounted for 20.9% of the total effect of academic stress on the subjective well-being.

CONCLUSION

Academic stress and resilience affected subjective well-being in graduate nursing students, while resilience partially mediated the relationship between academic stress and the subjective well-being.

NO PATIENT OR PUBLIC CONTRIBUTION

This study did not involve patients, service users, caregivers or members of the public.

Mediating role of resilience between learning engagement and professional identity among nursing interns under COVID-19: A cross-sectional study

AIM

The aim of the study was to explore the mediating effect of resilience between learning engagement and professional identity of nursing interns.

DESIGN

A descriptive, cross-sectional study design.

METHODS

An online questionnaire survey was conducted among nursing interns in Fujian Medical University from February 2022 to April 2022 by convenience sampling. The scores of learning engagement, resilience and professional identity were evaluated. The PROCESS Marco in SPSS was used to analyse the mediating effect.

RESULTS

A total of 222 senior nursing students participated in the questionnaire survey. Both learning engagement (r = 0.491, p < 0.01) and resilience (r = 0.537, p < 0.01) correlated positively with PI. Resilience is also positively related to PI (r = 0.693, p < 0.01). Also resilience played a partial mediating role in the relationship between learning engagement and professional identity (a*b = b = 0.2451, 95% CI: 0.1543, 0.3581), and its effect accounted for 53.3%.

The Relationship Between Personality Traits and Clinical Decision-Making, Anxiety and Stress Among Intern Nursing Students During COVID-19: A Cross-Sectional Study

Purpose

The aim of this study was to investigate whether the personality traits of intern nursing students could serve as valid predictors of their psychological status and clinical decision making. Additionally, we aimed to understand the psychological state of intern nursing students during the regular epidemic prevention and control stage of COVID-19.

Participants and Methods

This study was designed as a cross-sectional survey. A total of 181 intern nursing students involved in clinical placements participated in this study. Participants provided relevant data by completing the Big Five Inventory-44, the Self-Rating Anxiety Scale, the Perceived Stress Scale 14, and the Clinical Decision-Making in Nursing Scale.

Results

The results showed that neuroticism (β = -0.282, p < 0.01) and openness (β = 0.302, p < 0.001) played significant roles in predicting clinical decision-making skills among intern nursing students. Regression analysis also showed extraversion (β = -0.249, p < 0.01), openness (β = 0.2, p < 0.01), and neuroticism (β = 0.391, p < 0.001) could significantly predict stress in intern nursing students. The agreeableness (β = -0.354, p < 0.001) and neuroticism (β = 0.237, p < 0.01) could also predict the anxiety of intern nursing students. Additionally, some intern nursing students still suffered from anxiety and stress in the context of the ongoing pandemic.

Conclusion

Personality traits are good predictors of clinical decision-making, anxiety and stress among intern nursing students. In conclusion, the openness in personality traits of intern nursing students should be valued and cultivated in clinical work, which will benefit the development of nursing talents.

The Association of Experienced Long Working Hours and Depression, Anxiety, and Suicidal Ideation Among Chinese Medical Residents During the COVID-19 Pandemic: A Multi-Center Cross-Sectional Study

Background

Long working hours are common among medical residents and may increase the risk of mental disorders. We aimed to investigate the association between experienced long working hours and depression, anxiety, and suicidal ideation among Chinese medical residents during the COVID-19 pandemic.

Methods

This study was conducted in September 2022; 1343 residents from three center in Northeastern China were included in the final analysis (effective response rate: 87.61%). The data were collected from participants via online self-administered questionnaires. Depression and anxiety were measured by the Patient Health Questionnaire (PHQ-9) and the General Anxiety Disorder (GAD-7) scale, respectively. Adjusted odds ratios and 95% confidence intervals were determined after adjusting for potential confounders by binary unconditional logistic regression.

Results

The effective response rate was 87.61%. Among the 1343 participants, 12.88% (173), 9.90% (133), and 9.68% (130) had experienced major depression, major anxiety, and suicidal ideation, respectively. We found that longer weekly worktime increased the risk of major depression, particularly in those who worked for more than 60 hours per week (≥ 61 hours vs ≤ 40 hours, OR=1.87, P for trend = 0.003). However, this trend was not observed for either major anxiety or suicidal ideation (P for trend > 0.05 for both).

Conclusion

This study revealed that there was a considerable incidence of poor mental health among medical residents; furthermore, the longer weekly worktime was associated with a higher risk of major depression, especially for those who worked more than 60 hours per week, but this association was not observed in either major anxiety or suicidal ideation. This may help policymakers to develop targeted interventions.

Filipino nursing students' use of low-cost simulators during the COVID-19 pandemic: A summative content analysis of YouTube videos

This study examined Filipino nursing students' use of household materials as low-cost simulators and how they aid in online return demonstrations. Summative content analysis guided this study. We collected uploaded YouTube videos (n = 14) depicting Filipino nursing students using low-cost simulators in their skills demonstration. We used Bengtsson's approach to content analysis to analyze the data. Four themes of low-cost simulators were identified: home and hardware, health and beauty, creative articles, and entertainment. The categories under home and hardware were tools, containers, furniture, and packaging. Health and beauty low-cost simulators were toiletries and medical supplies. Creative articles included fabrics, clothing accessories, and stationeries. Entertainment low-cost-simulators had toys and computer accessories. During the COVID-19 pandemic, our research uncovered home equipment employed as low-cost simulators to help nursing students' online simulation of skills demonstration. We recommend further investigation of whether students learned using low-cost simulators.

Has the COVID-19 pandemic affected nursing students' career self-efficacy and professional calling? The mediating impact of professional identity

BACKGROUND

Professional calling (PC) is crucial for ascertaining their professional goals and fulfilling career choices in nursing students. Thus, understanding its antecedents and helping schools improve PC among nursing students is critical. This study aims to explore whether professional identity (PI), as a crucial antecedent of PC, acts as an intermediary between career self-efficacy (CSE) and professional calling during the COVID-19 pandemic.

METHODS

A sample of 565 nursing students were selected by a web-based survey through convenience sampling. The study was conducted from October to November 2020. Measures of CSE, PI, and PC were assessed during the COVID-19 pandemic. We analyzed demographic data and the correlation of the research variables. The significance of the mediation effect was assessed using a bootstrap method with SPSS.

RESULTS

CSE during the COVID-19 pandemic outbreak (r = 0. 359, p < 0. 01) and PI (r = 0. 670, p < 0. 01) were both relevant to PC among nursing students. In addition, CSE had a positive indirect effect on PC through PI (β = 0. 288, p < 0. 05).

CONCLUSIONS

Higher scores in CSE and a better PI were associated with PC in nursing students. Furthermore, a better CSE had an indirect effect on the PC of students through PI. The favorable evidence in our study confirms that nursing educators can adopt PI interventions to improve the sense of PC among nursing students.