The effect of a stress management program on first-year nursing students' clinical stress: A randomized controlled experimental study

BACKGROUND

Clinical clerkships lie at the core of nursing education and are crucial for developing professional skills. However, nursing students, especially freshmen, often encounter significant stress during their clinical experiences.

OBJECTIVES

This study investigated the effect of a stress management program on first-year nursing students' clinical stress levels.

DESIGN

This randomized controlled experimental study adopted a pretest-posttest-follow-up test research design.

SETTINGS AND PARTICIPANTS

Participants were recruited using simple randomization. The sample consisted of 64 first-year nursing students (intervention = 32; control = 32) from the nursing department of the faculty of health sciences of a university in Türkiye.

METHODS

Participants were randomized into intervention and control groups. The intervention group attended a stress management program, one weekly session for five weeks (intervention). The research was conducted between 21.02.2022 and 20.05.2022. Data were collected using a personal information form, the Perceived Stress Scale, the Physio-Psycho-Social Response Scale, and the Coping Behavior Inventory. The data were collected pretest and posttest the intervention and two months follow-up test. The data were analyzed using the two-way repeated measures analysis of variance (ANOVA).

RESULTS

The changes in the Perceived Stress Scale mean scores, group*time interaction, were statistically significant (p < 0.05). The results showed that the changes in the Coping Behavior Inventory "problem-solving" subscale mean scores, group*time interaction, were statistically significant (p < 0.05). The multiple comparisons showed a statistically significant difference in posttest Physio-Psycho-Social Response Scale "social behavioral symptoms" and "emotional symptoms" subscale scores between the intervention and control groups (p < 0.05). The multiple comparisons showed a statistically significant difference in posttest Coping Behavior Inventory "problem-solving" and "avoidance" subscale scores between the intervention and control groups (p < 0.05).

CONCLUSION

The stress management program helps first-year nursing students experience less stress and develop problem-solving skills before they perform clinical clerkships. It also allows them to suffer from fewer emotional and social behavioral symptoms and exhibit fewer avoidance behaviors.

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.

Cognitive mechanisms and resilience in UK-based general practitioners: cross-sectional findings

BACKGROUND

Being a general practitioner (GP) is a stressful occupation, and the strain GPs are under can have negative effects on their psychological well-being, as well as on the patients' experience of healthcare. Resilience can help buffer against this and is a dynamic process by which one can cope with adversity and stress.

AIMS

This study aimed to identify modifiable cognitive mechanisms related to resilience in GPs, specifically interpretation bias and cognitive reappraisal.

METHODS

One hundred and fourteen GPs completed an online cross-sectional correlational study. This comprised questionnaires assessing resilience, emotional distress, work environment and cognitive mechanisms (emotion regulation), as well as a task assessing interpretation bias.

RESULTS

Resilience of GPs was negatively correlated with measures of emotional distress. Furthermore, resilience was positively correlated with positive interpretation bias (r = 0.60, ρ = 0.60, P < 0.01) and cognitive reappraisal (r = 0.39, ρ = 0.40, P < 0.01). In a hierarchical regression, positive interpretation bias (B = 0.25, SE B = 0.06, β = 0.39, P < 0.01) was a significant independent predictor of resilience when controlling for depression, anxiety and stress.

CONCLUSIONS

This is the first study to establish an association between resilience and positive interpretation bias and cognitive reappraisal in GPs. Future research should use longitudinal designs to determine if they have a causal role in promoting resilience, and importantly whether interventions focusing on these processes may foster resilience in less resilient GPs.

Examining Predictors of Psychological Well-Being among University Students: A Descriptive Comparative Study across Thailand and Singapore

BACKGROUND

Psychological well-being (PWB) is a significant indicator of positive psychology. Thus far, the predictors of PWB are not well-understood among university students in Asian countries.

PURPOSE

This study aimed to investigate the relationships between PWB and its predictors (stress, resilience, mindfulness, self-efficacy, and social support) in Thai and Singaporean undergraduates. Stress is perceived to have a negative influence on PWB, but mindfulness, resilience, self-efficacy, and social support indicate positive influences.

METHODS

A cross-sectional descriptive predictive research design was used with 966 Thai and 696 Singaporean university students. After calculating an adequate sample size and performing convenience sampling, we administered the following six standard scales: the Perceived Stress Scale, the Connor-Davidson Resilience Scale, the Mindfulness Awareness Scale, the General Self-Efficacy Scale, the Multi-dimensional Scale of Perceived Social Support, and the Psychological Well-being Scale, along with a demographic questionnaire. Descriptive statistics, correlation analysis, and structural equation modeling were performed for participants' PWB.

RESULTS

Mindfulness had significant effects on both factors of PWB, including autonomy and growth, and cognitive triad, across two samples. In the Thai sample, resilience most strongly predicted autonomy and growth and perceived stress did so the cognitive triad, whereas in the Singaporean sample, perceived control most strongly predicted autonomy and growth and support from friends did so the cognitive triad.

CONCLUSION

These findings provide specific knowledge towards enhancing psychosocial interventions and promoting PWB to strengthen mindfulness, resilience, perceived control of stress, and social support.

Understanding the role of stress, personality and coping on learning motivation and mental health in university students during a pandemic

The aims explored the associations between stress, personality and coping on student mental health and compared defensive-pessimism and optimism as influences on learning motivation. Most research construes ‘stress’ as ‘distress’, with little attempt to measure the stress that enhances motivation and wellbeing. Undergraduate psychology students (N = 162) were surveyed on student and pandemic-related stressors, personality, support, control, mental health and learning motivation. Overall, adverse mental health was high and the lack of motivation acute. While positive ratings of teaching and optimistic thinking were associated with good mental health, context control was key. Adverse ratings of teaching quality lowered learning motivation. Support and conscientiousness bolstered learning motivation and conscientiousness buffered against the adverse impact of stress on motivation. Openness was associated with the stress involved in learning. For those anxious-prone, defensive-pessimism was as effective as optimism was in stimulating learning motivation. Developing context control, support and strategies linked to personality could bolster student resilience during and post Covid-19.

Psychological Impact during Confinement by COVID-19 on Health Sciences University Students-A Prospective, Longitudinal, and Comparative Study

BACKGROUND

The objective was to analyze the factors that influence reactions to confinement situations, such as personality, humor, coping with stressors, and resilience, and to compare this population with a normal situation of exposure to an intense academic stressor such as a partial test, and with the confinement situation caused by the COVID-19 pandemic.

METHODS

A longitudinal study was performed involving 116 health sciences students from Spain. Three situations were evaluated: a basal situation of normality at the beginning of the course, situation facing an academic stressor (partial test), and confinement situation due to COVID-19. The Positive and Negative Affect Schedule (PANAS), Coping Orientation to Problems Experienced (COPE), Connor-Davidson Resilience Scale, and NEO-FFI scale were used.

RESULTS

Significant differences were observed in the increase in negative humor and decrease in positive one, as well as decrease in "Focus on and Venting of Emotions". Personality factors that better predict humor at confinement were "conscientiousness" for having positive humor and low "extraversion" for negative humor.

CONCLUSIONS

The confinement situation due to COVID-19 has caused changes in predominant humor, as well as in coping strategies. Personality factors positively or negatively influence the situation.

Facteurs associés à la résilience des étudiants de Licence en sciences infirmières au Liban : une étude exploratoire descriptive

INTRODUCTION

It is well recognized that the nursing profession is stressful. This is due to the pressure of studies and internships during the three years of training, which could affect the health and academic results of nursing students. However, some students react positively to stress and are considered resilient, since they bounce back and rise to the challenges set in the face of this stress. Empirical studies have identified academic, clinical, personal, and social factors related to the resilience of nursing students.

METHOD

The objective of this descriptive correlational study was to explore some of the factors related to student resilience in the undergraduate nursing program at a university in Beirut. The data was collected using a standardized interview guide combining four North American instruments and the demographic academic profile of the students.

RESULTS

More than half of the students are resilient, and, among all the factors, only the feeling of self-efficacy is a significant predictor of the nursing students' resilience.

DISCUSSION

This study offers concrete guidelines for a nursing intervention promoting the retention of students in nursing training.

Psychological distress and well-being among students of health disciplines in Geneva, Switzerland: The importance of academic satisfaction in the context of academic year-end and COVID-19 stress on their learning experience

INTRODUCTION

University students' psychological health is linked to their academic satisfaction. This study aimed to investigate students' psychological health and academic satisfaction in the context of COVID-19 and academic year-end stress.

MATERIALS AND METHODS

Standardized self-filled scales for anxiety, depression, stress, psychological well-being, academic satisfaction (subjective assessment of students' quality of life in their educational setting), and an ad-hoc scale for stress on the learning experience due to COVID-19 were used in this cross-sectional study. Participants were first- to third-year students of eight different health-related tracks in Geneva, Switzerland. Descriptive statistics and hierarchical regression analyses were applied.

RESULTS

In June 2020, out of 2835 invited students, 433 (15%) completed the survey. Academic satisfaction was a stronger mental health predictor than COVID-19 stress on the learning experience, which mainly predicted stress and anxiety. Lower academic satisfaction scores were significantly associated with stress (β = -0.53, p < 0.001), depression (β = -0.26, p < 0.001), anxiety (β = -0.20, p < 0.001), while higher scores with psychological well-being (β = 0.48, p < 0.001). Identifying as female was strongly associated with anxiety and stress but not with depression or psychological well-being. Lower age was associated with stress only. The nature of the academic training had a lesser impact on mental health and the academic year had no impact.

CONCLUSIONS

Academic satisfaction plays a more substantial role than COVID-19 stress on the learning experience in predicting students' overall mental health status. Training institutions should address the underlying factors that can enhance students' academic satisfaction, especially during the COVID-19 period, in addition to ensuring that they have a continuous and adequate learning experience, as well as access to psychosocial services that help them cope with mental distress and enhance their psychological well-being.

Coping strategies of healthcare professional students for stress incurred during their studies: a literature review

BACKGROUND

Stress in healthcare professional students is well-documented, however coping strategies and their relationship with stress has not been comprehensively reviewed. It is necessary for students to use positive coping strategies to effectively reduce stress levels.

AIMS

The aim of this review is to identify coping strategies of healthcare professional students and their consequences.

METHODS

Studies conducted from 2010 to 2020 on coping strategies utilised by healthcare students were reviewed. An electronic database search was performed in January 2020 of three databases CINAHL, SCOPUS and PubMed.

RESULTS

Twenty-two studies were included in this review, using a wide range of survey instruments including the Brief Coping Orientation to Problems Experienced (Brief COPE) Inventory and the Coping Behaviour Inventory Common coping strategies utilised by healthcare students include problem-focused strategies such as planning, problem-solving and active coping. Coping strategies tended to vary depending on student's location, year of their course, gender and age. Positive coping strategies, such as problem-focused strategies, were associated with reduced stress levels and improved psychological health. Other emotion-focused coping strategies identified included acceptance, self-distraction, and optimism.

CONCLUSIONS

Findings may provide direction for third-level institutions in designing interventions (such as encouraging exercise) promoting the use of positive coping strategies.

Development and validation of a brief version of the traditional Chinese Stressors in Nursing Students scale among college nursing students in Taiwan

Objective:

The 43-item Stressors in Nursing Students (SINS) scale has been evaluated among nursing students in several countries, including China, Hong Kong, Japan, Pakistan, and Spain. However, the original four-factor structure has not been consistently replicated in all of these populations. The aim of this study was to develop a brief version of the traditional Chinese SINS (TC-SINS) scale and to validate it in Taiwanese nursing students.

Materials and Methods:

Data obtained from a cross-sectional survey study of 814 nursing students in a nursing college and a university in Taiwan were randomly divided into two parts. The first part was used to conduct an exploratory factor analysis using principal axis factoring with oblique rotation. After the removal of cross-loading items, the resulting scale was validated with the data from the second part using confirmatory factor analysis.

Results:

A three-factor solution (social, clinical, and education) with 23 items accounting for 54.5% of variance was obtained in the exploratory factor analysis. The confirmatory factor analysis further reduced the number of items to 20. The goodness-of-fit indexes were good (Root Mean Square Error of Approximation = 0.075 and Comparative Fit Index = 0.90).

Conclusions:

The number of items in the TC-SINS could be reduced from 43 to 20, without sacrificing its psychometric properties. The brief version of TC-SINS might be able to reduce respondent burden.

A multi-level examination of nursing students' resilience in the face of the COVID-19 outbreak: A cross-sectional design

AIMS

To examine nursing students' stress and coping with the coronavirus disease 2019 (COVID-19) pandemic through an ecological model of resilience. Specifically, to examine the relative contribution of different resilience levels in decreasing nursing students' strain symptoms: at the individual level, resilience trait; at the relational level, students' coping strategies; at the university level, nursing students' perceptions on their university's readiness to handle the virus outbreak; and at the national level, nursing students' trust in policymakers' decisions.

DESIGN

The study used a cross-sectional design.

METHODS

Undergraduate students of five universities were recruited via an electronic link sent to their emails during the first months of the COVID-19 outbreak: May-July 2020. Of them, 492 participants completed the research questionnaire.

RESULTS

Hierarchical Regression Analysis revealed that nursing students' resilience, as a multi-level factor, decreased the students' level of strain symptoms above and beyond their stress levels and control variables. Specifically, the nursing students' trait resilience, perceptions of their university's positive response to the pandemic and trust in their national policymakers were negatively associated with their strain symptoms. Conversely, disengagement-in-emotion coping strategies was positively associated with the students' strain symptoms.

CONCLUSIONS

Nursing students' resilience should be seen as a flexible resource that can be developed and influenced by their academic and clinical training, and by the intentions and actions of their university and the nursing administration at the Ministry of Health (MOH).

IMPACT

The findings call for the nursing administration at the MOH and for the university deans and department heads to prepare in advance a crisis plan that could be rapidly and effectively implemented when needed. Furthermore, topics such as developing flexible coping strategies should be integrated into the nursing curricula. These would allow students to prepare and cope better with adversity in their routine and in times of crisis.

Mindfulness as a well-being initiative for future nurses: a survey with undergraduate nursing students

BACKGROUND

Mindfulness can potentially positively impact well-being and resilience in undergraduate nursing students. The psychological well-being of such students undertaking clinical training is paramount to ensure optimal learning, and to equip them with skills to manage their wellbeing in future clinical practice. The aim of our study was to explore the views of undergraduate nursing students in relation to understanding and engaging with mindfulness, and how mindfulness could best be delivered within their university programme.

METHODS

An online survey was administered via a cloud-based student response system to a convenience sample of first year undergraduate nursing students completing a Bachelor of Science (BSc) Honours (Hons) degree in nursing at a University in the United Kingdom. Data were analysed using descriptive statistics and thematic analysis.

RESULTS

The survey achieved a response rate of 78% (n = 208). Seventy-nine percent of participants had heard of mindfulness and were interested in taking part in a mindfulness programme. Respondents reported that the ideal delivery of the programme would consist of weekly 45-min, in person group sessions, over a 6-week period. Respondents also indicated that a mobile application could potentially facilitate participation in the programme. Thematic analysis of open-ended comments, and free text, within the survey indicated 4 overarching themes: 1) Perceptions of what mindfulness is; 2) Previous mindfulness practice experiences; 3) Impact of mindfulness in nursing; 4) The need for a future well-being initiative for undergraduate nursing students.

CONCLUSIONS

Undergraduate nursing students perceived that a mindfulness programme has the potential to enhance well-being and future clinical practice. This student cohort are familiar with mindfulness and want more integrated within their undergraduate curriculum. Further research is required to examine the effectiveness of a tailored mindfulness intervention for this population that incorporates the use of both face-to-face and mobile delivery.

Nursing Student's Experiences of Meditation on Twin Hearts During Eight Weeks Practice: A Qualitative Content Analysis

Background

Meditation on Twin Hearts (MTH) involves blessing the earth to alleviate the sufferings, and praying for the well-being of the entire society using heart and crown chakra. This meditation is characterized by mechanisms of loving-kindness, self-healing imagery, and open awareness.

Purpose

This study aims to identify the experiences and perceived benefits associated with practicing MTH by nursing students.

Method

Qualitative method using content analysis was used to study meditation experiences. After obtaining the informed consent, 22 nursing students were introduced to MTH. Experiences and feedback from meditation sessions were reported each day during their 8 week practice. Nursing students also answered seven open-ended questions on the last day of the meditation session.

Findings

The verbatim descriptions of experiences reported by nursing students were abstracted to elements (17), properties (6), and categories (2). Identified properties are positive experiences, experiences of awareness, energy experiences, tangible outcomes, physiological reactions, and feedback on the study program.

Conclusion

The experiences narrated by nursing students include positive affective experiences, health benefits, resolution of problem, awareness and energy experiences, and prosocial tendencies. These findings indicate that MTH would enhance the well-being of the nursing students and could be used as a self-care measure.

Coping with Fears of Covid-19 Pandemic Among Nursing Students During Clinical Practice: Malawi's Perspective

PURPOSE

Fears of the Covid-19 pandemic have brought additional psychological pressure among nursing students. Nursing students at Mzuzu University in Malawi resumed clinical practice amidst the first wave of the pandemic and completed their rotation from September to December 2020. However, it was not known how they were coping with fears of the Covid-19 pandemic during clinical practice and this had set the impetus for conducting this study.

METHODS

The study used qualitative approach employing a descriptive phenomenological design. Four focus group discussions (FGDs) were conducted on students who had completed a clinical rotation during the first wave of the Covid-19 pandemic.

RESULTS

Four themes emerged from the data analysis, and these were staying positive amidst the Covid-19 pandemic; applying the Covid-19 preventive measures; the role of religion and use of avoidance strategies.

CONCLUSION

Students should be encouraged to use coping strategies that have been proven to promote psychological well-being in times of crisis such as the Covid-19 pandemic.

Stressful Life Events and Life Satisfaction among Chinese Older Adults: The Role of Coping Styles

This study aims to investigate the mediating effect of coping styles in the relationship between stressful life events and life satisfaction among Chinese older adults. To test the hypotheses, cross-sectional data (n = 8799) from the 2016 China Longitudinal Aging Social Survey (CLASS) were analyzed by Stata 15/SE in this study. Results indicated that stressful life events directly affected life satisfaction. Moreover, the association between stressful life events and life satisfaction was partially mediated by coping styles. This study had implications for the current body of knowledge and provided empirical evidence for social work practice and social policy.

Health-Related Quality of Life and Undergraduate Nursing Students: A Narrative Review

Background:

Undergraduate nursing students are vulnerable to stressful university learning environments and poor working conditions in clinical rotations. This can result in students leaving nursing programs or abandoning the profession following graduation. As a result, the health-related quality of life of nursing students is an important indicator to monitor student quality of life adequacy. Preventing premature student nurses' departure from the profession is necessary to reduce the nursing shortage.

Objective:

To describe the body of knowledge about the health-related quality of life for undergraduate nursing students during their qualification process.

Methods:

This was a narrative review through a six-database search, including Cochrane, CINAHL, Pubmed, Medline, PsycINFO and Livivio, from between January 1990 and June 2018, with updates in the search followed until November 2019. To assess study quality, the STROBE checklist was used.

Results:

Eight studies were included in a narrative synthesis. All studies were of cross-sectional design, and none included follow-up procedures. Most of the studies recruited participants from nursing courses and only one study recruited students from a national register. Sample sizes ranged from 110 individuals to 4,033 participants in the register-based study. Common health-related dimensions evaluated included stress, social support, mental health, fatigue, quality of life, and drug abuse. Stress, the most commonly studied dimension, was associated with clinical placements, final exams, and non-prescribed drugs. Social support networks were positively associated with coping abilities and self-esteem.

Conclusion:

There is low-quality evidence of the impact of nursing courses upon student health-related dimensions (stress, self-esteem, health-related behaviors). Nurse educators should be aware of these associations and support routine screening of students and their health-related dimensions. Interventions, such as consultation and study redesign, might increase the level of health-related dimensions. Nursing schools should further collaborate to investigate these associations and tailored interventions to positively affect health-related dimensions in nursing students.

Health-promoting and -impeding aspects of using peer-learning during clinical practice education: A qualitative study

AIM

The aim of the present study was to elucidate health-promoting and -impeding aspects of peer-learning by examining nursing students' descriptions of learning together as peers, and how this might interact with their health.

BACKGROUND

Peer-learning is a useful strategy for teaching and learning in nursing students' clinical practice education. In the research, benefits such as improved cooperation and increased self-confidence have been described and labelled as health-promoting.

DESIGN

A qualitative descriptive approach METHOD: Thirteen first-year nursing students aged 22-45 years, who had completed their first clinical practice education on a medical or surgical hospital ward, participated in one-on-one semi-structured interviews. The interviews were analyzed using qualitative content analysis.

RESULT

Working as a pair was primarily described as positive, as the peers felt basic support from each other, even though they described negative experiences that limited their own development and challenged their patience.

CONCLUSION

Peer-learning as a model for supervision in clinical practice incorporates valuable health-promoting aspects, as the students felt safe, supported, increased self-confidence, and participation. The interaction between peers helped them grow as human beings, and the mutual support the peers felt was a vital health-promoting aspect that limited the impact of the described health-impeding aspects, which included sometimes finding peer-learning trying, stressful and irritating.

Sources of Stress and Coping Strategies Among Undergraduate Nursing Students Across All Years

Background

Undergraduate nursing students experience high levels of stress during their programs. The literature on their stress is extensive, however, what is less well-known are the specific sources of stresses for students in different years of study.

Purpose

The aim of this study is to understand nursing students’ sources of stress and coping strategies in each year of study.

Method

A transversal descriptive qualitative study was used. A sample of 26 undergraduate students attending a university in Montreal, Canada were recruited and participated in a semi-structured interview. Data were analysed using inductive thematic analysis.

Results

The sources of stress differed according to year of study and related significantly to the specific novelty of that year. For first-year students, their stress was related to their academic courses. High clinical performance expectations and a lack of time for their personal lives was a main source of stress for second-year students. The prospect of graduating and transitioning into the work environment caused stress for students in their final year. Students across all years of study utilized similar coping strategies.

Conclusion

The findings suggest that interventions can be developed to address the sources of stress experienced by nursing students in each year of study.

Nursing Students' Perceptions of Faculty Caring as a Predictor of Students' Caring Behaviors

This cross-sectional, descriptive survey study aimed to examine the relationships among nursing students' perceptions of faculty caring, students' caring behaviors, and their confidence, satisfaction, and empathy in an undergraduate nursing program. The instruments included the Caring Behaviors Inventory-16 Student Version, Nursing Students' Perceptions of Instructor Caring, and students' confidence, satisfaction, and empathy. There were significant pair-wise relationships among students' perceptions of faculty caring, students' caring behaviors, satisfaction, confidence, and empathy. Students' perceptions of faculty caring were a significant predictor for students' caring behaviors. These findings are significant in future designing and implementing interventions to enhance students' learning experiences.

A literature review of emotional intelligence and nursing education

AIM

The purpose of this study is to investigate the current state of knowledge about emotional intelligence (EI) in nursing education BACKGROUND: Human relationships and emotions are an integral part of nursing care and contribute to care quality. This part of the profession must be addressed in nursing education to prepare students and deal with their emotions and the patients's. Research on emotional intelligence (EI) in nursing has been particularly developed recently. A broad understanding of many benefits of EI is crucial to include EI in this training program.

DESIGN

Systematic literature review METHODS: Undertaken using electronic database (Cairn; PubMed; Science Direct; Wiley online library) and specific search terms. This research covered articles published in English and French between 2007 and 2021. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines (PRISMA) directed the systematic review process.

RESULTS

57 articles are included in this systematic review. The literature focuses on EI and nursing education. The findings categorized into four themes: EI and performances; EI and Physical and mental health; EI and Social Relationship; and EI program.

CONCLUSIONS

This literature review reveals that EI has many benefits in nursing students. Several training programs aimed at developing this concept have proven to be effective in nursing education. We believe that a synthesis of this knowledge will then allow us to better understand the benefits of EI for a further implementation in nursing education. Perspectives and recommendations will also be formulated to enable the implementation of emotional skill development programs in such training.

Moral Resilience in Nursing Education: Exploring Undergraduate Nursing Students Perceptions of Resilience in Relation to Ethical Ideology

Introduction

Moral resilience has recently been proposed as one strategy to address moral distress in nurses and nursing students. Central to nursing students’ capacity for moral resilience is how they understood and enact resilience with an element of realism, suggesting an ethical, ideological influence. Resilience is shown to differ significantly across students, and possibly because of a disconnect between a students’ perceived resilience and their ethical ideology. Yet, resilience seldom has been explored in relation to ethical ideology.

Objective

This study aims to explore self-reported resilience in relation to ethical ideology in undergraduate nursing students, compare differences in scores, and explore relationships between study variables and selected demographic characteristics.

Methods

A descriptive cross-sectional research design was followed. An online encrypted survey was conducted among a convenient sample of nursing undergraduates who met the eligibility criteria and provided implied informed consent. This study complied with ethical principles outlined in the Canadian Tri-Council Policy Statement for research with human subjects. Ethical approval was secured from the University’s Research Ethics Board. Data were analyzed using mean scores, standard deviations, independent sample t-test, variance analysis with post hoc–testing, and Pearson correlation to explore differences in perceptions and associations between study and selected demographic variables.

Results

Undergraduate students have a high level of self-reported resilience. Statistically significant differences in self-reported resilience across selected demographic variables were observed. The association between resilience and ethical ideology was not significant. Ethical relativism was significantly correlated with age and year of study.

Conclusion

Findings suggest that faculty cultivating resilience in nursing students pays attention to gender’s influence discourses in students’ perceptions of resilience and ethical ideology and provides students with opportunities for ethical self-reflection and dialogue to critically examine their ethical ideological perspectives and the influence these may have on moral resilience development. Implications for future research are discussed.

Associations between health-related quality of life and health behaviors in Australian nursing students

Health-related quality of life (HRQoL) is being increasingly studied as an indicator of wellbeing. This study evaluated the HRQoL of nursing students and relationships between lifestyle behaviors including smoking, diet, alcohol intake and physical activity. A cross-sectional study was conducted in 2018 using the Short-Form 12V2 to measure the HRQoL of 475 students from both regional and metropolitan universities in Queensland, Australia. z-scores were aggregated into a Physical Composite Score (PCS) and a Mental Composite Score (MCS). Multivariate linear regression was used to explore the associations. Nursing students (94.5% female) had lower HRQoL scores relative to the general Australian population. Students enrolled at the regional university, with higher income; higher intakes of vitamin A, calcium, and iodine; and more physical activity had a higher Mental Composite Score, but those with health conditions and high intakes of meat, fat, carbohydrates, and sugar reported lower Physical Composite Score compared to their counterparts. Skipping breakfast, physical inactivity, and alcohol score were inversely associated with HRQoL. This study highlights the need for strategies to address the poor lifestyle and HRQoL in nursing students to support their physical and mental health.

Lessons learned through listening to biology students during a transition to online learning in the wake of the COVID-19 pandemic

During the Spring Semester of 2020, an outbreak of a novel coronavirus (SARS-CoV-2) and the illnesses it caused (COVID-19) led to widespread cancelling of on-campus instruction at colleges and universities in the United States and other countries around the world. Response to the pandemic in university settings included a rapid and unexpected shift to online learning for faculty and students. The transition to teaching and learning online posed many challenges, and the experiences of students during this crisis may inform future planning for distance learning experiences during the ongoing pandemic and beyond. Herein, we discuss the experiences of first- and second-year university students enrolled in a biology seminar course as their classes migrated to online environments. Drawing on reported student experiences and prior research and resources, we discuss the ways we will adjust our own teaching for future iterations of the course while offering recommendations for instructors tasked with teaching in online environments.

Impact of psychosocial factors on academic performance of nursing students in Thailand

Purpose

The purpose of this study is to investigate the psychosocial factors that impact the academic performance of nursing students.

Design/methodology/approach

A cross-sectional study was conducted with 767 nursing students from three nursing colleges in Thailand. Instruments included Counseling Center Assessment for Psychological Symptoms and Rosenberg Self-Esteem Scale. Path model analyses with the maximum likelihood method were utilized to examine the proposed model. Model fit was estimated using multiple indexes, including chi-square/df ratio (χ2/df), comparative fit index (CFI), Tucker-Lewis index (TLI) and the root mean square error of approximation (RMSEA).

Findings

Results indicated that family distress, emotional negativity, self-esteem and substance use were factors that related to nursing students' academic performance. Findings of path analyses indicated that the model demonstrated good fit: χ2 (2, N = 767) = 3.11, p = 0.48; χ2/df = 1.56; CFI = 1.00; TLI = 0.99; RMSEA = 0.027, (90% CI = [0.000, 0.082], PCLOSE = 0.68).

Originality/value

While prior research has examined some facets leading to academic success for nursing students, psychosocial factors have not received adequate attention. This study presents a model of family and individual psychosocial factors that impact academic performance of nursing students along with recommendations to help improve their well-being.

Applying the social cognitive model of well-being in the nursing clinical practicum: A structural equation modeling analysis with a Spanish student's sample

BACKGROUND

Clinical education, understanding as practicum, plays a key role in nursing education but has been identified as the most challenging and stressful experience for nursing students. Promoting student satisfaction and well-being during clinical practice has a significant effect on learning outcomes, retention and attrition.

OBJECTIVES

To examine the predictive power of a social cognitive model of wellbeing when applied to explain academic satisfaction in the clinical practicum and overall life satisfaction of Spanish nursing students.

DESIGN/PARTICIPANTS

A cross-sectional correlational study was conducted at four Spanish nursing schools in a 586 student's sample.

METHODS

Data were collected through a self-reported questionnaire that included measures of academic support, self-efficacy, goal progress, academic satisfaction, life satisfaction and trait positive affect. The research model was evaluated through structural equation modeling.

RESULTS

The proposed model fit well in the full sample and accounted for substantial portions of the variance in academic (50%) and life satisfaction (21%). Most of the hypotheses formulated were verified. The model was invariant across academic year.

CONCLUSIONS

The results indicated global support for the social cognitive model of academic satisfaction as a guide for developing interventions to facilitate the positive adjustment and wellbeing of nursing students in the practicum.

Psychological Distress and Well-Being among Students of Health Disciplines: The Importance of Academic Satisfaction

Background: Research on the mental health of students in health disciplines mainly focuses on psychological distress and nursing and medical students. This study aimed to investigate the psychological well-being and distress and related factors among undergraduate students training in eight different health-related tracks in Geneva, Switzerland. Methods: This cross-sectional study used established self-filled scales for anxiety, depression, stress, psychological well-being, and study satisfaction. Descriptive statistics and hierarchical regression analyses were applied. Results: In October 2019, out of 2835 invited students, 915 (32%) completed the survey. Lower academic satisfaction scores were strongly associated with depression (β = −0.26, p < 0.001), anxiety (β = −0.27, p < 0.001), and stress (β = −0.70, p < 0.001), while higher scores were associated with psychological well-being (β = 0.70, p < 0.001). Being female was strongly associated with anxiety and stress but not with depression or psychological well-being. Increased age was associated with enhanced psychological well-being. The nature of the academic training had a lesser impact on mental health and the academic year had none. Conclusion: Academic satisfaction strongly predicts depression, anxiety, stress, and psychological well-being. Training institutions should address the underlying factors that can improve students’ satisfaction with their studies while ensuring that they have access to psychosocial services that help them cope with mental distress and enhance their psychological well-being.

Anxiety, mental illness, learning disabilities, and learning accommodation use: A cross-sectional study

BACKGROUND

Nurse educators require a robust understanding of nursing students' attributes to meet their learning needs and support their success.

PURPOSE

This research seeks to understand the proportion of nursing students with self-reported medically diagnosed anxiety, mental illnesses (MI), learning disabilities (LD), and utilized learning accommodations (LA), and determine how these students compared to a normative sample regarding studying and test-taking anxiety.

METHOD

A secondary analysis of quantitative cross-sectional data that included the Academic Success Inventory for College Students (ASICS) tool. First-year students were surveyed (4-6 weeks after program start, and students in years 1 through 4 were surveyed at the end of both academic terms.

RESULTS

At program start, 21% were diagnosed with anxiety, 16% with MI, 2% with a LD, and 6% accessed LA. By fourth-year these proportions were 23%, 22%, 8% and 13% respectively. Alarming proportions of respondents exhibited anxiety related to test-taking compared to the ASICS normative sample with large effect sizes (Anxiety h = 0.884; MI h = 0.601; LD: h = 2.094; LA h = 0.725).

CONCLUSION

To support students, we highlight a need for early identification and tailored support, enriched faculty knowledge, faculty introspection and willingness to adapt, and time for relational and individual pedagogy.

The relationship between the undergraduate clinical learning environment and work readiness in new graduate nurses: A pre-post survey study

BACKGROUND

Due to projected nurse shortages, it is necessary that undergraduate programs optimise work readiness outcomes in new graduate nurses. Research that quantitatively evaluates characteristics of clinical nursing programs that predict increased work readiness is required.

OBJECTIVES

To explore the relationship between the undergraduate clinical learning environment and nurse perceptions of work readiness prior to and following, commencement as a new graduate nurse.

DESIGN

A pre-post follow-up study. Undergraduates were surveyed at the end of their Bachelor's degree (baseline) and at 8-10 weeks after commencement as a graduate nurse (Time 1).

SETTING

A multi-site, metropolitan private hospital in Victoria, Australia.

PARTICIPANTS

Nursing graduates who completed a university fellowship program (n = 26), or were undertaking their graduate year and had completed placement blocks within (n = 18) or outside (n = 31) the healthcare organisation.

METHODS

Participants self-completed the Clinical Learning Environment Inventory (CLEI) and Work Readiness Scale for Graduate Nurses (WRS-GN) at baseline and Time 1. Multiple regression analyses were performed.

RESULTS

CLEI scores significantly predicted work readiness outcomes (all p-values<.05), accounting for 16-36% and 17-28% of the variance of WRS-GN scores at baseline and Time 1, respectively. After adjusting for clustering due to clinical placement groups, CLEI Individualisation (p = .023) and Valuing Nurses Work (p = .01) predicted improved Time 1 WRS-GN Organisational Acumen. CLEI Innovative and Adaptive Culture scores predicted poorer Time 1 Organisational Acumen (p = .001).

CONCLUSIONS

Learning environments that offered high levels of individualised attention and valued nurses' work appeared to facilitate post-graduation engagement and identification with nursing practice. However, highly innovative and adaptive education may detract from optimal work readiness. Findings revealed that while important, the clinical learning environment only accounted for a small-to-moderate degree of nursing graduates' work readiness. To facilitate robust evidence-based improvement of clinical nursing education, future research should attempt to empirically establish the value of additional facilitators of work readiness.

The relationship between a disposition of gratitude, clinical stress, and clinical satisfaction in nursing students

PURPOSE

This study assessed a disposition of gratitude, and clinical practice stress and satisfaction in nursing students, to determine the relationship between them and provide some basic information towards improving their satisfaction with clinical practice.

DESIGN AND METHODS

This descriptive research was conducted on 171 nursing students from three universities in South Korea using a structured questionnaire.

FINDINGS

Students who had a stronger disposition of gratitude (t = 3.482; P < .001), lower clinical practice stress (t = -2.998; P < .003), and better health (t = 2.900; P < .004) were more satisfied with their Clinical practice (R² = 0.298; F = 13.853; P < .001).

PRACTICE IMPLICATIONS

The findings emphasized the development of programs to improve disposition of gratitude in curriculum or extracurricular activity to enhance Clinical practice satisfaction.

BSc nursing & midwifery students experiences of guided group reflection in fostering personal and professional development. Part 2

Reflective practice is a learning strategy supporting preregistration nursing and midwifery students in meeting everyday clinical practice challenges. This paper reports on a development and innovation evaluation using a qualitative approach exploring students' experiences of guided group reflection organised during fourth year undergraduate internship. Data were collected through student feedback and interviews using a descriptive approach. Three categories emerged from the findings; beginnings for reflective learning, engaging in reflective learning and being a reflective practitioner. Students reported that guided group reflection provided positive opportunities for enhancing confidence. Students demonstrated understanding of reflection and valued reflective time within the closed group structure, which fostered personal and professional development. Findings support the benefits of the established collaborative guided group reflection structures. Guided group reflection is described as a valuable learning strategy on the journey of becoming a nurse in an ever-demanding health care practice world.

Profile of nursing students: quality of life, sleep and eating habits

OBJECTIVE

to profile and analyze sleep quality, quality of life and eating habits of nursing students.

METHODS

a cross-sectional, comparative and correlational study with the following variables: sociodemographic characteristics, Pittsburgh sleep quality index, quality of life and eating habits. One hundred ninety-five students participated in the study.

RESULTS

participants were on average 24 years old. Results showed that females were prevalent (87.1%); 71.0% of the students had poor sleep quality; 98.9% used electronic devices before bedtime. Self-perception of quality of life was indifferent (38.3%), and self-perception of general health, 36.9% expressed satisfaction. Among the participants, 45.13% consumed one portion of fruit and 40.66% two to three portions of vegetables daily.

CONCLUSION

the study allowed the profile of these students, sedentary, overweight and poor sleep quality young students who studied and worked.

Clinical stress among undergraduate nursing students: perceptions of clinical nursing faculty

Clinical faculty have a critical role in recognizing the stress students experience in the clinical environment. Despite an increasing body of research on stress and student perceptions of stress, faculty perceptions of student stress have been relatively unexplored. A qualitative descriptive design provided a rich description of clinical nursing faculty perceptions of undergraduate baccalaureate nursing student stress in the clinical environment. Colaizzi's method guided data analysis. Four themes that emerged from the interview data were: feeling overwhelmed when encountering the unknown, which included the sub-themes of facing self-doubt and experiencing insecurity in nursing actions; struggling with personal life factors; enduring uncivil clinical interactions; and contending with nursing faculty interactions. This study assists in filling the gap for nursing education by providing a rich description of student stress as described by faculty. Implications include providing faculty a clearer understanding of the stress phenomenon so they may better educate and evaluate students.

Academic Stress and Self-Efficacy as Predictors of Academic Satisfaction among Nursing Students

Background:

number of factors contribute to psychological disturbances among university students. Most important, such psychological factors may influence their academic satisfaction that associates with their performance.

Purpose:

To examine prediction power of academic stress and academic self-efficacy on academic satisfaction among nursing students.

Methods:

A convenience sample of 117 nursing students recruited from two nursing programs in Jordan; one private and one governmental. Self-report format was used to collect data from students regarding academic stress, academic self-efficacy, and academic satisfaction.

Results:

Nursing students had moderate level of academic self-efficacy, high level of academic stress, and low to moderate level of satisfaction about curriculum and faculty performance. Positive relationship found between students Grade Point Average and academic stress and self-efficacy, while there was negative relationship with academic satisfaction (p < .05). None of the demographic variables had was a significant predictor of academic satisfaction (p > .05). regression showed that self-efficacy, interaction, explained 36% of academic satisfaction about faculties.

Conclusion:

Academic self-efficacy anxiety among nursing students found to contribute to their academic satisfaction. Therefore, academics and psychological counselors at academic institutions need to give more attention to the psychosocial interaction and enhance mentoring and counseling skills to their students.

Resilience, stress, and psychological well-being in nursing students: A systematic review

OBJECTIVE

Synthesize the evidence relating to the interaction of resilience, stress, and well-being in undergraduate nursing students across countries.

DESIGN

Systematic review DATA SOURCES: Peer reviewed studies published from 2008 to December 2018 were searched in CINAHL, Web of Science, Medline (OVID), PsycINFo and four biomedical databases originating from China (China National Knowledge Infrastructure, WanFang Data, VIP and CMB).

REVIEW METHODS

Adhering to the preferred reporting items for Systematic Reviews and Meta-analyses guidelines, eight databases were searched. Twelve studies, which met the inclusion criteria, were extracted, and subject to quality appraisal by two researchers.

RESULTS

In total, 12 papers were included. Outcome analysis revealed the level of resilience as moderate; stress levels were high and the incidence of negative psychological health accounts for a proportion of nursing students. The interaction between resilience and stress and well-being was high. Resilience and low stress were found to better predict well-being. All the studies cited recommendations to inform educational policy and practice in relation to resilience, well-being, and stress among undergraduate nursing students.

CONCLUSIONS

This was the first systematic review to synthesize the evidence relating to the interaction of resilience, stress, and well-being in undergraduate nursing students across cultural settings. Evidence confirms the importance of resilience in nursing students influencing stress and psychosocial morbidity. Nursing educational strategies that foster and enhance resilience is recommended.

Incivility through the continuum of nursing: A concept analysis

AIM

The aim of this study is to explore the gap between incivility in the workplace and academia and develop a connection to the psychosocial distress effects on the victims.

BACKGROUND

While incivility in nursing has reached epidemic proportions in the past decade, the current definitions of incivility are limited to the workplace or academia and lack consideration of the consequences related to the social well-being of the victim.

DESIGN

Rodgers' evolutionary method was used in this study.

DATA SOURCE

Following the PRISMA guidelines, articles were reviewed from PubMed and CINAHL between 2008 to 2019. Twenty articles describing incivility faced by staff nurses, student nurses, academic faculty, and nursing administrators were included in the final analysis.

REVIEW METHODS

Inductive thematic analysis was used to determine the antecedents, attributes, and consequences of incivility in nursing.

RESULTS

Findings included a culture of incivility and power gradients as antecedents. The attributes of incivility were verbal or non-verbal behaviors that demean, dismiss, or exclude the individual. Consequences of incivility are psychosocial and physiological distress.

CONCLUSION

A broader definition of incivility may be appropriate. Further research is needed to determine interventions to mitigate the effects of incivility.

Relationship between educational stress and psychological resilience in nursing students

Aim: The aim of this study was to determine the relationship between educational stress and psychological resilience in nursing students. Method: The descriptive and analytical design of the study consists of 602 students in the nursing department of the Faculty of Health Sciences of Ordu and Tokat Gaziosmanpasa University. Data were collected using Personal Information Form, Nursing Education Stress Scale (NESS), and Resilience Scale for Adults (RSA). Data, frequency distribution, descriptive statistics (mean, standard deviation) Mann Whitney U test, Kruskal Wallis test, and Spearman correlation test were used. Findings: The mean age of the students was 20.37±2.10, 73.8% of them were women, the mean NESS score was 66.76±16.56, and the mean RSA score was 99.99±5.19. There was a high positive correlation between NESS total, academic and application sub-dimensions, RSA structural style and future perception, NESS total and academic sub-dimension was negatively correlated with social resources and NESS academic and family cohesion. Conclusions: Acording to results,  nursing students experience moderate academic and practice stress. Among the factors that affect students' psychological well-being, there is a positive relationship between personal strength and future goals, quests and adaptation to future, and stress (in practice area). In addition, it can be said that the psychological resilience of the students is moderate when the scores of the students are evaluated. ​Extended English summary is in the end of Full Text PDF (TURKISH) file.   Özet Amaç: Bu çalışmanın amacı, hemşirelik öğrencilerinin eğitim stresi ile psikolojik dayanıklılıkları arasındaki ilişkiyi ve etkileyen faktörleri belirlemektir. Metod: Tanımlayıcı ve analitik tipte planlanan araştırmaya, Ordu ve Tokat Gaziosmanpaşa Üniversitesi Sağlık Bilimleri Fakültesi Hemşirelik Bölümünde öğrenim gören 602 öğrenci dahil edilmiştir. Veriler, Kişisel Bilgi Formu, Hemşirelik Eğitimi Stres Ölçeği (HESÖ) ve Yetişkinler için Psikolojik Dayanıklılık Ölçeği (YPDÖ) kullanılarak toplandı. Verilerin analizinde, frekans dağılımı ve tanımlayıcı istatistikler (ortalama, standart sapma), Mann Whitney U, Kruskal Wallis ve Spearman korelasyon testi kullanıldı. Bulgular: Öğrencilerin yaş ortalaması 20.37±2.10, %73.8’i kadın, HESÖ puan ortalaması 66,76±16,56, YPDÖ puan ortalaması ise 99,99±5,19’dur. HESÖ toplam, akademik ve uygulama alt boyutları ile YPDÖ yapısal stil ve gelecek algısı arasında yüksek derecede pozitif yönde, HESÖ toplam ve akademik alt boyutu ile sosyal kaynaklar arasında ve HESÖ akademik ile aile uyumu arasında negatif yönde ilişki olduğu saptandı. Sonuç: Hemşirelik öğrencileri orta düzeyde akademik ve uygulama alanlarında stres deneyimlemektedir. Öğrencilerin psikolojik iyi oluşlarını etkileyen faktörlerden kişisel özellikler ve geleceğe yönelik yeni amaç, arayışlar ve geleceğe uyumları ile stres (uygulama alanında) arasında pozitif ilişki bulunmaktadır.  Ayrıca, öğrencilerin YPDÖ puanlarına bakıldığında, psikolojik dayanıklılıklarının orta derece olduğu söylenebilir.

Low interest in clinical practicum placement is associated with increased stress in nursing students in Taiwan: A cross-sectional survey study

BACKGROUND

Nursing students often find themselves in a highly competitive environment, and stress is a commonly acknowledged experience in nursing students.

OBJECTIVES

The aim of this study was to explore factors, particularly an interest in nursing and in clinical practicum placement, associated with stress in Taiwanese nursing students.

DESIGN

Cross-sectional survey study.

SETTINGS

A nursing college in central Taiwan and a university in eastern Taiwan.

PARTICIPANTS

814 nursing students.

METHODS

Level of stress of the participants was measured using the 43-items Stressors in Nursing Students (SINS) scale, which was translated into a traditional Chinese version (TC-SINS). Simple and multiple linear regression analyses were used to evaluate factors significantly associated with stress.

RESULTS

A total of 814 nursing students completed the questionnaire with a return rate of 83.6%. The mean age of the participants was 18.9 years and 94.8% was female. Regarding the students' interest in nursing, 2.6% expressed that they strongly or somewhat disagree. In addition, regarding the students' interest in clinical practicum placement, 7.2% indicated that they strongly or somewhat disagree. Results from multiple regression analysis showed that students who expressed somewhat or strong disagreement to interest in clinical practicum placement were significantly associated with a higher level of stress. Of the various strategies for stress relief, listen to music (75.2%) was the most popular choice, followed by talk to a friend (72.3%), and catch up on sleep (61.3%). A third of the participants used three strategies for stress relief.

CONCLUSIONS

Low interest in clinical practicum placement was associated with increased stress levels in nursing students in Taiwan. Future studies should explore the underlying reasons for stress induced by clinical practicum placement, and possible solutions for stress reduction in nursing students.

A holistic understanding of the effect of stress on adolescent well-being: A conditional process analysis

Although traditional assumptions tend to conceptualize stress as inherently dysfunctional, psychological theory suggests that it is not intrinsically maladaptive. Contemporary models emphasize that the stress response can be differentiated into both negative and positive aspects, known as distress and eustress. Research examining the differential effect of positive and negative stress on adolescent well-being is limited and has been hindered by a lack of appropriate measurement tools. The aim of the present study was to utilize the recently developed Adolescent Distress-Eustress Scale to provide a balanced understanding of the impact of stress on positive mental health, holistically considering the effect of both distress and eustress on adolescent well-being. One thousand eighty-one Australian adolescents (M_age = 15.14, 54.03% female) completed an online survey composed of the Adolescent Distress-Eustress Scale alongside measures of well-being, self-efficacy, psychological ill-being, physical activity, and daytime sleepiness. Conditional process analysis suggested that distress exerted no direct influence on well-being, with the observed negative relationship fully mediated by psychological and behavioural variables. Contrastingly, eustress was both directly related to increased well-being and exerted an indirect effect through relationships with mediating variables. These results demonstrate that stress can have profoundly positive consequences. Theoretical contributions, implications for practice, and perspectives for future research are discussed.

Development of resilience in nursing students: A systematic qualitative review and thematic synthesis

Resilience is a term commonly used to describe the ability to turn adversity into opportunities and learn from demanding situations. There seems to be a need to identify support strategies for developing resilience among nursing students in order to strengthen their professional practice. The aim of this review was to synthesize qualitative research exploring how resilience can be developed in nursing students. The review question was: How can nurse educators support students' development of resilience? Relevant publications were identified by systematic data searches in May 2017 in the following electronic databases: MEDLINE, CINAHL, Scopus, Embase, PubMed, PsycInfo, Webb of Science, ProQuest, Academic and Eric. Eight qualitative research studies in English that explored resilience in the context of nursing education were included. Five descriptive themes emerged: Demonstrating caring relationships, Recognizing resources and power, Acknowledging uncertainty, Reframing burdensome experiences and Adjusting frames for learning. In addition, two overarching analytic themes emerged: An educational culture of trustworthiness and Readiness to care. In conclusion, a learning culture characterized by trustworthiness appears to be a catalyst for developing resilience in nursing students. A variety of support strategies in nursing education contribute to resilience in nursing students, thus influencing their readiness to care.

Campus Life Adaptation Scale for nursing undergraduates: Development and psychometric evaluation

BACKGROUND

As the number of studies about nursing students' adaptation to college life has increased, issues have surfaced regarding the validity of study results and the lack of valid and reliable instruments to measure nursing students' adaptation to college life.

STUDY OBJECTIVE

To develop a valid and reliable instrument to measure nursing students' adaptation to college life in view of the educational demands.

STUDY DESIGN

A methodological study design was employed to develop and test the measurement.

SETTING

Participants were distributed over a range of grades, from freshmen to seniors in six universities in Korea.

PARTICIPANTS

Convenience sampling was performed with 813 students from six nursing schools in Korea. The mean age of the nursing students was 21.7 (±4.70), and females were in the majority at 89.2%.

METHODS

Factors affecting campus life adaptation of nursing undergraduates were extracted by conducting a literature review and analyzing the interviews performed. Reliability and content validity were studied. The authors utilized a cross-validation measurement model using EFA with the first half of the dataset and CFA on the second half of the dataset to show the fit statistics of the factors identified via EFA verification.

RESULTS

Analysis of 34 items revealed six factors accounting for 55.1% of the total variance. The factors identified included interpersonal relationships, satisfaction with one's major, ease of studying one's major, stress management, preparation for employment, and academic commitment. The six-factor measurement models exhibited good fit indices. The concurrent validity, known group comparison, and reliability were satisfactory.

CONCLUSION

This Campus Life Adaptation Scale will offer a framework upon which counseling and management strategies can be developed to help nursing students successfully adapt to campus life.

Growing a Professional Identity: A Grounded Theory of Baccalaureate Nursing Students

BACKGROUND

The purpose of this study was to construct a grounded theory that describes the experiences and explains the process of prelicensure baccalaureate nursing students as they progressed in a traditional nursing program.

METHOD

Strauss and Corbin's approach to grounded theory was utilized to guide this study.

RESULT

The basic social psychological process (BSPP) for baccalaureate nursing students that emerged was "searching for balance and utilizing support networks while growing a professional identity." The core category identified was unanticipated expectations, whereas the subcategories that emerged were self-doubt, confidence, sacrifice, rigor, and relevance. To successfully progress through the program, students needed to relinquish preconceptions and acclimate to the academic and, ultimately, the professional nursing climate.

CONCLUSION

Findings support and broaden previous research on the expectations and professional identity formation of nursing students. Understanding this BSPP process is beneficial for educators to promote a student-centered learning environment. [J Nurs Educ. 2018;57(12):705-711.].

Development of student competencies for palliative care

AIM

Identify the palliative care learning needs of healthcare students and determine the acceptability of an innovative learning strategy for palliative care named competencia para cuidar en el hogar-paliar (CUIDAR-PALIAR) aimed to increase students' competencies.

METHODS

A single-group mixed methods design was used. A questionnaire was designed and semi-structured interviews were used to determine the palliative care competencies of undergraduate students; 90 students participated in the strategy.

FINDINGS

The learning needs of students are: approaches to death and loss, how to intervene with the patient's family, understanding of the palliative care context, management of the patient's pain and symptoms and the development of therapeutic communication skills.

CONCLUSION

The strategy is highly accepted by students, and statistically significant increases in palliative care were observed before and after the intervention. These preliminary results justify future interventions due to the potential effect of the strategy CUIDAR-PALIAR in the development of competencies for palliative care in undergraduate students.

Short-Term Effects of a Multidimensional Stress Prevention Program on Quality of Life, Well-Being and Psychological Resources. A Randomized Controlled Trial

It is well-documented that university students have an increased risk in developing psychological problems because they face multiple stressors. Cognitive, behavioral, and mindfulness-based stress prevention programs were shown to reduce symptoms of anxiety, depression, and perceived stress in university students. However, little is known of their effect on resource activation. Additionally, most validated interventions are unidimensional, i.e., including one stress-coping approach. In this study, we investigated the short-term effects of a multidimensional stress prevention program on students' quality of life, psychological symptoms and resources, and resilience factors against stress. Using an experimental design, 64 healthy undergraduate students (56 women), between 18 and 34 years old (M = 21.34, SD = 2.53), from the University of Fribourg, Switzerland, were randomly allocated either to the intervention or the wait-list control group. The intervention group participated in a multidimensional stress prevention program, integrating mindfulness-based activities, cognitive and behavioral strategies, social skills, and emotional regulation exercises. The program consisted of eight 2-h weekly sessions. Before and after the intervention, participants completed self-reported questionnaires evaluating quality of life; psychological symptoms such as depression, anxiety, social anxiety, and interpersonal problems; as well as psychological resources like self-efficacy, sense of coherence, self-compassion, and social support, presented online. A standardized clinical interview was performed at pre- and post-measurement times. To analyze the sort-term effects of the program, we used mixed, two-factorial ANOVAs (per-protocol analyses). In accordance with our hypotheses, our results showed significant reduction of psychological symptoms, including anxiety, interpersonal problems, and symptoms of pain; a significant increase in quality of life, sense of coherence, and self-compassion in students who participated in the intervention program compared to the control group, (all p < 0.05). No significant results were found for symptoms of depression, social anxiety, self-efficacy, and social support. These preliminary findings indicate specific short-term effects of our multidimensional stress prevention program on psychological symptoms and on quality of life as well as promising effects on psychological resources and factors associated with resilience against stress. Future studies should investigate the long-term effects of the intervention as well as the effects in clinical samples.

Coping and Pre-Licensure Registered Nursing Students: An Integrative Literature Review

Despite a wealth of information and growing diversity among nursing students, little is known about coping behaviors employed by these students or students educated in diverse environments. The aim of this integrative literature review was to examine what is known about stress, coping, measures of coping, and interventions to enhance coping, and in pre-licensure nursing students. Twenty-six peer-reviewed research articles were included. Stress, coping styles and behaviors, support, interventions, and instruments to measure coping were identified as key themes. Variations in coping were noted by gender, age, length of time in the program, and culture. Analysis of the literature illuminated the importance of support for students, and strong indications suggested educators play a pivotal role in helping students develop adaptive coping strategies. Nursing programs should consider incorporating coping instruction into the curricula.

Comparison of Attitudes Toward Death Between University Students Who Receive Nursing Education and Who Receive Religious Education

This study aims to compare attitudes toward death between university students who receive nursing education and who receive religious education. This study is cross-sectional in nature. It was conducted with the participation of 197 university students in a university located in the Eastern part of Turkey between June and August, 2017. Data were collected using the socio-demographic form and Turkish form of Death Attitudes Profile-Revised. Of all the students participating in the study, 52.8% received nursing education and 47.2% received religious education. It was found that majority of both groups had no education about death, or found the education they received insufficient. Besides, no significant differences were found between the students who received nursing education and who received religious education in terms of their attitudes toward death (p > 0.05). Results showed that students who received nursing education and who received religious education had similar attitudes toward death. In conclusion, the education given to students about the religious or health aspects of death in accordance with the curriculum seemed to have no effects on students' developing positive attitudes toward death.

Nursing Faculty Coaches: Uncovering a Hidden Resource for NCLEX-RN Success

This article presents a nursing faculty department’s strategy to empower nursing students identified as being at risk for not passing the National Council Licensure Examination for Registered Nurses (NCLEX-RN) on the first attempt while significantly increasing the nursing program’s overall first-time NCLEX-RN pass rate. These students were identified as being at risk because of their low scores on standardized assessments with national norms predicting the likelihood of passing the NCLEX on the first attempt. This account details the NCLEX-RN Coaching Partnership as an exemplar to support nursing students’ success through caring relationships with nursing faculty. Faculty coaches offered support, fostered confidence, and maintained accountability with the identified nursing students. The students provided positive feedback regarding the NCLEX-RN Coaching Partnership and ultimately attributed their passing to the coaching relationships. Seven of the eight identified students passed the examination on the first attempt; the overall program’s first-time NCLEX-RN pass rate increased significantly from 78% to 90%.

A cross-country comparative study on stress and quality of life in nursing students

PURPOSE

This study was conducted to compare perceptions of stress and quality of life (QoL) among nursing students from three countries (the Philippines, Greece, and Nigeria) and to examine the impact of stress on their QoL.

DESIGN AND METHODS

A comparative, cross-sectional research design was used in this study. Data were collected from 547 nursing students from three countries using the perceived stress scale (PSS) and the quality of life evaluation skill (QOLES).

FINDINGS

Students' perceptions of stress and QoL were different across the three countries. Furthermore, higher stress perceptions were identified from taking care of patients, the clinical environment, and faculty, peer, and staff encounters, which predicted a negative QoL.

PRACTICE IMPLICATIONS

The findings emphasized the need for empirically tested and culturally tailored interventions to effectively reduce stress and enhance the QoL in nursing students.