Sense of coherence, occupational stressors, and mental health among Japanese high school teachers in Nagasaki prefecture: a multiple regression analysis

The relationship between physical activity and the health of primary and secondary school teachers: the chain mediating effects of body image and self-efficacy

BACKGROUND

Active health is a new concept, model, and system to maintain the state of whole-person health. In the context of the increasingly serious health problems of primary and secondary school teachers, it is of great significance to explore the relationship between physical activity and primary and secondary school teachers' health based on the active health perspective.

METHODS

The survey involving 741 primary and secondary school teachers across representative provinces in China utilized the International Physical Activity Scale, Body Imagery State Scale, and General Self-Efficacy Scale. Data analysis employed SPSS 25.0 and Amos 24.0 software.

RESULTS

While no significant gender disparities were observed in body image and self-efficacy, age groups exhibited a bipartite and "V" shaped distribution. Female teachers demonstrated higher physical activity levels (2456.46) and superior physical fitness compared to males (2297.86). A positive correlation emerged between physical activity, body image, self-efficacy, and health status. Importantly, body image and self-efficacy partially mediated the relationship between physical activity and health status, accounting for 82.31% of the total effect.

CONCLUSIONS

Primary and secondary school teachers have real problems such as teachers' physical activity is generally insufficient, teachers' body image status is generally poor, and teachers' self-efficacy is low; physical activity is an important factor in promoting primary and secondary school teachers' health status, and low, medium, and high levels of activity all have a promoting effect on the health of primary and secondary school teachers, and the more active primary and secondary school teachers are in terms of physical activity, the better their body image, self-efficacy, and health status are, and the more active primary and secondary school teachers are in terms of physical activity, the more positive the physical activity, self-efficacy, and health status are. The more physically active primary and secondary school teachers are, the better their physical intention, self-efficacy and health status are.

SUGGESTIONS

improve the quality and effectiveness, promote the concept of active health among teachers; empower teachers, strengthen the institutional protection of teachers' health; reduce the burden and increase the quantity,and optimise the supply of health services for teachers.

University lecturers' perceived stress and self-rated health during COVID-19

BACKGROUND

In 2022, many universities transitioned from virtual learning back to in-person teaching. Significant changes in working conditions, along with COVID-19-related anxiety during the pandemic, might impact the well-being of lecturers.

OBJECTIVE

This study aims to assess the perceived stress, self-rated physical and occupational health of Vietnamese lecturers in 2022 compared to the pre-pandemic levels, and to identify their associating factors.

METHOD

This is a cross-sectional study conducted in May-June 2022 through an online survey questionnaire. A sample of 425 university lecturers were included. Participants' stress levels were assessed using the Perceived Stress Scale. Participants were asked to compare their current physical and occupational health with before the pandemic. Explanatory variables included (1) COVID-19 exposure; and (2) perceptions of changes in working environment due to the pandemic. Multivariable ordinal least squared regression analyses were used to estimate the coefficient and 95% confidence intervals for the associations between COVID-19 exposure variables, work conditions, and each outcome.

RESULTS

Our findings indicated that over 60% of participants experienced moderate stress, while nearly half reported worsened physical and occupational health during the pandemic. Gender, age, perceptions of workload, workplace safety, COVID-19 infection, and incentive programs were significant factors associated with higher stress levels and worse self-rated health.

CONCLUSION

To ensure occupational safety and support lecturers as they return to in-person classes, it is crucial to provide appropriate psychological and health support services.

Path Model of Reality Gap on the Mental Health of Novice School Nurses in Japan

Introduction

Mental health is a serious concern among novice school nurses in Japan. Numerous novice school nurses with various health problems experience high stress levels, affecting their mental health. They may be experiencing reality shock, a known risk factor for burnout and turnover, or its factor, the "reality gap."

Objective

This study aimed to examine the hypothetical model by which the reality gap affects the mental health of novice school nurses.

Methods

This cross-sectional study conducted a self-administered questionnaire survey, and responses were obtained from 102 novice school nurses. A path model was created based on a hypothetical model.

Results

After several revisions on the hypothesis model, a modified path model was generated (CFI = .98, TLI = .93, RMSEA = .06). The path model showed that reality gaps negatively affected work engagement, work engagement positively affected intention to stay, and intention to stay positively affected mental health. Reality gap was also directly negatively associated with mental health. Having various support networks reduced the effects of reality gaps on mental health. Additionally, social support in the workplace boosted work engagement.

Conclusion

Unique from other studies, this study contributed to understanding the effects of reality gaps on mental health. School managers and administrators should establish a support system that enables school nurses to receive various supports from within and outside the school. In addition, novice school nurses should take advantage of networks and support inside and outside school to reduce reality gaps and grow as professionals.

Comparison of primary school teachers' stress responses between pre-pandemic and pandemic periods: a large-scale nationwide survey in Japan

A schoolteacher's job is considered one of the most stressful occupations globally. The coronavirus disease 2019 pandemic has posed further challenges for schoolteachers. This study aimed to examine the effects of the pandemic on primary school teachers' stress responses in Japan. We analyzed the data from a nationwide survey of public-school teachers conducted between June 2019 and December 2021. The total numbers of participants were 65,968 in 2019, 72,248 in 2020, and 75,435 in 2021. Working hours and perceived main stressors as well as stress response scores were assessed. Contrary to expectations, the results showed that the stress response scores among primary school teachers did not increase in the first year of the pandemic. Rather, the stress response scores and the proportion of high-stress teachers significantly decreased from the pre-pandemic year (2019) to the first year of the pandemic (2020). However, the stress response scores showed a rising trend in the second year of the pandemic (2021). Participants' working hours decreased from 2019 to 2021. The findings in relation to teachers' main stressors matched these trends. Continuous monitoring of teachers' stress levels is required both during and after the pandemic.

Relationships Between Sense of Coherence, Self-perception of Voice and Work Environment Among Teachers

OBJECTIVE

to analyze the relationship between sense of coherence and sociodemographic data, remote physical work environment, and self-perception of symptoms, vocal handicap and vocal fatigue in teachers.

METHODS

Seventy eight teachers pertaining to the municipal education network of a Brazilian capital city participated in the study, during the period of social isolation by COVID-19. An online questionnaire was applied with sociodemographic and physical remote work environment questions, the Sense of Coherence Scale (SOC-13), the Brazilian Dysphonia Screening Tool (Br-DST), the Vocal Fatigue Index (VFI), and the Vocal Handicap Index (VHI-10). Descriptive analysis, bivariate and multivariate Logistic regression models were performed to check the proportion of teachers with high and low SOC among the different categories of independent variables. Student's t test and Mann Whitney test were used to compare SOC, IDV, and VFI scores between the groups, and Hedge's g test was used to access the effect size. The total scores of SOC, VHI and VFI were correlated using Pearson's Correlation Coefficient. All tests adopted a 5% significance level.

RESULTS

Male teachers and those over 45 years old were, respectively, 6.79 (95%CI = 1.16-39.58) and 5.27 (95%CI = 1.40-19.76) times more likely to present a high SOC. The variables associated with a lower chance of presenting high SOC were vocal restriction (OR = 0.21; 95%CI = 0.06-0.79) and voice-related physical discomfort (OR = 0.13; 95%CI = 0.02-0.78). Regarding the remote work environment, in bivariate analysis, teachers who were dissatisfied with air quality (OR = 0.08; 95%CI = 0.01-0.65), temperature (OR = 0.11; 95%CI = 0.01-0.92), and noise (OR = 0.25; 95%CI = 0.61-0.99) were less likely to have high SOC. Higher values of SOC are associated with lower self-perception of vocal fatigue and voice handicap (P < 0,001).

CONCLUSION

The way individuals face stressful situations interferes with the self-perception of their voice and their work environment. The relationship between the sense of coherence and voice perception is relevant to favor programs to promote vocal health and stress management in teachers.

The analysis of main stressors among high-stress primary school teachers by job positions: A nationwide survey in Japan

Objectives

A school teacher's job is considered one of the most stressful occupations worldwide. To maintain the mental health of teachers, it is crucial to clarify the factors affecting work-related stress among teachers. The present study thus aimed to examine the main stressors among primary school teachers considering the difference in job positions by using data from a large-scale nationwide survey.

Methods

We analyzed the data from a nationwide survey of public school teachers conducted between June and December 2021. The total number of participants was 138,651. The information of perceived main stressors, working hours per day, job workloads, job control, workplace support, and stress response scores were assessed by job position.

Results

Among all teachers' job positions, the working hours of vice-principals were the longest, but their stress response scores were the second lowest. In contrast, the stress response scores among diet and nutrition teachers and health education teachers were the highest; their supervisors' and co-workers' support scores were the lowest among all teachers. Quantitative and qualitative workloads, job control, workplace support from supervisors and co-workers are significantly associated with teachers' stress responses in all job positions. Perceived main stressors among teachers were different depending on job positions. However, regardless of job positions, relationships with supervisors and co-workers were significantly associated with stress response scores among teachers. Dealing with difficult students and parents as well as workloads of clerical tasks were also associated with teachers' stress responses depending on job positions.

Conclusions

Perceived main stressors among teachers were different depending on job positions. However, relationships with supervisors and co-workers were significantly associated with stress response levels among teachers regardless of job positions. This study highlighted the importance of interpersonal relationships at the workplace in terms of teachers' mental health. The results suggest that providing interpersonal skills training targeting co-workers' relationships and harassment prevention measures would be crucial to maintain teachers' mental health. The results also suggest that increasing school staff and providing sufficient organizational support for teachers will be required to prevent teachers' burnout.

COVID-19-related fear, stress and depression in school principals: impacts of symptoms like COVID-19, information confusion, health-related activity limitations, working hours, sense of coherence and health literacy

BACKGROUND

School principals have been reported to have a higher prevalence of burnout and psychological problems than their colleagues. During the pandemic, extra workload and pressure from unprecedented situations potentially cause fear, stress and depression. Therefore, we aimed to explore associated factors of stress, fear of COVID-19 (F-CoV-19S) and depressive symptoms among school principals.

METHODS

A cross-sectional online survey was conducted in Taiwan from 23 June to 16 July 2021. Data of 413 school principals were collected, including socio-demographic factors, COVID-19-related factors, work-related information, health status, sense of coherence (SoC), health literacy (HL), F-CoV-19S, stress and depression. Multiple linear and logistic regression models were utilized to explore associations.

RESULTS

School principals with symptoms like COVID-19 (S-COVID-19-S), or with health-related activity limitations had a higher score of stress (B = 0.92; p = .039) (B = 1.52; p < .001) and a higher depression likelihood (OR = 3.38; p < .001) (OR = 3.06; p < .001), whereas those with a better SoC had a lower stress score (B = -1.39; p < .001) and a lower depression likelihood (OR = 0.76; p = .020). School principals confusing about COVID-19-related information had a higher score of stress (B = 2.47; p < .001) and fear (B = 3.77; p < .001). The longer working time was associated with a higher fear score (B = 1.69; p = .006). Additionally, school principals with a higher HL score had a lower stress score (B = -1.76; p < .001), a lower fear score (B = -1.85; p < .001) and a lower depression likelihood (OR = 0.53; p = .043).

CONCLUSIONS

Health-related activity limitations, S-COVID-19-S, COVID-19-related information confusion and longer working hours were positively associated with at least one mental health problem (e.g. stress, fear and depression), whereas better SoC and HL showed the benefits to mitigate fear, stress and depressive symptoms in school principals. Our study provides evidence for appropriate strategies to improve principals' mental health during the pandemic.Key messages:School principals with health-related activity limitations or with symptoms like COVID-19 were more likely to be stressed and depressed.Higher levels of stress and fear were observed in school principals who confused about COVID-19-related information, and who had longer working time than before the pandemic.Better sense of coherence and higher health literacy could potentially mitigate the fear, stress and depressive symptoms in school principals.

How Do Happiness at Work and Perceived Organizational Support Affect Teachers' Mental Health Through Job Satisfaction During the COVID-19 Pandemic?

Purpose

The role of happiness at work (HW) on mental health (MH) in the education sector in Indonesia has not been widely examined. Additionally, the inconsistent results of previous studies on the relationship between job satisfaction (JS) and MH have led to the uncertainty of JS being a mediator. This study aims to fill the gap in knowledge by examining the effect of HW and perceived organizational support (POS) on teachers' MH, with JS as a mediator.

Methods

This research employed a quantitative approach with a cross-sectional study design, using partial least squares structural equation modeling with SmartPLS software. The research participants included 490 teachers in the Special Capital Region of Jakarta province.

Results

The results indicate that HW is the highest predictor of teachers' MH, and POS is the highest predictor of JS. Another notable finding is that JS was found to have a positive but not significant effect on teachers' MH. However, it did impact the failure of the mediation relationship of this research model, which did not align with previous studies' findings.

Conclusion

Schools must pay attention to HW to improve teachers' MH. Additionally, they should provide support to teachers to increase their JS, especially during the COVID-19 pandemic.

Educators' Psychosocial Burdens Due to the COVID-19 Pandemic and Predictive Factors: A Cross-Sectional Survey of the Relationship with Sense of Coherence and Social Capital

This study aims to identify the social and psychological burdens placed on educators during the third wave of the COVID-19 pandemic in Japan and to propose an optimal form of support. We investigated educators' perceptions of psychological and socioeconomic anxieties and burdens, sense of coherence, and social capital using a questionnaire survey of 1000 educators in January 2021. Multivariate regression analyses were conducted to analyze the associations between the variables. Results: Approximately 80% of the respondents considered COVID-19 a formidable, life-threatening illness. Our results revealed that the higher the social capital, the greater the fear of COVID-19, and the higher the sense of coherence, the lower this fear. Conclusions: The anxiety burden of implementing infection prevention was higher than the anxiety burden associated with distance learning. The predictive factors for educators' perceptions of burden included sense of coherence, gender, and age. Our findings suggest the importance of having the government and educational institutions provide multidimensional assistance that matches educators' individual characteristics.

Optimized electroencephalogram and functional near-infrared spectroscopy-based mental workload detection method for practical applications

Background

Mental workload is a critical consideration in complex man–machine systems design. Among various mental workload detection techniques, multimodal detection techniques integrating electroencephalogram (EEG) and functional near-infrared spectroscopy (fNIRS) signals have attracted considerable attention. However, existing EEG–fNIRS-based mental workload detection methods have certain defects, such as complex signal acquisition channels and low detection accuracy, which restrict their practical application.

Methods

The signal acquisition configuration was optimized by analyzing the feature importance in mental workload recognition model and a more accurate and convenient EEG–fNIRS-based mental workload detection method was constructed. A classical Multi-Task Attribute Battery (MATB) task was conducted with 20 participating volunteers. Subjective scale data, 64-channel EEG data, and two-channel fNIRS data were collected.

Results

A higher number of EEG channels correspond to higher detection accuracy. However, there is no obvious improvement in accuracy once the number of EEG channels reaches 26, with a four-level mental workload detection accuracy of 76.25 ± 5.21%. Partial results of physiological analysis verify the results of previous studies, such as that the θ power of EEG and concentration of O₂Hb in the prefrontal region increase while the concentration of HHb decreases with task difficulty. It was further observed, for the first time, that the energy of each band of EEG signals was significantly different in the occipital lobe region, and the power of \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\beta_{1}$$\end{document}β1 and \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\beta_{2}$$\end{document}β2 bands in the occipital region increased significantly with task difficulty. The changing range and the mean amplitude of O₂Hb in high-difficulty tasks were significantly higher compared with those in low-difficulty tasks.

Conclusions

The channel configuration of EEG–fNIRS-based mental workload detection was optimized to 26 EEG channels and two frontal fNIRS channels. A four-level mental workload detection accuracy of 76.25 ± 5.21% was obtained, which is higher than previously reported results. The proposed configuration can promote the application of mental workload detection technology in military, driving, and other complex human–computer interaction systems.

A novel reliability-based regression model for medical modeling and forecasting

BACKGROUND AND AIMS

In recent decades, modeling and forecasting have played a significant role in the diagnosis and treatment of different diseases. Various forecasting models have been developed to improve data-based decision-making processes in medical systems. Although these models differ in many aspects, they all originate from the assumption that more generalizable results are achieved by more accurate models. This means that accuracy is considered as the only prominent feature to evaluate the generalizability of forecasting models. On the other side, due to the changeable medical situations and even changeable models' results, making stable and reliable performance is necessary to adopt appropriate medical decisions. Hence, reliability and stability of models' performance is another effective factor on the model's generalizability that should be taken into consideration in developing medical forecasting models.

METHODS

In this paper, a new reliability-based forecasting approach is developed to address this gap and achieve more consistent performance in making medical predictions. The proposed approach is implemented on the classic regression model which is a common accuracy-based statistical method in medical fields. To evaluate the effectiveness of the proposed model, it has been performed by using two medical benchmark datasets from UCI and obtained results are compared with the classic regression model.

RESULTS

Empirical results show that the proposed model has outperformed the classic regression model in terms of error criteria such as MSE and MAE. So, the presented model can be utilized as an appropriate alternative for the traditional regression model in making effective medical decisions.

CONCLUSIONS

Based on the obtained results, the proposed model can be an appropriate alternative for traditional multiple linear regression for modeling in real-world applications, especially when more generalization and/or more reliability is needed.

Teachers' mental health during the first two waves of the COVID-19 pandemic in Poland

BACKGROUND

Teaching work is stressful, moreover during the pandemic teachers' stress might have been intensified by distance education as well as by limited access to social support, which functions as a buffer in experiencing stress. The aim of the research was to investigate the relation between distance education and teachers' well-being, and their close relations and other social relations during the first two waves of the COVID-19 pandemic.

METHODS

The research was conducted in two stages on 285 Polish primary and secondary school teachers who were recruited by means of the chain referral method. The following measures were used: The Depression Anxiety & Stress Scales-21, Berlin Social Support Scales, The Relationship Satisfaction Scale and The Injustice Experience Questionnaire.

RESULTS

The teachers experienced at least mild levels of stress, anxiety and depression, both during the first as well as the second waves of the COVID-19 pandemic in Poland. It has been confirmed that there is a negative relation between relationship quality change and social relations quality change, and stress, anxiety and depression. The variables taken into consideration in the research have provided the explanation for the variation of stress-from 6% in the first stage of the research to 47% in the second stage; for the variation of anxiety-from 21% to 31%; and for the variation of depression-from 12% to 46%, respectively.

CONCLUSIONS

The research results show that due to distance work the distinction between professional work and family life might have been blurred, and as a consequence teachers' well-being could have been worsened. The isolation put on to stop the spreading of the virus might have contributed to changes in social relations, in close relations in particular, and at the same time negatively influenced teachers' abilities to effectively cope with the crisis situations.

The Influence of Technology on Mental Well-Being of STEM Teachers at University Level: COVID-19 as a Stressor

Stress can result in psychopathologies, such as anxiety or depression, when this risk factor continues in time. One major stressor was the COVID-19 pandemic, which triggered considerable emotional distress and mental health issues among different workers, including teachers, with another stressor: technology and online education. A mixed-method approach is presented in this research, combining a cross-sectional study of university teachers from Ecuador and Spain with a medium of twenty years of working experience (N = 55) and a bibliometric analysis carried out in three databases (161 documents). The levels of anxiety and depression, and therefore the risk of developing them as mental disorders, were high. The lack of training (p < 0.01), time (p < 0.05), or research regarding the use of technology in education (p < 0.01) and stress caused by COVID-19 (p < 0.001) were linked to frequency. The most relevant observational study obtained through the bibliometric analysis (138 citations and over 65% of methodological quality) indicated that previous training and behavioral factors are key in the stress related to technology. The combination of the results indicated that mental health in STEM teachers at university is related to diverse factors, from training to the family and working balance.

Association between student-teacher ratio and teachers' working hours and workload stress: evidence from a nationwide survey in Japan

Background

Too long work hours of Japanese school teachers, along with an increasing number of teachers taking leave due to mental illness, are well known and recognized as a serious social problem. In order to prevent the spread of COVID-19 by reducing the density in the classroom, the Japanese government has decided to reduce the upper-limit of class size in primary schools after 2021, which is expected to result in lowering the student-teacher ratio. The aim of this study was to examine the association between student-teacher ratio, teacher work hours and teacher stress.

Methods

Data on student-teacher ratio, teacher work hours, and teacher stress were obtained from a large-scale international survey conducted by OECD. The number of teachers participated in the survey was 3308 (primary school) and 3555 (lower-secondary school). After excluding teachers with missing observations, the analytic sample consisted of 2761 (primary school) and 3006 (lower-secondary school) teachers. Multivariate regression analysis was performed.

Results

Regression results revealed that student-teacher ratio was positively correlated with total work hours and workload stress of teachers. In particular, teachers working in schools with high student-teacher ratio spent more time on time-consuming tasks such as marking/correcting student work and communication with parents or guardians. The coefficient estimates suggested that, on average, lowering the student-teacher ratio by five in lower-secondary school was associated with 2.8 hours shorter working hours per week (p<0.001).

Conclusion

Our empirical results suggested that the class-size reduction policy starting in 2021 could reduce teacher stress and long work hours through the consequent decrease in student-teacher ratios.

Analysis of the correlation between occupational stress and mental health of primary and secondary school teachers

BACKGROUND

With the rapid advancement of the educational reform, the requirements for primary and secondary school teachers are increasing, which makes the work pressure of teachers become greater, which can lead to a variety of mental health problems. It is the primary task to promote the psychological health of primary and secondary school teachers by analyzing the stress of teachers and putting forward reasonable countermeasures.

OBJECTIVE

The study aimed to analyze the direct and indirect effects of occupational stress on the mental health level of primary and secondary school teachers.

METHODS

317 teachers from 6 rural primary and secondary schools in Zhejiang province were selected as research subjects. A questionnaire was designed to collect information of occupational stress, mental health, and social support scores. The teachers were compared for differences in gender, marriage status, class teacher, occupational stress, and mental health. The correlation among occupational stress, mental health, and social support was analyzed by structural equation model.

RESULTS

The occupational stress of male teachers was higher than that of female teachers in self-development, work load, and career expectation, and the mental health was lower than that of female teachers in work (P < 0.05). The occupational stress of married teachers was significantly higher than that of unmarried teachers, and their mental health was significantly higher than that of unmarried teachers (P < 0.05). The occupational stress of teachers with senior professional titles was lower than that of teachers with primary and intermediate titles in the dimensions of self-development, work load, and career expectation (P < 0.05). The occupational stress of class teachers was higher than that of non-class teachers in terms of student factors, work load, and career expectation (P < 0.05). The direct path coefficient between occupational stress and mental health was -0.421, and the indirect path coefficient between occupational stress and mental health was -0.172.

CONCLUSIONS

The occupational stress of male, married, class teacher, and teacher with the primary and intermediate titles was significantly greater than that of female, unmarried, non-class teacher, and senior title teacher. In conclusion, the occupational stress of primary and secondary school teachers can not only directly predict the mental health level, but also indirectly affect the mental health level through social support.

Job strain and sense of coherence: Associations with stress-related outcomes among teachers

Background: Teachers constitute an occupational group experiencing high levels of stress and with high sick-leave rates. Therefore, examining potentially protective factors is important. While prior research has mainly focused on the link between teachers’ own experiences of their work environment and stress-related outcomes, it is also possible that colleagues’ perception of the work environment and their possibilities for dealing with work-related stress contribute to influencing individual teachers’ stress. Aim: The aim of this study was to investigate how teachers’ reports of high job strain (i.e. high demands and low control) and sense of coherence (SOC), as well as the concentration of colleagues reporting high strain and high SOC, were associated with perceived stress and depressed mood. Methods: The data were derived from the Stockholm Teacher Survey, with information from two cross-sectional web surveys performed in 2014 and in 2016 (N=2732 teachers in 205 school units). Two-level random intercept linear regression models were performed. Results: High job strain at the individual level was associated with higher levels of perceived stress and depressed mood, but less so for individuals with high SOC. Furthermore, a greater proportion of colleagues reporting high SOC was associated with lower levels of perceived stress and depressed mood at the individual level. Conclusions: High SOC may be protective against work-related stress among teachers. Additionally, the proportion of colleagues reporting high SOC was related to less individual stress, suggesting a protective effect of school-level collective SOC.

Female nursing graduate students' stress and health: the mediating effects of sense of coherence and social support

BACKGROUND

Ninety-five percent of nursing graduate students in South Korea are women, and most are often engaged in both academic coursework and work outside of the academic environment. Nursing graduate students often experience stress leading to physical and mental health problems that negatively affect their academic performance and persistence during graduate programs. The purpose of this study was to test multiple mediation effects of sense of coherence (SOC) and social support in the relationship between stress and health status of nursing graduate students.

METHODS

The participants of this study were 231 female nursing graduate students from 14 universities. Data were collected using an online survey conducted between August and October 2019. Bootstrap techniques using the PROCESS macro for SPSS software were applied to assess the multi-mediating effects.

RESULTS

The total effect (B = - 12.29, p < .001) and direct effect (B = - 7.07, p < .001) of perceived stress on health status were significant. Perceived stress had negative direct effects on social support (B = - 0.41, p < .001) and SOC (B = - 5.77, p < .001). SOC had a positive direct effect on health status (B = 0.59, p < .001). However, social support was not a significant predictor of health status (B = 1.24, p = .232). In addition, there was a positive direct effect of social support on SOC (B = 5.23, p < .001). Furthermore, the indirect effect of perceived stress on health status through SOC was significant (B = - 3.42, 95% CI = - 5.2616, - 1.8906). There was also a significant indirect effect of perceived stress on health status through social support and SOC (B = - 1.28, 95% CI = - 2.1663, - 0.5992).

CONCLUSION

It is necessary to create strategies that enhance nursing graduate students' SOC and social support to reduce their perceived stress and to improve their health status.