Stress/Resource Complex, Sense of Coherence and Professional Identity Among Nursing Students: A Latent Profile and Mediation Analysis

Personality portraits, resilience, and professional identity among nursing students: a cross-sectional study

BACKGROUND

The lack of professional identity can impede the transition from nursing students to qualified nurses and exacerbate the shortage of health care professionals. Personality is important to resilience-building and professional identity development in nursing students. However, the associations among personality, resilience, and professional identity are less explored. The study aims to identify latent subtypes of personality, to evaluate the mediating role of resilience between personality and professional identity in nursing students, and to provide practical guidance for educators' subsequent interventions with nursing students' professional identity.

METHODS

1397 nursing students were recruited from Be Resilient to Nursing Career (BRNC) between October 2020 and April 2022 by cluster sampling from 4 universities in China. NEO Five-Factor Inventory, 10-item Connor-Davidson Resilience Scale, and Professional Identity Questionnaire for Undergraduate Students were administered. Analyses of latent profiles and mediations were performed.

RESULTS

Three latent personality types were identified: Over-sensitivity (35.4%), Ordinary (53.8%), and Flexibility (10.8%). Nursing role model was found to be a significant indicator of personality (Ordinary as ref, Over-sensitivity: OR = 0.73, 95% CI: 0.57-0.93, P = 0.010; Flexibility: OR = 1.85, 95% CI: 1.29-2.65, P = 0.001). The association between personality portraits and professional identity were significantly mediated by resilience (P < 0.05).

CONCLUSIONS

There exists heterogeneity in nursing students' personality. Resilience plays a significant role in mediating the relationship between personality and professional identity.

The effect of perceived stress on social isolation in young and middle-aged maintenance haemodialysis patients: A polynomial regression and response surface analysis

Patients on maintenance haemodialysis (MHD) face social isolation due to the far-reaching effects of their disease and treatment. Based on the Transactional Model of Stress and Coping, we analysed the relationship between perceived stress and social isolation in patients, and the mediating role of internal health-related locus of control (IHLC) from the perspective of co-existence of perceived helplessness (HEL) and perceived self-efficacy (SEL). We used structured questionnaires to investigate 332 cases of young and middle-aged MHD patients in four tertiary hospitals in Guangdong, China. Polynomial regression and response surface analysis were conducted, along with tests of mediating effects on the data. The research was based on STROBE guidelines. The results showed that perceived stress is significantly and positively associated with social isolation. When the HEL and SEL of perceived stress were congruent, the joint effect of the two was in a positive curvilinear relationship to social isolation, when the two were incongruent, the risk of social isolation was lower for "low HEL-high SEL" patients compared to the "high HEL-low SEL" combination. The more congruent in HEL -SEL, the lower the risk of social isolation for the patients, with the IHLC playing a mediating role in this association. This study reveals that the coexistence of perceived stress's HEL and SEL affects social isolation through congruent and incongruent matching mechanism, providing additional explanations for the mechanism of occurrence of patients' social isolation.

Professional identity and sense of coherence affect the between compassion fatigue and work engagement among Chinese hospital nurses

BACKGROUND

With the continuous improvement of people's health needs, the public's requirements for medical care are also getting higher and higher. Work engagement is a positive psychological state related to the work. It is very important to maintain nurses' work engagement, however, due to many factors, the level of nurses' work engagement is not high and nursing managers should identify the influencing factors of work engagement, and take positive measures to fully improve nurses' work engagement.

OBJECTIVES

To explore the influence of compassion fatigue, professional identity and sense of coherence on nurses' work engagement.

METHODS

From January 2022 to June 2022, convenience sampling was used to select clinical nurses from 9 tertiary hospitals in Henan Province of China as the research objects for a questionnaire survey. Statistical methods included descriptive statistical analysis, Pearson correlation analysis and the PROCESS Macro Model 4 and 7 in regression analysis.

RESULTS

The results showed that compassion fatigue was significantly negatively correlated with sense of coherence, professional identity and work engagement (P<0.01), professional identity was significantly positively correlated with sense of coherence and work engagement (P<0.01), and there was a significant positive correlation between sense of coherence and work engagement (P<0.01). Professional identity played a partial mediating role between compassion fatigue and work engagement, accounting for 46.40% of the total effect; meanwhile, sense of coherence moderated the effect of compassion fatigue on professional identity and formed a moderated mediation model.

CONCLUSIONS

Compassion fatigue has a negative predictive effect on nurses' work engagement. Professional identity and sense of coherence further explained the relationship of compassion fatigue on compassion fatigue and work engagement through mediating and moderating effects.

Sense of Coherence or resilience as predictors of psychological distress in nursing students during the COVID-19 pandemic

Background

The COVID-19 pandemic lead to the occurrence of numerous psychological distress among students. This study aimed to determine the level of psychological distress as well as the predictive role of Sense of Coherence (SOC) and resilience in nursing students.

Methods

A cross-sectional descriptive study was conducted on 310 nursing students in Ahvaz Jundishapur University of Medical Sciences, Iran. The data of the study was collected through the demographic information questionnaire, the General Health Questionnaire (GHQ), the Academic Resilience Inventory (ARI), and the Sense of Coherence Scale (SOC-13).

Results

Students' mean scores for the GHQ, ARI, and SOC were 5.81 ± 1.37, 102.88 ± 11.91, and 54.54 ± 6.46, respectively. Regression models showed that two domains of SOC [meaningfulness (β = -0.28, p < 0.001), manageability (β = -0.19, p = 0.001)], female gender (β = 0.12, p = 0.015), and overall ARI (β = -0.12, p = 0.037), were significantly associated with the GH of nursing students. SOC domains [meaningfulness (β = -0.19, p = 0.002), manageability (β = -0.15, p = 0.006)], problem-oriented/positive thinking domain of ARI (β = -0.15, p = 0.011), sex (β = 0.12, p = 0.015), and history of death in first-degree relatives (β = 0.12, p = 0.021) were significantly associated with social dysfunction domain of GH. Three domains of SOC [meaningfulness (β = -0.26, p < 0.001), manageability (β = -0.13, p = 0.032), and comprehensibility (β = -0.13, p = 0.039)], were significantly associated with psychological distress domain of GH.

Conclusion

Our results indicated that low SOC and resilience were predictors of psychological distress in nursing students. Accordingly, interventions such as teaching stress management skills, the skills of using positive coping methods in dealing with stressful situations, and self-management skills are necessary to improve the level of resilience and SOC in nursing students.

Development and validation of a nomogram model for medication non-adherence in patients with chronic kidney disease

OBJECTIVE

The high prevalence of medication non-adherence in patients with chronic kidney disease places a tremendous burden on healthcare resources. The study was designed to develop and validate a nomogram model of medication non-adherence in patients with chronic kidney disease in China.

METHODS

A multicenter cross-sectional study was conducted. 1206 chronic kidney disease patients were consecutively enrolled from Be Resilient to Chronic Kidney Disease (registration number: ChiCTR2200062288) between September 2021 and October 2022 in four tertiary hospitals in China. The Chinese version of four-item Morisky Medication Adherence Scale was used to assess the medication adherence of the patients and associated factors consisted of socio-demographic information, self-designed medication knowledge questionnaire, the 10-item Connor-Davidson Resilience Scale, the Beliefs about Medicine questionnaire, the Acceptance Illness Scale, and the Family Adaptation Partnership Growth and Resolve Index. Least Absolute Shrinkage and Selection Operator regression was performed to select significant factors. Concordance index, Hosmer-Lemeshow test and decision curve analysis were estimated.

RESULTS

The prevalence of medication non-adherence was 63.8%. Area under the curves ranged from 0.72 to 0.96 in internal and external validation sets. The predicted probabilities of the model were consistent with those of the actual observations by Hosmer-Lemeshow test (all P > .05). The final model included educational level, occupational status, duration of chronic kidney disease, medication beliefs (perceptions of the need to take medications and concerns about adverse effects), and illness acceptance (adaptation and acceptance of the disease).

CONCLUSIONS

There is a high prevalence of medication non-adherence among Chinese patients with chronic kidney disease. A nomogram model based on five factors has been successfully developed and validated and could be incorporated into long-term medication management.

Association between circadian rhythm and sleep quality among nursing interns: A latent profile and moderation analysis

Background

Disturbances in circadian rhythms are common among night-shift workers and result in poor sleep quality. Nevertheless, the heterogeneity of circadian rhythms and their relationship with sleep quality is less explored in nursing interns. Therefore, we aimed to identify the latent subtypes of circadian rhythm, explore their relationship with sleep quality, and evaluate their moderating role between perceived stress and sleep quality in nursing interns.

Materials and methods

In all, 452 nursing interns were recruited between October 2020 and January 2021 from Be Resilient to Nursing Career (BRNC), which is a multicenter, prospective cohort of a career growth program for nursing students. They were assessed using the 10-item Chinese Perceived Stress Scale, Circadian Type Inventory, and Pittsburgh Sleep Quality Index. Latent profile analysis and moderation analysis were performed.

Results

Overall, 72.3% of the nursing interns reported poor sleep quality. We identified three latent subtypes of circadian rhythms, namely, Vigorousness (40.1%), Inadaptability (18.6%), and Flexibility (41.1%). Females (OR = 1.97, 95% Cl: 1.01-3.83, P = 0.047) with normal body mass index (OR = 1.62, 95% CI: 0.95-2.76, P = 0.078) were prone to Flexibility. Circadian rhythm types significantly moderated the association between perceived stress and sleep quality (P < 0.05).

Conclusion

Nursing interns suffer from poor sleep. There exists heterogeneity of circadian rhythm subtypes in nursing interns, and attention should be paid to those with Inadaptability type. The association between perceived stress and sleep quality is significantly moderated by circadian rhythm subtypes.

Associations among fear of childbirth, resilience and psychological distress in pregnant women: A response surface analysis and moderated mediation model

INTRODUCTION

Prenatal psychological distress is prevalent during pregnancy. This study aimed to estimate the associations among fear of childbirth, resilience and psychological distress.

METHODS

A total of 1,060 Chinese pregnant women were enrolled from Be Resilient to Postpartum Depression (ChiCTR2100048465) and the following instruments were administered to them: Childbirth Attitudes Questionnaire, Connor-Davidson Resilience Scale, Perceived Social Support Scale, General Self-Efficacy Scale, Adverse Childhood Experience scale and Hospital Anxiety and Depression Scale. A dominance, a response surface analysis and a moderated mediation analysis were performed.

RESULTS

In terms of psychological distress, resilience and fear of childbirth could explain 41.6% (0.148/0.356) and 33.1% (0.118/0.356), respectively. Pregnant women with high resilience-low fear of childbirth had significantly lower levels of psychological distress than those with low resilience-high fear of childbirth. The indirect effects of fear of childbirth on psychological distress through resilience was significantly (B = 0.054, 95% CI 0.038 to 0.070). The interactions between fear of childbirth and adverse childhood experiences (β = 0.114, 95% CI -0.002 to 0.231, p = 0.054) and between resilience and adverse childhood experiences (β = -0.118, 95% CI -0.222 to -0.012, p < 0.05) were significant.

CONCLUSION

Resilience, fear of childbirth and adverse childhood experiences may be three important factors to psychological distress in Chinese pregnant women.