Understanding Resilience Among Generation Z Baccalaureate Nursing Students: A Hermeneutical Phenomenology Study

BACKGROUND

Supporting resilience for nursing student success is critical to future health care. This study explored the meaning and process of resilience among Generation Z traditional baccalaureate nursing students.

METHOD

Using a qualitative hermeneutical phenomenology approach, 13 Generation Z nursing students with the lived experience of resilience were surveyed and interviewed. Results were analyzed interpretively.

RESULTS

Themes of resilience among Generation Z nursing students were identified relative to study questions. Identified themes included "Maneuvering the Murky Water" and "This Can Either Ruin Me or I Can Keep Moving With It," as well as a resilience process within the context of nursing education. Open-response data provided further reflective insights on resilience and recommendations for resilience in nursing education programs.

CONCLUSION

Supporting resilience begins with understanding students' individual and generational perspective. Future nursing education research should include innovative interventions wherein the perspectives of Generation Z students are central to design. [J Nurs Educ. 2024;63(7):460-469.].

Do academic advising and levels of support affect nursing students' mental health? A cross-sectional study

AIM

The current study aimed to identify the association between social support, academic advising and mental health disorders among nursing students.

BACKGROUND

Stress and workload can trigger multiple mental health disorders, especially for nursing students. Thus, academic advising and counselling help support students with academic and mental health problems.

DESIGN

This cross-sectional study utilized online questionnaires in Egypt and Saudi Arabia.

METHODS

Multidimensional Scale of Perceived Social Support (MSPSS), Patient Health Questionnaire (PHQ-4) and the Student Academic Advising and Counseling Survey (SAACS) were utilized to measure social support, depression and anxiety and evaluation of academic advising and counselling services, respectively.

RESULTS

The study included 1134 nursing students (mean age of 20.3 years). Students with higher academic advising satisfaction were 37% less likely to experience depression (OR 0.63, 95% CI 0.46-0.85) and mental disorders (OR 0.68, 95% CI 0.50-0.94). Moderate family social support was associated with lower depression (OR 0.58, 95% CI 0.37-0.93) and mental disorders (OR 0.55, 95% CI 0.33-0.92).

CONCLUSION

Academic advising and social support can mitigate mental health disorders among nursing students. These findings will help nurses and post-secondary providers develop strategies to support nursing students during difficult times.

Determining the Effect of Psychological Resilience on Death, the Fear of Death, and Death Acceptance in Nursing Students in Turkey

This study will investigate the effects of psychological resilience on death, fear of death and acceptance of death in nursing students. This study was descriptive and cross-sectional. The sample of the study consisted of 270 students who voluntarily participated. The data were collected using a descriptive characteristics questionnaire, the resilience scale for adults (RSA) and the multidimensional orientation to death and dying inventory MODDI-F. A positive and significant correlation was found between the Acceptance Subscale, RSA and MODDI-F subscale scores. Nursing students' attitudes towards death and dying are affected by their psychological resilience. Psychological resilience should be increased because nursing students are candida for future caregivers. For this reason, within the scope of the findings of the study, it is recommended that during the theoretical and practical nursing education process, students should be reinforced by conducting studies on the dying patient through educational teaching methods such as role play and case presentations. In addition, ıt is thought that an interview or focus group on nursing students' psychological resilience and attitudes towards death can provide a more comprehensive source of information on the subject.

The protective role of resilience and social support against burnout during the COVID-19 pandemic

Background

The COVID-19 pandemic brought on a range of stressors in homes and workplaces. With no sign of ending after one year, burnout was a concern. Resilience has been known to shield against the effects of stress. While often thought of as an individual trait, previous studies have shown social support to improve resilience. The study aimed to examine the extent of burnout in the Singapore population and whether social support and resilience cushioned the impact of COVID-19 related stressors a year into the pandemic.

Methods

Participants were 858 Singapore residents who participated in a larger study between October 2021 and September 2022. The Copenhagen Burnout Inventory provided Work-and Personal-related burnout scores. Multivariable linear regression was used to identify demographic variables associated with burnout. Path analysis revealed the associations between COVID-19 stressors, social support, resilience and burnout.

Results

22 and 19% of the sample reported work and personal burnout respectively, with younger adults being more burnt out than older adults. Higher stress was associated with higher burnout and higher social support was associated with lower burnout. Path analysis revealed that the relationship between social support and burnout was partially accounted for by increased resilience.

Conclusion

Managing altered work arrangements, career expectations, and increased responsibilities at home may contribute to greater levels of burnout in the younger adults. Increased employer support and targeted interventions could mitigate the impact of these stressors. The study also highlighted the importance of maintaining social connections even while physically distancing.

Nursing students' readiness towards the 'new normal' in clinical practice: a distributed cognition qualitative perspective

BACKGROUND

Clinical practicums are a core component of baccalaureate nursing education. Following the coronavirus pandemic, there have been extensive changes in the workforce environment that may potentially affect nursing students' experience and readiness for clinical practicums.

METHODS

A qualitative study was conducted to explore final-year nursing students' experiences and readiness for their final clinical practicum before becoming a registered nurse. A purposive sample of 24 final-year baccalaureate nursing students was included in this study. Individual semi-structured interviews were conducted face-to-face via Zoom. The data was analysed using an inductive thematic analysis approach.

RESULTS

Three themes depicting students' experiences and clinical readiness were elucidated. The themes included: (1) Experiencing multiple concerns, (2) requiring a network of support, and (3) easing the transition to professional practice. Students considered the final clinical practicum as challenging and demanding which evoked numerous concerns.

CONCLUSIONS

Considering the stress that final-year nursing students experience, it will be important to devise strategies ranging from personal, relational, and environmental protective factors to enable their successful transition and completion of clinical practice.

Modeling the social determinants of resilience in health professions students: impact on psychological adjustment

Stressors inherent to training and stemming from the learning environment are associated with high rates of burnout, depression, and mental health problems in health professions students (HPS). There is evidence that disadvantaged or stigmatized groups are particularly affected. These problems not only impact students after graduation but may also have detrimental effects on patient outcomes. Resilience, conceptualized as the process of adapting well in the face of adversity, has inspired an increasing number of interventions aimed at addressing those problems in HPS. These interventions have mostly targeted individual students and their psychological traits while ignoring social and structural factors that may enhance or undermine individual resilience. To address this gap in the literature, the authors reviewed the evidence for psychosocial determinants of resilience and proposed a model inspired by the social determinants of health literature and the "upstream-downstream" metaphor. In this theoretical paper, the authors propose that upstream determinants such adverse childhood experiences and socioeconomic and sociodemographic markers of disadvantage have a direct effect on psychological adjustment and an indirect effect mediated by resilience. Additionally, the authors propose that the institutional downstream drivers of learning environment, social support, and sense of belonging moderate the direct and indirect effects of the upstream determinants on psychological adjustment. Future research should test these hypotheses and gather evidence that may guide the development of interventions. The authors present their model as part of a comprehensive response to recent calls to action to address diversity, equity and inclusion in health professions education.

An integrative review of resilience among nursing students in the context of nursing education

AIM

This integrative review aimed to examine empirical research on resilience among nursing students in the context of nursing education. Resilience helps nursing students handle challenges, such as changing learning styles and experiencing their first clinical practice.

DESIGN

An integrative review.

METHODS

The search terms focused on resilience and health in nursing students and nursing education. The database used in this review were CINAHL Plus, PubMed and MEDLINE. The Mixed Methods Appraisal Tool appraised the studies' quality.

RESULTS

This study explored 52 records and revealed three current research focuses related to nursing students' resilience: (1) the concept and description of resilience, (2) the characteristics affecting resilience and (3) the mediating role of resilience in maintaining holistic health. Recommendations include adding a resilience topic to the nursing curriculum, providing resilience enhancement programs, examining the relationship between resilience and holistic health and exploring the influence of resilience about global health crises.

PUBLIC CONTRIBUTION

Resilience among nursing students plays a vital role in helping them to overcome adversities during their nursing education. Additionally, after graduation, nursing students can continue contributing to society as resilient Registered Nurses in the future.

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

AIM

This study investigated the mediating role of resilience in the relationship between academic stress, COVID-19 anxiety, and quality of life (QoL) among Filipino nursing students during the COVID-19 pandemic.

BACKGROUND

The COVID-19 pandemic has impacted the QoL of nursing students who are experiencing mental health issues. The mediating role of resilience in mitigating the effects of academic stress and COVID-19 anxiety on nursing students' QoL remains understudied.

METHODS

This study employed a correlational cross-sectional design, with a convenience sample of 611 Filipino nursing students. Data were collected using the scales Connor and Davidson Resilience, Brunnsviken Brief Quality of Life, COVID-19 Anxiety, and Perception of Academic Stress and analyzed using Pearson's r, bivariate analysis, and multistage regression analyses.

RESULTS

Academic stress and COVID-19 anxiety negatively correlated with QoL and resilience. Resilience was positively associated with QoL and reduced the effect of academic stress on QoL, indicating that resilience is a crucial mediating variable between academic stress and QoL. Finally, resilience had a significant mediating influence on QoL, as evidenced by a reduction in the effect of COVID-19 anxiety on QoL among nursing students.

CONCLUSIONS

Filipino nursing students' QoL was affected by academic stress and COVID-19-related anxiety. However, resilience mediated this impact, preserving QoL.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Nursing colleges and affiliated hospitals must collaborate to monitor academic stress and pandemic-related anxiety. Nursing students should be provided with programs such as seminars and team-building activities to enhance their resilience.

Determinants of nursing students' inclination to ethical values: Compassionate love and perceived social support from the family

BACKGROUND

Since professional values and the associated behaviors constitute the basis of practice in nursing, which is a profession based on professional ethics and ethical values, it is important to determine the inclination of nurses and nursing students to ethical values and the associated factors.

AIM

In this study, it was aimed to determine nursing students' levels of inclination to ethical values, compassionate love and perceived social support from the family, to examine the relationship between sociodemographic characteristics, compassionate love and perceived social support from family and inclination to ethical values, and the determining factors affecting the inclination to ethical values.

DESIGN

This is a descriptive relational study.

METHODS

The study was conducted with 558 students studying at the faculty of nursing between April-June 2022. The data were collected face-to-face using the Personal Information Form, Inclination to Ethical Values Scale, Compassionate Love Scale, and Scale of Perceived Social Support from Family.

RESULTS

It was found that there was a positive and significant relationship between compassionate love and perceived social support from the family and the level of inclination to ethical values, and that the mean scores of compassionate love (β = 0.882) and perceived social support from the family (β = 0.623) explained 89.3% of the change in the level of inclination to ethical values.

CONCLUSIONS

It was observed that males, freshman students, those with illiterate parents and students who did not take courses on ethics were in the risky group in terms of inclination to ethical values, and that sociodemographic characteristics, compassionate love and perceived social support from the family were the determinants of inclination to ethical values.

The impact of social support and stress on academic burnout among medical students in online learning: The mediating role of resilience

Background

As the COVID-19 pandemic continues, online learning and long-term isolation from social and clinical settings has exacerbated mental health problems and symptoms of academic burnout among medical students. However, few studies have discussed symptoms of academic burnout as a result of reduced social support, and increased stress among medical students during the process of online learning. To fill this gap, this study investigated the influencing factors and mechanism of academic burnout in medical students' online learning process. Both the positive inhibition effect of positive factors such as social support, and the negative aggravation effect of negative factors such as stress were explored, while the mediating and protecting role of resilience is also discussed.

Method

We collected survey data from a total of 817 medical students from a medical school in China who participated in online learning during the fall 2021 semester. An online questionnaire was sent to the students in January, 2022. Items adapted from the DASS Scale developed by Lovibond and Lovibond were used to measure medical students' stress levels. The perceived social support of medical students was assessed by the Gregory MSPSS. Resilience was evaluated by the 10-Item Connor–Davidson Resilience Scale (CD-RISC). Items from the Maslach Burnout Inventory–Student Survey (MBI-SS) were used to calculate students' academic burnout. Descriptive analysis, correlation analysis, hierarchical linear regression analysis and structural equation modeling were used to analyze the collected data.

Results

The results identified that in the context of online learning there was a positive correlation between medical students' stress and academic burnout, and their resilience played a partial mediating role. However, social support did not directly affect academic burnout, but inhibited the prevalence of academic burnout through resilience. In addition, stress was negatively related to resilience, while social support was positively related to resilience. Resilience was found to be negatively related to medical students' academic burnout in online learning.

Conclusion

The results of this study can provide a reference for the future development of appropriate educational strategies and coping measures to ameliorate the academic burnout of medical students.

The predictive role of nursing students' individual characteristics and psychological resilience in psychological distress

PURPOSE

This study aims to determine the predictive role of nursing students' individual characteristics and psychological resilience in psychological distress.

DESIGN AND METHODS

This study is a descriptive cross-sectional study. The study sample included 652 nursing students. Binary logistic regression analysis was used for analysis.

FINDINGS

It has been determined that 65.3% of nursing students have psychological distress. Having a chronic disease, being a woman, poor academic success, choosing the profession so as not to be unemployed, being single and low psychological resilience are factors that affect psychological distress.

PRACTICE IMPLICATIONS

It is recommended to screen nursing students for psychological distress to increase interventions that improve the psychological resilience of risky 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.

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.