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Erschens R, Schröpel C, Herrmann-Werner A, Junne F, Listunova L, Heinzmann A, Keis O, Schüttpelz-Brauns K, Herpertz SC, Kunz K, Zipfel S, Festl-Wietek T. The mediating role of self-efficacy in the relationship between past professional training and burnout resilience in medical education: a multicentre cross-sectional study. BMC MEDICAL EDUCATION 2024; 24:875. [PMID: 39143612 PMCID: PMC11323524 DOI: 10.1186/s12909-024-05854-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 08/01/2024] [Indexed: 08/16/2024]
Abstract
BACKGROUND Meta-analyses indicate a high prevalence of burnout among medical students. Although studies have investigated different coping strategies and health interventions to prevent burnout, professional experience's influence on burnout resilience as seldom been explored. Therefore, in our study we aimed to examine the self-efficacy's mediating role in the relationship between past vocational training and burnout resilience. In the process, we also analysed the associations between study-related variables and burnout resilience. METHODS In our cross-sectional study, we analysed the data of 2217 medical students at different stages of their university education (i.e. 1st, 3rd, 6th, 10th semester, and final year) at five medical faculties in Germany. The questionnaire included items addressing variables related to medical school, previous professional and academic qualifications, and validated instruments for measuring burnout and self-efficacy. RESULTS The overall prevalence of burnout was 19.7%, as defined by high scores for emotional exhaustion and notable values in at least one of the other two dimensions (cynicism or academic efficacy). Higher levels for self-efficacy (p < .001), having children (p = .004), and financing education with personal earnings (p = .03) were positively associated with burnout resilience, whereas having education financed by a partner or spouse (p = .04) had a negative association. In a mediation analysis, self-efficacy exerted a suppressor effect on the relationship between vocational training and burnout resilience (indirect effect = 0.11, 95% CI [0.04, 0.19]). CONCLUSIONS Self-efficacy's suppressor effect suggests that the positive association between vocational training and burnout resilience identified in the mediation analysis disappears for students who have completed vocational training but do not feel efficacious. Those and other findings provide important insights into the psychological mechanisms underlying the development of burnout resilience in medical students and suggest the promotion of self-efficacy in medical education.
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Affiliation(s)
- Rebecca Erschens
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany.
| | - Carla Schröpel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Anne Herrmann-Werner
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
- Tübingen Institute for Medical Education, University of Tübingen, Tübingen, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Otto von Guericke University Magdeburg, University Hospital Magdeburg, Leipziger Straße 44, 39120, Magdeburg, Germany
| | - Lena Listunova
- Medical Faculty Heidelberg, Office of Students' Affairs, Heidelberg University, Heidelberg, Germany
| | - Andrea Heinzmann
- Medical Faculty, Albert-Ludwigs-University Freiburg, Office of the Dean of Studies, Freiburg, Germany
| | - Oliver Keis
- Office of the Dean of Studies, Medical Faculty, Ulm University, Ulm, Germany
| | - Katrin Schüttpelz-Brauns
- Medical Education Research Department, Division for Study and Teaching Development, Medical Faculty Mannheim at Heidelberg University, Mannheim, Germany
| | - Sabine C Herpertz
- Department of General Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Kevin Kunz
- Medical Faculty, Albert-Ludwigs-University Freiburg, Office of the Dean of Studies, Freiburg, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
- Office of Students' Affairs, University's Faculty of Medicine, Tübingen, Germany
| | - Teresa Festl-Wietek
- Tübingen Institute for Medical Education, University of Tübingen, Tübingen, Germany
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Díez M, Parra Á, García-Mendoza MDC, Queija-Sánchez I. Depression, Anxiety, and Stress Among Emerging Adult Undergraduates: A Longitudinal and Two-Cohort Study. HEALTH EDUCATION & BEHAVIOR 2024; 51:553-561. [PMID: 38553981 DOI: 10.1177/10901981241240745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2024]
Abstract
Mental disorders constitute one of the population's principal health problems, especially among undergraduates. This quantitative study compared levels of depression, anxiety, and stress in a sample of emerging adult university undergraduates from a gender perspective (1) during the initial and intermediate years of emerging adulthood and (2) in two different cohorts. A total of 383 Spanish emerging adult university undergraduates were monitored longitudinally (2015-2018) and two cohorts were compared (2015-2020). Participants completed the validated Spanish version of the Depression Anxiety Stress Scale-21. Mean-level and rank-order stability was found across the two waves of the longitudinal study in relation to levels of depression, anxiety, and stress. Significant differences were found between the two cohorts, indicating higher levels of psychological distress in 2020 than in 2015. Women were found to have higher levels of psychological distress, particularly stress, than men in both waves and cohorts. Results are discussed in relation to the negative effects of the COVID-19 health crisis on the emotional health of emerging adults. The present study highlights the need to establish measures designed to improve the mental health of emerging adults, which was more severely affected by the COVID-19 crisis than by the aftermath of the 2008 financial crisis. It also underscores the need to develop interventions designed to alleviate the greater degree of stress suffered by women.
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Zhou Y, Wang L, Yang K, Huang J, Li Y, Li W, Zhang P, Fan F, Yin Y, Yu T, Chen S, Luo X, Tan S, Wang Z, Feng W, Tian B, Tian L, Li CSR, Tan Y. Correlation of allostatic load and perceived stress with clinical features in first-episode schizophrenia. J Psychiatr Res 2024; 172:156-163. [PMID: 38382239 DOI: 10.1016/j.jpsychires.2024.02.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 02/03/2024] [Accepted: 02/07/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND Stress plays an important role in the etiology of schizophrenia. However, the mechanisms by which chronic physiological stress and perceived stress relate to the clinical features of schizophrenia may differ. We aimed to elucidate the relationships among chronic physiological stress indexed by allostatic load (AL), perceived stress, and clinical symptoms in individuals with first-episode schizophrenia (FES). METHODS Individuals with FES (n = 90, mean age = 28.26years old, 49%female) and healthy controls (111, 28.88, 51%) were recruited. We collected data of 13 biological indicators to calculate the AL index, assessed subjective stress with the Perceived Stress Scale-14 (PSS-14), and compared AL and perceived stress between groups. Patients with FES were also evaluated with the Positive and Negative Syndrome Scale (PANSS) and the Calgary Depression Scale for Schizophrenia (CDSS). RESULTS Individuals with FES had higher AL and PSS score than healthy controls. There were no significant correlations between AL and PSS score in either patients or controls. Among individuals with FES, the AL index was associated with the severity of positive symptoms, while the PSS score was positively associated with CDSS score. Both elevated AL and PSS were correlated with the occurrence of schizophrenia. CONCLUSIONS Physiological stress, as reflected by AL, may be more related to positive symptoms, while perceived stress appear to be associated with depressive symptoms in individuals with FES. Longitudinal studies are necessary to explore the relationships between interventions for different stressor types and specific clinical outcomes in FES.
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Affiliation(s)
- Yanfang Zhou
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Leilei Wang
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Kebing Yang
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China.
| | - Junchao Huang
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Yanli Li
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Wei Li
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Ping Zhang
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Fengmei Fan
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Yi Yin
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Ting Yu
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Song Chen
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Xingguang Luo
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Shuping Tan
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Zhiren Wang
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Wei Feng
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Baopeng Tian
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Li Tian
- Institute of Biomedicine and Translational Medicine, Department of Physiology, Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - Chiang-Shan R Li
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Yunlong Tan
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
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Ge JL, Feldman DB, Shu TM. The Relationships of Hope, Optimism, and Academic Motivation With GPA Among University Students in Hong Kong. Psychol Rep 2023:332941231184144. [PMID: 37335773 DOI: 10.1177/00332941231184144] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
Research demonstrates the relationship between dispositional hope and GPA, but mixed results regarding the relationship between dispositional optimism and GPA. Hope and optimism also have been shown to predict academic motivation. However, no study has yet investigated all of these factors together, and most research concerns only Western samples. In a cross-sectional sample of 129 Hong Kong university students, we administered measures of internal hope (hope regarding one's own capabilities), external-family hope (hope derived from family), optimism, and intrinsic and extrinsic academic motivation. We found significant zero-order correlations between internal hope and GPA, but not between external-family hope nor optimism and GPA. Mediation analyses showed that internal hope directly related to GPA, and did not appear mediated by academic motivation. Given our findings, future studies testing hope-based interventions in similar samples may be warranted. We discuss implications for culturally adapting hope interventions.
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Affiliation(s)
- Jacqueline L Ge
- Department of Counseling Psychology, Santa Clara University, Santa Clara, CA, USA
| | - David B Feldman
- Department of Counseling Psychology, Santa Clara University, Santa Clara, CA, USA
| | - Tse-Mei Shu
- The Hong Kong University of Science and Technology, Hong Kong
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Bekesiene S, Smaliukienė R, Kanapeckaitė R. The Relationship between Psychological Hardiness and Military Performance by Reservists: A Moderation Effect of Perceived Stress and Resilience. Healthcare (Basel) 2023; 11:healthcare11091224. [PMID: 37174765 PMCID: PMC10178462 DOI: 10.3390/healthcare11091224] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 04/19/2023] [Accepted: 04/22/2023] [Indexed: 05/15/2023] Open
Abstract
The purpose of this study is to evaluate the effect of hardiness on the perceived military performance of reservists, i.e., young people who have full-time jobs in a civilian sector and perform military training as a part of their civic duty. We proposed the conceptual model with conditional indirect effects of the hardiness on personal military performance, where mediated moderation effects are observed from personality traits and variables important for military service: team cohesion, perceived stress, and psychological resilience. The final dataset was comprised of 384 self-reported paper-pencil questionnaires filled out by reserve soldiers, and PROCESS Macro 3.5 Model 7 and Model 14 were used for the analysis. The results revealed that perceived stress (Model 1) and psychological resilience (Model 2) have a statistically significant moderate mediating effect on the interlink between hardiness and performance when personality traits and team cohesion are taken into consideration. The change in R2 is statistically significant and explains how perceived stress and psychological resilience affect individuals. When psychological hardiness is low, the level of perceived stress has a statistically significant moderating effect, i.e., it reduces the effect of hardiness on performance. When comparing the effects of perceived stress and psychological resilience, the latter has a stronger moderating effect on performance. Specifically, the moderating effect of resilience was more evident in Model 2 (66.9% variance, r = 0.818) for the military performance of the reservists than the perceived stress in Model 1 (52.5% variance, r = 0.724). This means that resilience increases the accountability of Model 2 compared to Model 1 by 14.4%. We conclude that resilience training could statistically significantly increase the military performance of reserve soldiers as a tactical population.
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Affiliation(s)
- Svajone Bekesiene
- General Jonas Zemaitis Military Academy of Lithuania, Silo 5a, LT-10322 Vilnius, Lithuania
| | - Rasa Smaliukienė
- General Jonas Zemaitis Military Academy of Lithuania, Silo 5a, LT-10322 Vilnius, Lithuania
| | - Rosita Kanapeckaitė
- General Jonas Zemaitis Military Academy of Lithuania, Silo 5a, LT-10322 Vilnius, Lithuania
- Institute of Psychology, Vilnius University, Universiteto g. 9/1, LT-01513 Vilnius, Lithuania
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Zhu P, Xu T, Xu H, Ji Q, Wang W, Qian M, Shi G. Relationship between Anxiety, Depression and Learning Burnout of Nursing Undergraduates after the COVID-19 Epidemic: The Mediating Role of Academic Self-Efficacy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4194. [PMID: 36901200 PMCID: PMC10002455 DOI: 10.3390/ijerph20054194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 01/31/2023] [Accepted: 02/04/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Although cross-sectional studies on the learning status of nursing undergraduates during the COVID-19 epidemic have surged, few studies have explored the normalization of COVID-19 on students' learning burnout and mental health. The study was designed to investigate the learning burnout of nursing undergraduates in school under the normalization of the COVID-19 epidemic and explore the hypothesized mediation effect of academic self-efficacy in the relationship between anxiety, depression and learning burnout in Chinese nursing undergraduates. METHODS A cross-sectional study was conducted among nursing undergraduates in the school of nursing of a university in Jiangsu Province, China (n = 227). A general information questionnaire, College Students' Learning Burnout Questionnaire, Generalized Anxiety Disorder Scale (GAD-7), and Patient Health Questionnaire depression scale (PHQ-9) were administered. Descriptive statistical analysis, Pearson correlation analysis, and multiple linear regression analysis were performed via SPSS 26.0. Process plug-in (Model 4) was used to test the mediating effect of academic self-efficacy (bootstrap 5000 iterations, α = 0.05). RESULTS Learning burnout (54.1 ± 0.656) was positively correlated with anxiety (4.6 ± 0.283) and depression (5.3 ± 0.366) (p < 0.01) and was negatively correlated with academic self-efficacy (74.41 ± 0.674) (p < 0.01). Academic self-efficacy plays a mediating role between anxiety and learning burnout (0.395/0.493, 80.12%) and a mediating role between depression and learning burnout (0.332/0.503, 66.00%). CONCLUSION Academic self-efficacy has a significant predictive effect on learning burnout. Schools and teachers should strengthen the screening and counselling of students' psychological problems, detect learning burnout caused by emotional problems in advance and improve students' initiative and enthusiasm for learning.
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Zhou H, Wang Y, Cheng L. The mediating effect of self-directed learning in the relationship between caring and resilience among Chinese nursing students: A multi-center cross-sectional study. NURSE EDUCATION TODAY 2022; 119:105598. [PMID: 36272323 DOI: 10.1016/j.nedt.2022.105598] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 08/30/2022] [Accepted: 10/06/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Despite the proliferation of literature focusing on resilience, a paucity of research has attempted a thorough and accurate examination of factors that contribute to resilience among nursing students. OBJECTIVES To examine the mediating effect of self-directed learning in the relationship between caring and resilience in Chinese nursing students. DESIGN A cross-sectional design. SETTINGS Five universities in China. PARTICIPANTS Undergraduate nursing students (N = 511). METHODS The Caring Ability Inventory, Self-Rating Scale of Self-Directed Learning, and Connor-Davidson Resilience Scale (CD-RISC) were administered. Socio-demographic and academic data were collected from nursing students after obtaining their informed consent. A multiple linear regression analysis was performed to assess factors associated with resilience. A structural equation model with bootstrapping estimation was conducted to further explore the potential mediating role of self-directed learning in the relationship between caring and resilience. RESULTS The average score of CD-RISC for nursing students was 92.96 ± 14.85. Multiple linear regression analyses indicated that caring and self-directed learning were significantly positively associated with resilience. Self-directed learning (β = 0.327, 95% Confidence Interval [CI]: 0.049-6.667, p < 0.001) had a significant mediating effect on the relationship between caring and resilience in nursing students, explaining 67.1% of the total effect of caring on resilience. CONCLUSIONS Interventions that enhance students' self-directed learning have the potential to enhance resilience level. Innovative pedagogical approaches, strategic reinforcement, and nursing curriculum transformation are recommended to promote self-directed learning awareness and internalize self-directed learning skills.
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Affiliation(s)
- Hua Zhou
- School of Nursing, Sun Yat-sen University, Nonglin Street, Yuexiu District, Guangzhou, China.
| | - Yarui Wang
- School of Nursing, Sun Yat-sen University, Nonglin Street, Yuexiu District, Guangzhou, China.
| | - Li Cheng
- School of Nursing, Sun Yat-sen University, Nonglin Street, Yuexiu District, Guangzhou, China.
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Deng Y, Cherian J, Khan NUN, Kumari K, Sial MS, Comite U, Gavurova B, Popp J. Family and Academic Stress and Their Impact on Students' Depression Level and Academic Performance. Front Psychiatry 2022; 13:869337. [PMID: 35782431 PMCID: PMC9243415 DOI: 10.3389/fpsyt.2022.869337] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
Current research examines the impact of academic and familial stress on students' depression levels and the subsequent impact on their academic performance based on Lazarus' cognitive appraisal theory of stress. The non-probability convenience sampling technique has been used to collect data from undergraduate and postgraduate students using a modified questionnaire with a five-point Likert scale. This study used the SEM method to examine the link between stress, depression, and academic performance. It was confirmed that academic and family stress leads to depression among students, negatively affecting their academic performance and learning outcomes. This research provides valuable information to parents, educators, and other stakeholders concerned about their childrens' education and performance.
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Affiliation(s)
- Yuwei Deng
- School of Mechatronics Engineering, Daqing Normal University, Daqing, China
- School of Marxism, Heilongjiang University, Harbin, China
| | - Jacob Cherian
- College of Business, Abu Dhabi University, Abu Dhabi, United Arab Emirates
| | - Noor Un Nisa Khan
- Faculty of Business Administration, Iqra University Karachi Pakistan, Karachi, Pakistan
| | - Kalpina Kumari
- Faculty of Department of Business Administration, Greenwich University Karachi, Karachi, Pakistan
| | - Muhammad Safdar Sial
- Department of Management Sciences, COMSATS University Islamabad (CUI), Islamabad, Pakistan
| | - Ubaldo Comite
- Department of Business Sciences, University Giustino Fortunato, Benevento, Italy
| | - Beata Gavurova
- Faculty of Mining, Ecology, Process Control and Geotechnologies, Technical University of Kosice, Kosice, Slovakia
| | - József Popp
- Hungarian National Bank–Research Center, John von Neumann University, Kecskemét, Hungary
- College of Business and Economics, University of Johannesburg, Johannesburg, South Africa
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