Measuring use of resourcefulness skills: psychometric testing of a new scale

The link among academic stress, sleep disturbances, depressive symptoms, academic performance, and the moderating role of resourcefulness in health professions students during COVID-19 pandemic

Background

The rapid shift to virtual learning in response to the COVID-19 pandemic contributed to high academic stress among health profession students. High academic stress was associated with impaired psychosocial well-being and decreased academic performance.

Objectives

The purpose of this study was to assess the relationship between academic stress, anxiety, sleep disturbances, depressive symptoms, academic performance, and the moderating effect of resourcefulness among undergraduate health profession students.

Methods

This descriptive and cross-sectional study included undergraduate health profession students. The primary investigator distributed the study link to all students through the university's Central Messaging Centre, Twitter account, and WhatsApp. The study variables were measured using the Student Life Stress Inventory, the Generalized Anxiety Disorder-7 questionnaire, the Centre for Epidemiology Scale of Depression, the Pittsburgh Sleep Quality Index, and the Resourcefulness Skills Scale. Pearson R correlation and linear regression analysis were utilized for statistical analysis.

Results

Our sample included 94 undergraduate health profession students, 60 % of which were females with a mean age of 21, and the majority were nursing and medicine students. High academic stress, anxiety, sleep disturbances, depressive symptoms, and resourcefulness were reported among 50.6 %, 43 %, 79.6 %, 60.2 %, and 60 % of the participants, respectively. However, no effect of resourcefulness was found on any of the study variables. Instead, academic stress and sleep disturbances were the strongest predictors of depressive symptoms regardless of the level of resourcefulness.

Conclusion

Adequate academic support during virtual learning and tools to early detect subtle signs of high academic stress, anxiety, depression, and sleep disturbance should be routinely utilized by educational institutions. In addition, incorporating sleep hygiene and resourcefulness training in health professions education is highly indicated.

Stressors and learned resourcefulness in baccalaureate nursing students: a longitudinal study

OBJECTIVE

This correlational longitudinal study examined levels and relationships of Learned Resourcefulness (LR), stressors, and academic performance in baccalaureate nursing students at a North Carolina university.

METHOD

Gadzella's Student-life Stress Inventory (SSI) and Rosenbaum's Self-Control Scale (SCS) administered to 85 students in two groups upon admission and graduation.

RESULTS

LR increased, while stress decreased significantly in both groups (p < 0.05). Both groups (95.3% female, 85.8% Caucasian) reported similarly high frustration, pressure, and emotional reactions to stress. Significant relationship between taking tests and stress (p < 0.01). Stressors (p < 0.05) and age (p < 0.01) significant predictors of academic performance. Significant correlations of LR and work status (p < 0.01), and increased self-esteem (p < 0.05). No significant relationships among LR, stressors, and academic performance.

CONCLUSION

Results validate high levels of stress and suggest that higher LR enhances coping skills and decreases stress longitudinally, which can improve academic performance and retention.

IMPLICATIONS FOR INTERNATIONAL AUDIENCE

Trends and relationships in stressors and LR should be explored internationally in larger, more diverse samples of college students in nursing and other majors in relation to depression, anxiety, health-related behaviors, demographics, and academic performance. LR can be assessed, taught, learned, and enhanced. Greater numbers of qualified, competent nursing graduates with stronger clinical judgment, coping, and problem-solving skills will address the critical global nursing shortage and improve the quality, safety, and access of health care worldwide.

Factors That Influence Women's Symptoms of Postpartum Depression After Discharge of Their Preterm Infants From the NICU

OBJECTIVE

To examine resourcefulness, perception of child vulnerability, and stress in relation to symptoms of postpartum depression (PPD) in women after discharge of their preterm infants from the NICU.

DESIGN

Cross-sectional, descriptive, correlational study.

SETTING

An urban NICU follow-up clinic, a pediatric office in the northeastern United States, and an online NICU parent support group.

PARTICIPANTS

Seventy-four women who gave birth to preterm infants who were discharged home from the NICU.

METHODS

The participants completed a demographic data questionnaire, the Resourcefulness Scale, Child Vulnerability Scale, Perceived Stress Scale, and Edinburgh Postnatal Depression Scale. I examined the relationships among these data using correlational analysis and hierarchical multiple linear regression analysis.

RESULTS

Perception of child vulnerability and stress were predictors of symptoms of PPD; these variables accounted for 9% (p = .001) and 18% (p < .001) of the variation in symptoms of PPD, respectively. Although resourcefulness initially predicted PPD, it was no longer significant when controlling for demographic variables in the final regression analysis.

CONCLUSIONS

These results supported previously reported findings on the effects of women's perceptions of their child's vulnerability and stress on symptoms of PPD. However, the findings are not consistent with those of previous research regarding the inverse relationship between resourcefulness and symptoms of PPD. Nurses can implement interventions for women regarding perceptions of child vulnerability and stress to decrease symptoms of PPD after their preterm infant's discharge from the NICU.

Stress Experiences and Mental Health of Pregnant Women: The Mediating Role of Social Support

Stress in pregnancy is an exceedingly common issue that impacts the mother's mental health and the health of her baby. Yet, women with a supportive network of friends and family may experience lower stress and improved mental health. Therefore, the aims of this secondary analysis were to (a) examine relationships between stress experiences (i.e. perceived stress, pregnancy-specific stress) and indicators of mental health (i.e. absence of depressive symptoms and resourcefulness), (b) determine the effects of social support on stress experiences and indicators of mental health, and (c) determine if social support mediates the relationship between stress experiences and indicators of mental health. A convenience sample of 82 women in their second and third trimester of pregnancy participated in the parent study. Findings indicate that stress experiences were moderately correlated with indicators of mental health and social support predicted stress experiences and indicators of mental health. All social support mediation models were not significant with the exception of social support mediating the relationship between pregnancy-specific stress and resourcefulness. This was the first study to investigate the mediating role of social support on the relationship between pregnancy-specific stress and resourcefulness. Pregnant women may benefit from social support interventions to meaningfully reduce their stress and promote mental health. Such interventions may be physical activity, group prenatal care, or even peripartum home visits.

Grandchildren's Depressive Symptoms and Perceptions of Family Functioning: Protective and Influencing Factors

A recent increase in children living with grandparents places more children at increased risk for emotional, psychological, or behavioral problems. This study used the Resiliency Model of Family Stress, Adjustment, and Adaptation to examine how children's living situation, parental monitoring, child's resourcefulness, and perceived support affect depressive symptoms and perceived family functioning. Of participants, 36% ( n = 56) lived with their parents only, 44% ( n = 69) lived with a grandmother as their primary caregiver, and 20% ( n = 31) lived in a multigenerational household. Results indicate parental monitoring and support affected perceptions of family functioning. Subjective support and resourcefulness affected depressive symptoms. No effects were found from living situation and demographic factors. Resourcefulness had the strongest effect on depressive symptoms, with a 3-point decrease in symptoms for each incremental increase in resourcefulness. This study provides insight into factors influencing children's depressive symptoms and perceived family functioning, and provides direction for the development of future interventions.

Resourcefulness Training for Dementia Caregivers: Establishing Fidelity

Providing care for an elder with dementia can produce extreme stress that adversely affects caregiver health. Learning to be resourceful, which involves practicing resourcefulness skills using a journal or voice recorder, may reduce caregiver stress. However, before testing the effectiveness of journaling and voice recording as resourcefulness training (RT) practice methods, intervention fidelity should first be established. This pilot trial with 63 women dementia caregivers examined the fidelity of journaling and voice recording and whether allowing a choice between the methods affected RT intervention fidelity. Following RT, Resourcefulness Scale scores were similar for journal and recorder methods but higher for caregivers in the choice versus random condition. Patterns of RT skill use documented in journals or recordings were similar for choice and random conditions and for journal and recorder methods. The results support the implementation fidelity of RT that allows caregivers to choose a method to reinforce their resourcefulness skills.

The Effect of a Resourcefulness Training Intervention on Relocation Adjustment and Adaptive Functioning among Older Adults in Retirement Communities

The population of older adults is increasing rapidly and is expected to reach 83.7 million by the year 2050. Previous research demonstrates that greater resourcefulness is associated with better quality of life and life satisfaction. The purpose of this pilot study was to evaluate the effects of a resourcefulness training intervention on positive cognitions, resourcefulness, relocation adjustment, and adaptive functioning among older adults who have relocated to retirement communities. Resourcefulness theory provided the theoretical framework for this study. Forty older adults who relocated to three retirement communities in Milwaukee, WI were randomly assigned to either a diversional activity group or to a resourcefulness training (RT) intervention group. Two older adults dropped out of the study (one from the diversional activity group and one from the RT group), leaving 38 elders. The results of the study indicated that there were slight increases (a trend) in the mean of positive cognitions, relocation adjustment, adaptive functioning, and personal resourcefulness in the expected direction for the RT intervention group as compared to the diversional group. Recommendations for future research include the use of larger and more diverse samples over a longer periods of time (6 weeks and 12 weeks post-intervention) as well as the use of cut scores on the resourcefulness scale so that the RT training intervention is taught to those who need it.

Is cognitive lifestyle associated with depressive thoughts and self-reported depressive symptoms in later life?

Key components of cognitive lifestyle are educational attainment, occupational complexity and engagement in cognitively stimulating leisure activities. Each of these factors is associated with experiencing fewer depressive symptoms in later life, but no study to date has examined the relationship between overall cognitive lifestyle and depressive symptoms. This task is made more complex because relatively few older participants in cross-sectional studies will be currently experiencing depression. However, many more will show evidence of a depressive thinking style that predisposes them towards depression. This study aimed to investigate the extent to which cognitive lifestyle and its individual components are associated with depressive thoughts and symptoms. Two hundred and six community-dwelling participants aged 65+ completed the depressive cognitions scale, the geriatric depression scale and the lifetime of experiences questionnaire, which assesses cognitive lifestyle. Correlational analysis indicated that each of the individual lifestyle factors—education, occupational complexity and activities in young adulthood, mid-life and later life—and the combined cognitive lifestyle score was positively associated with each other and negatively with depressive symptoms, while all except education were negatively associated with depressive thoughts. Depressive thoughts and symptoms were strongly correlated. Cognitive lifestyle score explained 4.6 % of the variance in depressive thoughts and 10.2 % of the variance in depressive symptoms. The association of greater participation in cognitive activities, especially in later life, with fewer depressive symptoms and thoughts suggests that preventive interventions aimed at increasing participation in cognitively stimulating leisure activity could be beneficial in decreasing the risk of experiencing depressive thoughts and symptoms in later life.

Personal beliefs, learned resourcefulness, and adaptive functioning in depressed adults

Learned resourcefulness and personal beliefs are significant predictors of adaptive functioning. The mediating effect of personal beliefs on the relationship between learned resourcefulness and adaptive functioning was validated in adults with depression. The findings from this study may provide the basis for developing a useful nursing intervention constituting resourcefulness skills with positive personal beliefs to help patients with depression improve their ability to function well in their daily activities.

ABSTRACT

Research has shown that patients with depression have difficulty with performing daily tasks and meeting their own personal care needs. According to Beck's cognitive theory of depression, such deficits in adaptive functioning are affected by disturbances in specific personal beliefs that reflect the process of regulating cognitions. Rosenbaum's learned resourcefulness theory proposed that adaptive functioning is influenced by learned resourcefulness, while learned resourcefulness is associated with the process regulating cognitions. This study aims to test the mediating effect of personal beliefs on the relationship between resourcefulness and adaptive functioning. The study involved a cross-sectional design. Participants consisted of 187 adults with depression in southern Taiwan. The data were collected through four instruments: Cognitive Triad Inventory, Self-Control Schedule, modified Community Living Skills Scale, and a demographic questionnaire. Both resourcefulness and personal beliefs were significant predictors of adaptive functioning, and personal beliefs mediated the effect of learned resourcefulness on the adaptive functioning of the adults with depression. The results validate the role played by personal beliefs in effecting learned resourcefulness and adaptive functioning among adults with depression and provide direction for designing nursing interventions that consider personal beliefs when teaching resourcefulness skills to adults with depression.

Measuring use of positive thinking skills: psychometric testing of a new scale

Positive thinking interventions improve adaptive functioning and quality of life in many populations. However, no direct measure of positive thinking skills taught during intervention exists. This psychometric study of a convenience sample of 109 autism spectrum disorder (ASD) caregivers examined a new eight-item Positive Thinking Skills Scale (PTSS), which measures the frequency of use of positive thinking skills. The PTSS was found to be internally consistent (α = .90). Construct validity was supported by significant correlations (p < .01) with positive cognitions (r = .53), resourcefulness (r = .63), depression (r = -.45), and general well-being (r = .40). The findings support use of the PTSS as a potential indicator of intervention fidelity among ASD caregivers. However, because it is not specific for ASD caregivers, the PTSS has the potential for wider usage in other populations for whom the identification of specific positive thinking skills could provide direction for future intervention.