The mediating effect of psychological resilience on empathy and professional identity of Chinese nursing students: A structural equation model analysis

Resilience as Empathy Predictor in Nursing Students

Objective

To determine if resilience can predict empathy. Specifically, explain what would be the effect of the resilience dimen-sions on the dimensions of empathy in the nursing students examined in this study.

Methods

Cross-sectional study with the participation of 340 nursing students from a private university in Colombia. Jefferson's Empathy Scale (student version) and the Resilience-Trait Scale were used. The complete psychometry of the Empathy and Resilience scales was carried out, followed by the application of Structural Equations.

Results

Ecological Resilience predicts negatively the dimensions of "Compassionate Care" (β = -0.11) and "Walking in the pa-tient's shoes" (β = -0.19); the Engineering Resilience predicts positively the dimension "Walking in the patient's shoes" (β = 0.08).

Conclusion

Overall, resilience predicts empathy, thereby, introducing empathetic training of nursing students in the population stud-ied must also include training in resilience.

The relationship between psychological capital, stress, micro-learning environment, and professional identity in nursing interns: a structural equation modeling study

Background

Nursing interns play a crucial role in shaping the future nursing workforce, as their professional identity is closely linked to workplace retention rates and patient outcomes. Thus, investigating the factors that influence nursing interns' professional identity is important.

Objective

To evaluate the relationship between psychological capital, stress, micro-learning environment, and professional identity among nursing interns.

Methods

This was a cross-sectional study. The sample consisted of 388 nursing interns from 8 comprehensive teaching hospitals across five cities in Hubei Province between March and April 2024. Data were collected using a Descriptive Information Questionnaire, the Psychological Capital Questionnaire, the Student Nurse Stress Index scale, the Healthcare Education Micro Learning Environment Measure, and the Professional Identity Scale. The structural equation model was applied to explore the influencing factors of nursing interns' professional identity.

Results

The mean total score for professional identity was 35.57 ± 7.47. Psychological capital positively influenced professional identity directly (β = 0.16, P < 0.01), while stress as measured using the student nurse stress index had a negative impact (β = -0.20, P < 0.01). High scores on the healthcare education micro-learning environment measure positively contributed to the development of professional identity (β = 0.69, P < 0.001). Furthermore, psychological capital was identified as a mediator in the association between the healthcare education micro learning environment and professional identity, as well as between the student nurse stress index scores and professional identity.

Conclusion

The study suggests that a higher level of psychological capital, low stress levels, and a satisfied micro-learning environment are essential in fostering professional identity among nursing interns. It recommends collaboration between nursing schools and clinical departments to enhance nursing interns' psychological capital and stress management skills, creating a positive and safe working environment, thereby fostering professional identity among nursing interns.

The impact of empathy on professional identity among Chinese junior male nurses: a moderated mediation model

Background

Nursing care is essential, but the role of junior male nurses in medical and health services is underestimated; thus, many junior male nurses leave the profession due to a lack of professional identity.

Objective

This study examined how the mediating effect of emotional intelligence and the moderating role of locomotion mode influence the relationship between empathy and professional identity among Chinese junior male nurses.

Methods

This cross-sectional descriptive study was conducted among junior male nurses in China from December 2021 to May 2022. We asked participants from ten hospitals to complete a questionnaire regarding empathy, emotional intelligence, locomotion mode, and professional identity. Bootstrap and simple slope methods were used to test the moderated mediation model.

Results

Emotional intelligence partly mediated the effects of perspective-taking on professional identity (β = 0.253, p < 0.05). Furthermore, locomotion mode moderated the relationships between perspective-taking and emotional intelligence, perspective-taking and professional identity, and emotional intelligence and professional identity (β = 0.136, p < 0.01; β = 0.107, p < 0.05; β = -0.155, p < 0.01).

Conclusion

The findings revealed that,the mediating effect of emotional intelligence on the relation between perspective-taking and professional adaptability was moderated by locomotion mode. Whereas. These findings are meaningful for early intervention and the improvement of professional identity among junior male nurses.

Intrinsic Factors and Psychological Safety Among Nursing Students During Simulation-Based Learning-A Correlational Design

INTRODUCTION

Well-designed simulation-based learning (SBL) experiences enhance students' self-confidence, self-efficacy, clinical judgment, and psychomotor skill development. An emerging concept in SBL research is psychological safety. There is currently no research on factors influencing psychological safety specifically related to the SBL environment, nor is there any literature found to determine whether intrinsic student characteristic, such as self-compassion and resilience, contributes to SBL learning outcomes. The aim of this study is to determine whether there is a relationship between nursing students' intrinsic characteristics (self-compassion, resilience, and anxiety sensitivity) and their psychological safety.

METHODS

Bivariate correlation was used to examine associations among sociodemographic variables and outcome variables. Multiple regression was used to determine the predictive nature of the sociodemographic variables. Assumptions for variables in multiple regression models were tested (normal distribution, heteroscedasticity, multicollinearity). All data were analyzed in SPSS, Version 28. The P value of significance was set at 0.05 for all analyses.

RESULTS

Most of the 118 participants were non-Hispanic (89%), White (65%), and females (95%). Results of the demographic bivariate analysis revealed no significant differences among this diverse group or semester in the curriculum for psychological safety. The multiple regression found self-compassion (β = 29, P = 0.004), anxiety sensitivity (β = -0.16, P = 0.049), and resilience (β = 0.26, P = 0.004) predict psychological safety.

CONCLUSIONS

The importance of creating a psychologically safe learning environment has been recognized as essential to best practices. Our findings suggest that an understanding of student characteristics that impact their perception of psychological safety will allow educators to develop strategies to better support learners in the simulation environment.

How positive mental well-being influences professional identity and the mediating mechanisms in Chinese nursing students

AIM

To examine the association between positive mental well-being and professional identity in nursing students. The mediating effects of resilience and nurse-patient relationship were explored.

BACKGROUND

Professional identity of nursing students can influence their pursuit of a nursing career. Negative mental health problems, such as anxiety, depression, and high stress, are known risk factors for professional identity. Few studies have examined the association of professional identity with positive mental well-being and underlying mechanisms.

METHODS

This was a cross-sectional study of Chinese nursing students on clinical placement. The Warwick-Edinburgh Mental Well-being Scale, Professional Identity Scale, Connor-Davidson Resilience Scale, Nurse-Patient Relationship Scale, and Patient Health Questionnaire were used, and demographic and study-related characteristics were measured. Multivariable linear regression and mediation analyses analyzed the associations. We followed the STROBE reporting guidelines.

RESULTS

Of 208 participants, the total scores of positive mental well-being and professional identity were at a moderate level. Positive mental well-being was associated with professional identity after adjusting for confounders including the main reason for choosing nursing and negative mental health. Resilience was a full mediator of the association between positive mental well-being and professional identity, whereas nurse-patient relationship was a partial mediator.

DISCUSSION AND CONCLUSION

Positive mental well-being was associated with professional identity in Chinese nursing students on clinical placement, mediated through resilience and nurse-patient relationship. Positive mental well-being can be a facilitator for the professional identity of nursing students, and resilience and nurse-patient relationship could be potential mechanisms for nurse professional development.

IMPLICATIONS FOR NURSING AND/OR HEALTH POLICY

Nurse researchers, educators, and policymakers are informed to increase the awareness of positive mental well-being and develop interventions targeting resilience and nurse-patient relationship for building a stable and satisfied nursing team.

The Mediating Role of Psychological Resilience in Chinese Nursing Students' Professional Identity and Learning Burnout

PURPOSE

This study investigated whether professional identity predicts learning burnout among Chinese nursing students, and whether resilience moderates this relationship.

METHODS

This cross-sectional study recruited 635 students from a nursing college at a medical university in Hefei, China. Data were collected using the professional identity questionnaire, learning burnout scale for college students, and 10-item Connor-Davidson Resilience Scale. Pearson's correlation analysis was used to investigate the relationships between variables. The mediation effect was evaluated using linear regression and the bootstrap method in SPSS.

RESULTS

Nursing students exhibited intermediate learning burnout levels (average scores: 54.95 ± 10.42). Professional identity was positively correlated with psychological resilience (r = .42, p < .001), whereas learning burnout was negatively correlated with professional identity (r = - .54, p < .001) and psychological resilience (r = - .57, p < .001). Psychological resilience mediated the relationship between professional identity and learning burntout to the tune of 32.8%.

CONCLUSION

Psychological resilience mediates the relationship between professional identity and learning burnout. Thus, nursing educators can mitigate student burnout by developing their students' professional identities and psychological resilience.

Feasibility and effects of mindfulness-based stress reduction (MBSR) for improving resilience, posttraumatic stress disorder symptoms and posttraumatic growth among military medical college students

BACKGROUND

Increased stress among medical students in military college has been a challenge in the field of education. One approach to addressing stress reduction is mindfulness training. MBSR has been verified to improve the health status of different individuals. The aim of this study was to examine whether MBSR improves the psychological resilience, posttraumatic stress and posttraumatic growth of medical students in military college.

METHODS

MBSR was performed with students from a military medical university. A total of 372 students were surveyed by questionnaires, including the 10-item of Connor-Davidson Resilience Scale, Posttraumatic Growth Inventory, PTSD Checklist for DSM-5, Satisfaction with Life Scale, and Mindful Attention Awareness Scale, before the intervention, after the intervention and one month later. A control group of students also answered the questionnaires at the three time points but did not participate in the MBSR intervention. Statistical analyses were performed using repeated-measures ANOVA.

RESULTS

The results suggest that the MBSR group experienced significant improvements in resilience, posttraumatic growth, life satisfaction, and mindful attention awareness scores, as well as significant reductions in depression, anxiety, and PTSD intrusive symptoms scores after the intervention. These results were not found in the control group. One month after the intervention, all of these variables showed varying degrees of maintenance effects in the MBSR group.

CONCLUSION

The MBSR intervention was effective, as the medical students in military college in the MBSR group exhibited improvements in psychological resilience, posttraumatic growth, satisfaction with life and mindful attention awareness, depression, anxiety and intrusive symptoms.

Centrality and bridge connections between cognitive emotion regulation strategies and professional identity among Chinese undergraduate nursing students: A network analysis

AIM

To construct a network structure for cognitive emotion regulation among Chinese undergraduate nursing students and identify central nodes and to explore the bridge connections between cognitive emotion regulation strategies and professional identity from the perspective of network analysis.

BACKGROUND

Undergraduate nursing students are currently in a poor psychological condition and cognitive emotion regulation strategies can help them use positive approaches to regulate their emotions. There may be a link between cognitive emotion regulation strategies and professional identity.

DESIGN

This was a cross-sectional study that used network analysis.

METHOD

A total of 218 Chinese undergraduate nursing students were selected and surveyed using the Cognitive Emotion Regulation Questionnaire and the Professional Identity Questionnaire. A network analysis model was constructed and the related indices were calculated using R 4.3.0 software.

RESULTS

Network analysis showed that the central nodes of undergraduate nursing students' cognitive emotion regulation strategies were positive reappraisal, refocusing on planning and catastrophising; In the bridge network of cognitive emotion strategies and professional identity, professional self-concept, positive reappraisal, benefits of stay and risk of resignation and refocusing on planning were the nodes with the strongest bridge strength.

CONCLUSION

The salient central and bridge nodes can serve as potential targets for interventions aimed at improving the mental health of undergraduate nursing students. Nursing educators must be trained in cognitive emotion regulation and appropriately guided to use positive emotion regulation strategies in their studies and work. Educators should focus on the relation between cognitive emotion regulation and professional identity to improve the mental health of nursing students and stabilise the nursing workforce.

Psychological resilience mediates sense of professional mission and career success in Chinese intensive care unit nurses: a cross-sectional study

BACKGROUND

The nursing industry's stability and progress are adversely affected by the high attrition rate and shortage of nurses; therefore, it is critical to investigate the variables that influence the professional stability of nurses. The sense of professional mission and career success have positive significance for reducing nurses' job burnout. The purpose of this study is to explore the potential mediating role of psychological resilience in this relationship.

METHODS

Self-reported questionnaires were utilized by 335 intensive care unit (ICU) nurses to assess their sense of professional mission, psychological resilience, and career success in this cross-sectional study. A structural equation model was developed to validate the relationship between the variables.

RESULTS

There is a correlation among sense of professional mission, psychological resilience and career success. Significant mediating effect of psychological resilience exists between sense of professional mission and career success.

CONCLUSIONS

In this study, psychological resilience plays an intermediary role between sense of professional mission and career success, which provides support for further understanding the mechanism between sense of professional mission and career success and bolstering the case for devising comprehensive intervention strategies for psychological resilience. Nursing managers should focus on nurses' sense of professional mission and psychological resilience, and implement strategies to enhance nurses' psychological resilience in order to boost their career success.

Insomnia mediates the relation between empathy and anxiety among nursing students: a latent moderated mediation model of self-compassion

BACKGROUND

Nursing students are faced with multiple challenges and have a higher probability of suffering from anxiety. The current study aims to explore the relation between empathy and anxiety, examining the mediation and moderation effects of insomnia and self-compassion, respectively.

METHODS

This study employed a convenient sampling method, recruiting 1,161 nursing students (female = 923, male = 238, Meanage = 18.37, SDage = 2.38) from three universities in China. These students completed the questionnaires online, including General Anxiety Disorder -7 (GAD-7), Jefferson Scale of Physician Empathy-Nursing student (JSPE-NS), Youth Self-rating Insomnia Scale -8 (YSIS-8), and Self-Compassion Scale (SCS). The study employed latent variable structural equation models to analyze the relation and mechanisms between empathy and anxiety. Then, the mediated role of insomnia and the moderated role of self-compassion were examined.

RESULTS

The prevalence rates of anxiety and insomnia in the current sample are 18.24% and 26.76%, respectively. The results showed that empathy could negatively predict anxiety, with a significant mediating effect of insomnia between them (B = -0.081, p < 0.05, 95% CI [-0.197, -0.063]). Additionally, it was proven that self-compassion moderated the positive relation between insomnia and anxiety. With a higher level of self-compassion, the indirect effect of empathy on anxiety through insomnia was weaker (B = -0.053, p < 0.01, 95% CI [-0.095, -0.019]). When individuals showed a lower level of self-compassion, the indirect effect of empathy on anxiety through insomnia was stronger (B = -0.144, p < 0.01, 95% CI [-0.255, -0.059]).

CONCLUSION

The analysis of this research proved that empathy was negatively related to anxiety, and insomnia served as a mediator between empathy and anxiety. Besides, the protective role of self-compassion on individuals' mental health was identified. The findings of the study suggest that the education of nursing students should highlight the significance of fostering empathy and self-compassion. The intervention on insomnia may be helpful in reducing the levels of anxiety since insomnia is a risky factor for anxiety.

Meaningful Connections: Exploring the Relationship Between Empathy and Professional Identity Formation

OBJECTIVE

To describe the literature on the connections between empathy and professional identity formation (PIF) in pharmacy and other health professions education. A PRISMA-Scoping Review methodology was used for this study. Searches were conducted in PubMed and CINAHL from 2010 to January 12, 2023, with English added as a limiter. Articles had to address empathy and PIF, whether implicitly or explicitly. "Theory talk" was modified and utilized with 6 levels of connectedness to assess article quality.

FINDINGS

A total of 419 articles were reviewed for inclusion into the study with a total of 45 articles being included. Seventeen (37.8 %) and 12 articles (26.7 %) included a definition for empathy and PIF, respectively. Thirty-eight articles (84.4 %) implicitly discussed a connection between PIF and empathy. Educational initiatives that fostered connections between empathy and PIF focused on classroom activities, clinical rotation activities, and assessments. Key elements to enhance empathy and PIF development across articles focused on mentorship, role models, and reflective practice, alongside intentional curricular integration. Similarly, barriers to empathy and PIF are multifaceted.

SUMMARY

Despite educational initiatives in the literature that attempt to foster connections between empathy and PIF in classroom activities, clinical rotation activities, and assessments, most connections are implicit, as opposed to explicit. This may be due to the multiple barriers, such as the hidden curriculum, which make the connection between empathy and PIF difficult. This area needs further research and development given the importance of empathy in all health care provider interactions.

Resilience and Flexibility for Clinical Nurses: A Latent Class Analysis

Aim

To explore potential resilience and psychological flexibility patterns in nurses and analyze the effects of related factors such as growth mindset and professional recognition of categories.

Background

Resilience and psychological flexibility can help nurses resist occupational pressure and play essential roles in promoting personal growth and professional development.

Methods

A latent category approach was used to examine the patterns of heterogeneity in resilience and flexibility among 805 nurses. Differences in the influences related to resilience and flexibility were analyzed using univariate and multivariate logistic regressions, with demographic information, growth mindset, and career recognition as covariates.

Results

Participants were divided into three potential categories: toughness-flexible (32.8%), power-deficit-emotional (23.1%), and toughness-rigid (44.1%). The results of multivariate logistic regression analysis showed that monthly income, mode of employment, growth mindset, and professional identity were influential factors in the potential categories of nurse resilience and flexibility.

Conclusion

One cohort of nurses had high resilience and low flexibility, and psychological rigidity was related to the fact that the monthly income was less than RMB 5,000 and the contractual mode of employment. An excellent growth mindset and a high professional identity indicate that nurses are resilient and flexible. Implications for Nursing Management. Hospitals and nursing managers should pay attention to nurses' different career development needs and implement appropriate safeguards.

The relationship between ethical leadership and nurse well-being: The mediating role of workplace mindfulness

AIM

The purpose of this study was to explore the relationship between nurses' well-being and their ethical leadership, and the mediating role of workplace mindfulness in this relationship.

DESIGN

This was a quantitative cross-sectional study.

METHODS

This cross-sectional study was conducted in three tertiary hospitals in central China from May 2022 to July 2022, and the Nurses' Workplace Mindfulness, Ethical Leadership and Well-Being Scale were distributed and collected via the Internet. A total of 1579 nurses volunteered to participate in this study. SPSS 26.0 statistical software was used to analyse the data by Z-test and Spearman's rank correlation; the internal mechanism of workplace mindfulness and ethical leadership on nurses' well-being was completed by AMOS 23.0 statistical software.

RESULTS

The scores of nurses' well-being, workplace mindfulness and ethical leadership were 93.00 (81.00, 108.00), 96.00 (80.00, 112.00) and 73.00 (67.00, 81.00) respectively. The professional title, age and department atmosphere affect their well-being. Spearman's analysis showed that nurses' well-being was positively correlated with ethical leadership (r = .507, p < .01) and workplace mindfulness (r = .600, p < .01); workplace mindfulness partially mediated the relationship between ethical leadership and nurses' well-being accounting for 38.5% of the total effect ratio [p < .001, 95% CI = (0.215, 0.316)].

CONCLUSION

Nurses' well-being was at a medium level, and had a higher score in ethical leadership and workplace mindfulness, and workplace mindfulness played a partial mediating role between ethical leadership and nurses' well-being.

IMPACT

This suggests that nursing managers need to pay attention to clinical nurses' well-being experience, actively focus on the relationship among ethical leadership, workplace mindfulness and well-being and integrate core values such as positivity and morality into nurses' daily routines, so as to improve the work enthusiasm and well-being experience of clinical nurses, enhancing the nursing quality and stabilizing the nursing team.