Nursing Students' Emotional State and Perceived Competence During the COVID-19 Pandemic: The Vital Role of Teacher and Peer Support

Predictors of nursing students' stress, anxiety, and depression during the COVID-19 pandemic in a Hispanic-serving University in South Texas: A cross-sectional study

BACKGROUND

In nursing education, there have been several studies on the impact of the COVID-19 pandemic on the ability of nursing students to cope while in nursing school.

PURPOSE STATEMENT

The goal of this study is to assess undergraduate nursing students' support mechanisms as predictors of stress, anxiety, and depression during the COVID-19 pandemic within a Hispanic-serving institution in South Texas.

METHODS

Across-sectional design was used in this study. An online survey using self-reported questionnaires was used to gather data from an undergraduate nursing student cohort during the Fall 2021 semester. Linear regression was used to identify the predictors of student mental health.

RESULTS

Higher resilience and spiritual well-being were associated with reduced perceived stress, anxiety, and depression. Higher family functioning was associated with reduced perceived stress, and student employment as a salaried worker in a healthcare facility was associated with reduced depression. Finally, recovering from a symptomatic COVID-19 infection was associated with increased perceived stress.

CONCLUSIONS

The COVID-19 pandemic had a detrimental effect on nursing students' mental health, exacerbated by the transition to virtual learning. Fostering resilience and spiritual well-being in addition to targeted faculty support to nursing students that recovered from COVID-19 may promote improved mental health in a pandemic context, for nursing students immersed in the predominantly Hispanic-American culture of South Texas.

Interpersonal sensitivity and its associated factors among nursing students during the COVID-19 pandemic: a network analysis

BACKGROUND

Interpersonal sensitivity is a crucial individual characteristic, particularly for young nursing students. However, limited research has specifically examined interpersonal sensitivity in nursing students. This study aimed to employ network analysis to investigate the interconnectedness of interpersonal sensitivity and its associated factors among nursing students during the COVID-19 pandemic.

METHODS

Network analysis was employed to explore the network structure. The first network model was developed to evaluate interpersonal sensitivity. The second network model was constructed to investigate the associations between interpersonal sensitivity and variables that were found to be statistically significant in the multivariable linear regression model.

RESULTS

A total of 864 nursing students participated in the study. The strongest nodes in assessing interpersonal sensitivity among nursing students encompass three distinct aspects: compliments, genuine understanding, and criticism. The multivariate linear regression analysis revealed significant associations between interpersonal sensitivity and various factors, including openness (β = 0.67), anxiety symptoms (β = 0.45), well-being (β = -0.63), loneliness (β = 1.55), and perceived social support (β = 0.66).

CONCLUSIONS

This study yields valuable insights into the phenomenon of interpersonal sensitivity among nursing students amid the COVID-19 pandemic. These findings emphasize the significance of incorporating targeted interventions addressing these factors into nursing education curricula.

Prevalence of Impostor Phenomenon Among Final-Semester Baccalaureate Nursing Students

BACKGROUND

Impostor phenomenon (IP) is characterized as an internal sense of intellectual fraudulence and the inability to internalize success. It was identified by Clance and Imes in 1978 in a study with high-achieving women and has since been found among other professionals. Studies regarding IP are limited in nursing and among nursing students.

PURPOSE

The purpose of the study was to evaluate the prevalence of IP among senior baccalaureate nursing (BSN) students at a public central Texas university immediately prior to graduation.

METHODS

Senior BSN students were given an anonymous survey utilizing the Clance Impostor Phenomenon Scale.

RESULTS

Of the 86 senior BSN students, 82.5% completed the anonymous survey. Among students, 45.1% experienced moderate IP, 46.5% experienced frequent IP, and 8.5% experienced intense IP.

CONCLUSIONS

The incidence of IP was higher than expected. This study has implications for the future of nursing, including academic retention and postgraduation performance.

Psychometric properties of the Short-Form Five Facets of Mindfulness Questionnaire among nursing students in China: A confirmatory factor analysis

AIM

To analyse the factorial structure and psychometric properties of the Chinese Short-Form Five Facets of Mindfulness Questionnaire (FFMQ-SF) among nursing students in the Chinese mainland.

DESIGN

A cross-sectional study.

METHODS

A total of 240 undergraduate nursing students were recruited from a school of nursing in Beijing, China from 25 to 30 April 2021. FFMQ-SF and Depression-Anxiety-Stress Scale were used to collect information on the mindfulness level and mental health status of the study participants. Descriptive analyses were performed to examine the demographic characteristics. Confirmatory factor analyses (CFAs) were used to test the structural, convergent and discriminant validity of the scale model. Pearson correlation analysis was used to test the correlation between the variables and the criterion validity.

RESULTS

The overall fit of the scale model is good (Bollen-Stine χ2 = 177.206, df = 142, GFI = 0.923, AGFI = 0.883, TLI = 0.980, CFI = 0.983, RMSEA = 0.032, SRMR = 0.090). One-factor models using CFA demonstrated the overall best fit for four out of five subscales of the FFMQ-SF. In the five-factor CFA of the FFMQ-SF, the composite reliability values of the five factors were from 0.685 to 0.870 and the values of average variance extracted were from 0.426 to 0.627.

PATIENT OR PUBLIC CONTRIBUTION

The students who participated in this study contributed to the advancement of knowledge on mindfulness and mental health among nursing students in China. They voluntarily completed the online questionnaires and provided their honest and valid responses. Their data was used to evaluate the psychometric properties of the FFMQ-SF and to examine the relationship between mindfulness and psychological problems. Their feedback also helped to improve the quality and applicability of the FFMQ-SF instrument for future research and practice.

Exploring levels of empathy and assertiveness in final year physiotherapy students during clinical placements

Empathy and assertiveness are two essential soft skills for any healthcare professional's competence and ethical development. It has been shown that empathy can be influenced throughout the training of a future healthcare professional, particularly during the clinical placement period. This research aims to assess fourth-year physiotherapy students' empathic and assertive development before and after clinical placement. A longitudinal observational study was conducted with fourth-year physiotherapy students during the academic year 2022/2023. A preliminary assessment of empathy and assertiveness levels was carried out before the start of the clinical placement and at the end of the placement using the Individual Reactivity Index to assess empathy and the Rathus Test to assess assertiveness. The results show a statistically significant difference (p ≤ 0.05) in both the empathy subscales of perspective-taking and empathic-concern between the pre- and postassessment, as well as an inverse correlation between the empathy subscale of personal distress and assertiveness. It is concluded that students show adequate results in empathy and assertiveness. However, there is some influence of clinical practice on the development of empathy, and future intervention studies need to be considered. Furthermore, students with higher levels of assertiveness have lower levels of personal distress, suggesting that assertiveness is closely related to empathy.

Effect of simulation-based zoom learning on clinical decision-making among undergraduate nursing students and experiences of students and instructors: A mixed methods study

Aim

To determine the effect of simulation-based Zoom learning (SBZL) on perceived capabilities and clinical decision-making skills among undergraduate nursing students and to explore experiences of the instructors and students participating in SBZL.

Background

Nursing is a practice profession and students acquire clinical decision-making skills in clinical settings. However, the COVID-19 pandemic has disrupted conventional clinical learning activities. In this study, the outcomes of implementing SBZL in an undergraduate programme to support students' clinical learning were examined.

Design

A mixed methods design was employed.

Methods

This study recruited 195 final-year students to participate in the SBZL programme, which was developed based on the NLN Jeffries Simulation Theory to guide its design, implementation and evaluation. Case scenarios were developed and simulated through Zoom. Students' perceived capabilities, perceptions of the learning environment and clinical decision-making skills were assessed before and after SBZL. A historical control group of 226 previous final year students who had received a clinical practicum was included for comparison. Semi-structured interviews were conducted with 11 instructors and 19 students to explore their experiences of participating in SBZL.

Results

A total of 102 students completed the post-SBZL questionnaire. An increase in perceived creative thinking (mean difference = 0.24, p < 0.001) was observed post-SBZL. After SBZL, the perceptions of the learning environment were significantly improved. However, the SBZL group demonstrated lower perceived problem-solving capability than the control group (mean difference = 0.14, p = 0.007). Clinical decision-making was significantly improved in the SBZL group than in the control group (p < 0.001). Both the instructors and students reported positive experiences with SBZL, and highlighted challenges and factors for improving its implementation.

Conclusions

SBZL showed improvement in perceived creative thinking, perceptions of the learning environment and clinical decision-making. This innovative teaching and learning method can be valuable for nursing education in various regions to prepare students for real-life roles.

Tweetable abstract

Simulation-based Zoom learning is better than traditional teaching in improving clinical decision-making skills among undergraduate nursing students.

The prospective associations among time management tendency, negative emotions, and problematic smartphone use in Chinese nursing students: enlightenment from COVID-19

Purpose

The regularity of epidemic prevention and control measures in China has meant that nursing students have been exposed to more electronic devices, while problematic smartphone use has increased. The purpose of this study is to determine the prospective associations among time management tendency, negative emotions, and problematic smartphone use in nursing students during the COVID-19 pandemic.

Methods

A longitudinal study was conducted between November 2021 and May 2022. A total of 989 nursing students participated. The convenience sampling method was adopted and the following tools were used: the Adolescence Time Management Disposition Scale, the Depression Anxiety Stress Scales - 21, and the Mobile Phone Addiction Index. Multiple parallel mediation models were used by Mplus.

Results

Time management tendency had a significantly negative effect on problematic smartphone use (p < 0.05). Further tests using mediation models showed that stress as a negative emotion mediated the relationship between time management tendency and problematic smartphone use (p < 0.05) over time.

Conclusion

Nursing educators need to strengthen the stress resistance and time management ability of nursing students.

Nursing Students' Experiences on Psychosocial Learning Environment, Personal and Social Challenges and Communication in Periods of Social Isolation: A Qualitative Study

In March 2020, the World Health Organization declared the global COVID-19 pandemic outbreak and the Norwegian government declared lockdown to stop the virus from spreading. In Norway, universities were immediately closed, and all teaching and learning were done digitally for the rest of the spring semester 2020. Our aim was to explore nursing students experience with studying and learning, as well as the psychological consequences it may incur during a period of social isolation during the Covid-19 pandemic lockdown. The study is a qualitative study based on a focus group with 6 nursing students. The analysis was conducted following Kvale's approach to qualitative analysis. Three main categories were identified: (1) psychosocial learning environment, (2) personal and social challenges, and (3) communication. We found that the restrictions due to social isolation and pandemic restrictions such as closing of the university campus, has impacted students` study situation significantly, both psychosocially and academically. If social isolation should be necessary in the future, universities need to use methods such as group discussions, quizzes, and short breaks in the lectures to prevent unnecessary problems among the students. Personal challenges due to the social isolation, such as anxiety or other mental health issues are more difficult to avoid or prevent, but the universities must be better prepared to give students more personal communication, have unformal meetings and providing more information to the students in times of crisis.

Nursing students' experience of workplace violence in clinical practice: A qualitative systematic review

AIMS

To systematically identify, appraise and synthesise qualitative studies investigating Registered Nurse students' (RNS) experiences of workplace violence (WPV) while on clinical placement. It is expected that the literature review findings will guide the development of targeted programs and policies to address WPV against RNS.

BACKGROUND

WPV affects RNS during clinical placements as they are vulnerable to violence due to their limited experience and skills to challenge abusive behaviour. In this review, RNS are students enrolled in a Bachelor of Nursing program to become registered nurses and exclude students who are enrolled in nursing program that does not lead to registration as a registered nurse. For example, enrolled in nursing programs and postgraduate nursing programs. RNS are chosen for their scope of practice and the training requirements. RNS reported experiencing WPV mainly from colleagues, staff, teachers, doctors and supervisors, which resulted in leaving nursing practice, impacting students' progression and healthcare systems. This review examines all types of violence RNS face irrespective of the abuser.

METHODS

A qualitative systematic review of existing literature was conducted through a comprehensive database search of eight databases MEDLINE, CINAHL, Web of Science, Scopus, Embase, Cochrane Central and ProQuest. Furthermore, reference lists of included studies were searched to identify further research. English language qualitative primary studies of any study design were searched from inception to 6th June 2022 and included if they met the inclusion criteria. Double review process utilised from screening until data synthesis reported according to PRISMA. JBI critical appraisal tools were used to assess the studies, and data extraction utilised JBI QARI tool and screened for credibility and confidence in findings.

RESULTS

A total of 18 studies met the inclusion criteria, and the studies were conducted in nine countries. Five main themes relating to RNS experiences of WPV while on clinical placement were identified, including: 'Types of workplace violence', 'Perpetrators', 'Causes', 'Consequences' and 'Management of workplace violence'.

CONCLUSIONS

This qualitative systematic review provides new and significant knowledge in understanding the phenomenon of WPV experienced by RNS while on clinical placement.

RELATIVE TO CLINICAL PRACTICE

This review highlights the unwillingness of RNS to reach out to instructors or clinical placement leaders in many situations and identifies avenues of support and awareness that are crucial to empower and enabling students to seek support.

Enhancing Chinese students' academic engagement: the effect of teacher support and teacher-student rapport

Academic engagement plays an undeniable role in students' leaning outcome. Therefore, identifying the influential antecedents of promoting students' academic engagement is extremely crucial. Despite previous empirical studies have delved into the part played by several student-related and teacher-related factors in triggering Chinese students' academic engagement, the exploration on the roles of teacher support and teacher-student rapport is still scant. Thus, this study attempts to concentrate on the influence of teacher support and teacher-student rapport on undergraduate students' academic engagement in China. Three scales of the questionnaire-one each for teacher's support, student-teacher rapport, and the level of academic engagement-were completed by a total of 298 undergraduate students. Spearman Rho test was adopted to detect the correlations between the variables. Following that, multiple regression analysis was used to estimate the predictive power of the dependent variables. The result found that teacher support and teacher-student rapport exert a tremendous influence on boosting Chinese students' academic engagement. The leading implications and future directions are also presented.

Importance of Soft Skills in Health Sciences Students and Their Repercussion after the COVID-19 Epidemic: Scoping Review

Soft skills (SKs) are skills related to the interaction among people and their way of dealing with tasks. Increasingly valued in the workplace, they are especially relevant in health professionals due to the importance of the relationship among them and their patients and families. Given their importance, the university training of healthcare professionals must promote the development of SKs. The COVID-19 pandemic has been a turning point in many areas, changing the learning process and, even more, the use of these soft skills as a fundamental ingredient in human relationships. The aim of this study was to analyse the available evidence regarding SKs in health science students, specifically nursing students, and to describe whether there is a worsening in the development of such skills after the COVID-19 pandemic. According to the PRISMA-ScR methodology for systematic reviews, this study included articles on social skills and possible changes in these skills as a consequence of the pandemic in health sciences students The results highlight the importance of these emotional competences for future nurses, being particularly relevant for communication and emotional self-awareness and showing their influence on academic aspects, such as academic performance or mental health and coping skills. A major limitation of the present study was not considering aspects such as compassion or empathy. However, the novelty provided by this work is the analysis of the changes in SKs produced as a consequence of the pandemic. It is definitely clear that there is a need to enhance emotional intelligence, and thus soft skills, in future health professionals.

The influence of emotional burnout and resilience on the psychological distress of nursing students during the COVID-19 pandemic

The aim of this study was to measure and analyse the association of emotional burnout and resilience with the psychological distress of students who finished their nursing studies after the peak of the COVID-19 pandemic. The mental health of nursing students was affected during the pandemic, and resilience seems to counteract the negative effects. This is a cross-sectional study. The data (quantitative) were gathered at the beginning of the second term of the academic year 2020/2021. The study was carried out in the Spanish university context. Self-reported measures were gathered using three one-dimensional, valid, and reliable scales: the Psychological Distress Scale (K-10), the Emotional Burnout Scale (EBS), and the short version of the Connor-Davidson Resilience Scale (CD-RISC10). A total of 393 students of different Spanish universities participated in this study. A valid linear regression model was obtained, which allowed verifying that psychological distress is explained, with 37% variance, by emotional burnout and resilience. The total score in emotional burnout has more relevance than the total score in resilience, and the latter has a negative tendency. Facing the factors that generate emotional burnout in students in the academic scope and promoting resilience in them are fundamental aspects that contribute to their psychological well-being. The reflection should be extended to clinical practices. Universities are urged to think about last-year students, their experiences, perceptions, and feelings, to determine how their susceptibility to emotional burnout and psychological distress can be minimized in their future clinical practices. Strategies to promote their resilience should also be studied.