Moderating Role of Coping Style on the Relationship between Stress and Psychological Well-Being in Hong Kong Nursing Students

The effect of laughter therapy on self-efficacy and psychological well-being in nursing students

BACKGROUND

Academic self-efficacy and psychological well-being play a crucial role in the mental health of nursing students and influence whether they decide to remain in the nursing profession.

AIMS

This study aimed to determine the effect of laughter therapy on self-efficacy and psychological well-being in nursing students.

METHODS

In this randomized controlled study, 208 nursing students were randomly assigned to an experimental (n = 102) and a control (n = 106) group. The experimental group received laughter therapy face-to-face once a week for eight weeks. No intervention was applied to the control group. In both groups, data were collected at the beginning of the study and the end of the eighth week using a Sociodemographic Questionnaire Form, the Academic Self-Efficacy Scale, and the Psychological Well-Being Scale.

RESULTS

In the post-study group comparisons, there was a statistically significant difference in the scores for the total Academic Self-Efficacy Scale, the external emotion management and collegiality subscales, and the total Psychological Well-Being Scale (p > 0.05). With regard to all the scale scores, no statistically significant difference was found in the groups in the pre- and post-comparisons (p > 0.05).

CONCLUSIONS

It was determined that laughter therapy increased the mean psychological well-being score in the experimental group. It was also found that after the laughter therapy, distraction and loss of interest in lectures decreased, stress and anxiety levels decreased, eating and sleeping habits were regulated, and social media use decreased. Laughter therapy can be used to increase self-efficacy and psychological well-being.

Academic resilience in nusing students: a concept analysis

BACKGROUND

Academic resilience is a crucial concept for nursing students to cope with academic challenges. Currently, there is significant variation in the description of the concept attributes of academic resilience among nursing students, which impedes the advancement of academic research. Therefore, it is essential to establish a clear definition of the concept of academic resilience for nursing students.

PURPOSE

The purpose of this paper is to report the results of concept analysis of academic resilience of nursing students.

METHODS

The Rodgers evolutionary concept analysis was employed to test the attributes, antecedents, consequences and related concepts of academic resilience of nursing students. Walker and Avant's method was utilized to construct a model case and provide empirical referents.

RESULTS

The findings indicate that the attributes of nursing students' academic resilience include self-efficacy, self-regulation and recovery, and the antecedents include internal factors and external environmental factors. The consequences include adaptability, career maturity, adversity quotient level, probability of academic success, a sense of belonging to school and low levels of psychological distress.

CONCLUSION

The systematic understanding of academic resilience among nursing students provides a pathway for nursing educators and students to enhance academic resilience, promote academic success, and establish a foundation for the training of more qualified nurses.

The process and indicators of resilience among nursing students in clinical practicum in Taiwan: A qualitative study

Background

Resilience is essential for managing stress and maintaining equilibrium. During the clinical practicum, nursing students may experience tremendous physical and mental stress, and these negative experiences are considered a source of resilience for students. However, no universal definition of resilience among nursing students exists in the literature, occasioning the need to define the processes and indicators of resilience.

Purpose

This study aims to explore the resilience process and indicators among nursing students in clinical practicum in Taiwan. Participants: Fifteen fifth-year junior college nursing students in Northeastern Taiwan who had completed the clinical practicum were interviewed, including 12 females and three males. All participants were aged 20.3 ± 0.61 years and all participants had clinical practicum experiences over four months.

Methods

A qualitative descriptive study, using purposive and snowball sampling methods, was conducted to collect the experience of the nursing students in their internship. Data were collected using a semi-structured guide and deep interviews, and analyzed through the content analysis method by Waltz, Strickland, & Lenz (2010).

Results

Based on the participants' practical experiences during their clinical practicum, three main themes and nine indicators were identified. The resilience of nursing students is considered a process. The main themes are (1) uncontrolled clinical practical stress, (2) Maintain learning-life balance, (3) Positive attitude toward nursing.

Conclusions

Resilience is a critical factor to stabilize nursing students and enable them to recover from adversity. Both positive and negative experiences significantly impacted the students' attitudes and confidence levels during the clinical practicum. The findings will provide faculty to adapt their teaching method to various situations of nursing students.

A study on different types of moral courage and coping styles of clinical nurses: based on potential profile analysis

BACKGROUND

In professional ethics-related events, there are various unpleasant and complex ethical issues that require strong moral courage. Our aim is to identify and describe the potential categories of moral courage among nurses and to clarify the coping styles of nurses under different categories.

METHOD

A cross-sectional study was conducted using three data collection tools: a self-designed general information questionnaire, a Chinese version of the Moral Courage Scale, and a Trait Coping Style Questionnaire. Three hundred fourteen nurses from a tertiary hospital in Heilongjiang Province, China, were analysed using potential profile analysis, descriptive analysis, and Mann-Whitney U test data.

RESULT

The latent profile analysis (LPA) results indicate that the two-profile model is the most suitable and supports the existence of two different moral courage profiles: the low moral courage group (60.51%) and the high moral courage group (39.49%), with a high relative entropy value (0.922). The results point to a good profile solution, and there are significant differences between the two profiles. The Mann-Whitney U-test results showed that the positive coping scores of the high moral courage group were significantly higher than those of the low moral courage group, and the negative coping scores of the high moral courage group were significantly lower than those of the low moral courage group.

CONCLUSION

Our results reveal the heterogeneity of moral courage in the nurse sample and indicate that nurses in the high moral courage group tend to choose positive coping styles, while nurses in the low moral courage group are more likely to develop negative coping emotions. This provides important significance and reference value for nursing managers, who can propose customised management plans based on the types of moral courage of the nursing community and the coping styles under different categories.

Associations among stressors, perceived stress, and psychological distress in nursing students: a mixed methods longitudinal study of a Hong Kong sample

Background

Nursing students are at risk for high-stress levels and psychological distress. Limited longitudinal studies have been conducted examining factors associated with stress levels and psychological distress of nursing students in their course of study.

Purpose

The purpose of this study was to examine the levels of stress and corresponding stressors, particularly those predicting psychological distress, among nursing students over their 5 years of study.

Methods

A longitudinal design, using questionnaires and focus group interviews of a single cohort of nursing students in Hong Kong and following them over their 5 years of training. The Stressors in Nursing Students Scale-Chinese version and the Chinese version of General Health Questionnaire-12 were used to assess stress levels and psychological distress, respectively.

Results

Ninety-seven participants completed the questionnaires 5 times. Quantitative findings revealed that the overall stress levels of the nursing students increased over 5 years (from mean = 3.08 to 3.33), with the highest levels in the second wave (mean = 3.33). Nursing students experienced higher stress during years 2 (p = 0.006) and 4 (p = 0.037). Psychological distress was the highest in year 3 (sum score = 18.47) (p = 0.002) but declined from year 4 (p < 0.001). Thematic analysis revealed that academic performance issues, coping challenges, unfavorable learning environments, relationships were identified as the stressors. However, nursing students also used positive coping strategies to pursue success and seek support.

Conclusion

This study suggests that the year of study is a significant predictor of stress levels among nursing students, especially during the first and senior years due to heavy academic workload. Psychological distress was observed among nursing students, and those who worked more part-time jobs tended to report higher levels of distress. The junior year was associated with higher levels of distress related to financial and time-related stress, while academic and personal problems were more prevalent during the senior year.

COVID-19 perseverative cognition and depressive symptoms in Hong Kong: The moderating role of resilience, loneliness and coping strategies

BACKGROUND

The COVID-19 pandemic significantly increased depression prevalence in general population. However, the relationship between persistent dysfunctional thinking associated with COVID-19 (perseverative-cognition) and depression, and its potential moderators are understudied. We aimed to examine the association between COVID-19 perseverative-cognition and depression, and the moderating effect of potential risk and protective factors on this association in general public during the peak of fifth COVID-19 wave in Hong Kong.

METHODS

This survey recruited 14,269 community-dwelling adults between March 15-April 3, 2022 to investigate association between COVID-19 perseverative-cognition and depression, and the moderating effect of resilience, loneliness and three coping strategies (including emotion-focused, problem-focused and avoidant coping) on this association, using hierarchical regression models and simple slope analyses. COVID-19 perseverative cognition was assessed by the Obsession with COVID-19 Scale (OCS) and depressive symptoms were measured by the Patient Health Questionnaire-9 (PHQ-9).

RESULTS

Perseverative-cognition was positively associated with depression severity. Resilience, loneliness and three coping strategies moderated the association between perseverative-cognition and depression. Specifically, greater resilience and emotion-focused coping ameliorated the association between perseverative-cognition and depression, while higher levels of loneliness, avoidant and problem-focused coping accentuated such association.

LIMITATIONS

Cross-sectional design precluded establishing causality among variables.

CONCLUSION

This study affirms that COVID-19 perseverative-cognition is significantly related to depression. Our findings indicate the potential critical role of enhanced personal resilience and social support, and adoption of emotion-focused coping in mitigating negative effect of COVID-19 related maladaptive thinking on depression severity, thereby facilitating development of targeted strategies to reduce psychological distress amidst the prolonged pandemic.