Public Health Sciences Department, University of Liege, Liege, Belgium.
Interfaculty Research Unit in Didactics and Teacher Training, University of Liege, Liege, Belgium.
J Adv Nurs. 2021 Jun;77(6):2748-2760. doi: 10.1111/jan.14806. Epub 2021 Mar 3.
To describe nursing student self-esteem prior to the influence of nursing education and to explore the relationship between self-esteem and dropout.
Cohort study.
At the beginning of their first year of study, in October 2017, 464 nursing students completed a questionnaire that assessed their self-esteem level via Tafarodi & Swann Scale and self-esteem profile following Mruk's model, along with sociodemographic information, state anxiety, self-efficacy, intention to continue and social support. One year later, data on grades and re-enrolment were collected. Multivariate analyses explored the factors influencing self-esteem level (multiple regression), self-esteem profile (multinomial logistic regression) and dropout (binary logistic regression).
RESULTS/FINDINGS: The mean level of self-esteem was 50.8 (9.0), scale of 16 to 80. Forty-nine per cent of self-esteem profiles were classified as 'high', 20.1% as 'defensive acceptance based', 11.2% as 'defensive achievement based' and 19.6% as 'low'. State anxiety (p < 0.0001), self-efficacy about completion of the nursing programme (p < 0.0001) and self-efficacy about internship (p < 0.0001) were associated with self-esteem. The dropout rate was 21.5%. Self-esteem level (p = 0.039) and academic performance (p < 0.0001) were associated with dropout.
While nursing student self-esteem is often described as low, we know little about its baseline before entering the nursing programme and the factors that influence it. The dropout rate among first-year nursing students is high, but self-esteem is rarely explored as a possible explanation. We found that students had medium, and potentially fragile, self-esteem when starting their nursing education, and that self-esteem was associated with dropout.
Given that association and the impact of self-esteem on well-being and professional behaviour, educational institutions should foster self-esteem both generally and in students with anxiety or low self-efficacy. Future research should explore nursing student self-esteem using a longitudinal mixed methods approach. Society should value nurses and nursing students.
描述护理专业学生在接受护理教育之前的自尊状况，并探讨自尊与辍学之间的关系。
队列研究。
在 2017 年 10 月，即第一学年开始时，464 名护理专业学生填写了一份问卷，该问卷使用 Tafarodi 和 Swann 量表以及 Mruk 模型的自尊量表评估他们的自尊水平，同时还收集了人口统计学信息、状态焦虑、自我效能感、继续学习的意向和社会支持。一年后，收集了成绩和重新注册的数据。多元分析探讨了影响自尊水平（多元回归）、自尊模式（多项逻辑回归）和辍学（二项逻辑回归）的因素。
结果/发现：自尊的平均水平为 50.8（9.0），范围为 16 到 80。49%的自尊模式被归类为“高”，20.1%为“防御性接纳”，11.2%为“防御性成就”，19.6%为“低”。状态焦虑（p<0.0001）、完成护理计划的自我效能感（p<0.0001）和实习的自我效能感（p<0.0001）与自尊相关。辍学率为 21.5%。自尊水平（p=0.039）和学业成绩（p<0.0001）与辍学相关。
虽然护理专业学生的自尊通常被描述为较低，但我们对他们进入护理项目之前的自尊基线以及影响自尊的因素知之甚少。一年级护理专业学生的辍学率很高，但很少有研究探讨自尊是否是一个可能的原因。我们发现，学生在开始护理教育时自尊心处于中等水平，而且可能较为脆弱，自尊与辍学有关。
鉴于这种关联以及自尊对幸福感和职业行为的影响，教育机构应该普遍培养学生的自尊心，并特别关注那些有焦虑或低自我效能感的学生。未来的研究应该使用纵向混合方法来探讨护理专业学生的自尊。社会应该重视护士和护理专业的学生。
