College of Nursing, University of Santo Tomas, Manila, Philippines.
School of Nursing, Midwifery and Social Sciences, Central Queensland University, Rockhampton, Queensland, Australia.
Int J Ment Health Nurs. 2023 Oct;32(5):1390-1404. doi: 10.1111/inm.13179. Epub 2023 May 30.
Nursing students' stress, protective factors (e.g. resilience, social support, mindfulness and self-efficacy) and psychological well-being (PWB) have been well reported in the literature. However, the interactions of these variables were scarcely examined in the latter part of the COVID-19 pandemic and in the context of a developing country. This cross-sectional correlational study complying with STROBE guidelines tested a hypothetical model of the interrelationships of nursing students' stress, protective factors and PWB using structural equation modelling (SEM). Nursing students (n = 776) from five nursing schools in the Philippines were conveniently recruited from September 2022 to January 2023. Six validated self-report scales (Perceived Stress Scale, Multi-dimensional Scale of Perceived Social Support, Generalized Self-Efficacy Scale, Connor-Davidson Resilience Scale, Mindful Attention Awareness Scale, and Psychological Wellbeing Scale) were used to collect data. SEM, mediation analyses and path analyses were used for data analysis. The emerging model demonstrated acceptable model fit parameters. Stress negatively impacted protective factors, while all the protective factors positively influenced PWB. Social support mediated the influence of stress on resilience, mindfulness and PWB. Resilience is a significant mediator of stress, self-efficacy, social support and PWB. Mindfulness mediated the influence of stress, social support and self-efficacy on PWB. Finally, self-efficacy had a mediating role between resilience and mindfulness. Nursing institutions and nurse educators can use the proposed model as their basis for empirical and theoretical evidence in creating programmes that will strengthen nursing students' protective factors, thus reducing stress while improving PWB and learning outcomes.
护理专业学生的压力、保护因素（如韧性、社会支持、正念和自我效能感）和心理健康（PWB）在文献中已有详细报道。然而，在 COVID-19 大流行后期和发展中国家的背景下，这些变量的相互作用很少被研究。本横断面相关性研究遵循 STROBE 指南，使用结构方程模型（SEM）检验了护理专业学生压力、保护因素和 PWB 之间相互关系的假设模型。2022 年 9 月至 2023 年 1 月，从菲律宾五所护理学校方便招募了护理专业学生（n=776）。使用了六个经过验证的自我报告量表（感知压力量表、多维感知社会支持量表、一般自我效能感量表、Connor-Davidson 韧性量表、正念注意意识量表和心理健康量表）来收集数据。使用 SEM、中介分析和路径分析进行数据分析。新兴模型显示出可接受的模型拟合参数。压力对保护因素有负面影响，而所有的保护因素都对 PWB 有积极影响。社会支持中介了压力对韧性、正念和 PWB 的影响。韧性是压力、自我效能感、社会支持和 PWB 的重要中介。正念中介了压力、社会支持和自我效能感对 PWB 的影响。最后，自我效能感在韧性和正念之间起中介作用。护理机构和护士教育者可以将提出的模型作为他们的基础，为创造能够增强护理专业学生保护因素的项目提供实证和理论依据，从而减轻压力，同时提高 PWB 和学习成果。
