Xu Yutong, Zhang Wanting, Wang Jia, Guo Zihan, Ma Weiguang
School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
J Adv Nurs. 2024 Mar 11. doi: 10.1111/jan.16144.
The resilience education of intern nursing students has significant implications for the development and improvement of the nursing workforce. The clinical internship period is a critical time for enhancing resilience.
To evaluate the resilience level of Chinese nursing interns and explore the effects of factors affecting resilience early in their careers, focusing on the mediating roles of career adaptability between clinical learning environment and resilience.
The cross-sectional study design was adopted. From March 2022 to May 2023, 512 nursing interns in tertiary care hospitals were surveyed online with the Connor-Davidson Resilience Scale, the Clinical Learning Environment Scale for Nurse and the Career Adapt-Abilities Scale. Structural equation modelling was used to clarify the relationships among these factors. Indirect effects were tested using bootstrapped confidence intervals.
The nursing interns showed a moderately high level of resilience [M (SD) = 70.15 (19.90)]. Gender, scholastic attainment, scholarship, career adaptability and clinical learning environment were influencing factors of nursing interns' resilience. Male interns with good academic performance showed higher levels of resilience. Career adaptability and clinical learning environment positively and directly affected their resilience level (β = 0.62, 0.18, respectively, p < .01). Career adaptability was also positively affected by the clinical learning environment (β = 0.36, p < .01), and mediated the effect of clinical learning environment on resilience (β = 0.22, p < .01).
Clinical learning environment can positively affect the resilience level of nursing interns. Career adaptability can affect resilience directly and also play a mediating role between clinical learning environment and resilience. Thus, promotion of career adaptability and clinical teaching environment should be the potential strategies for nursing interns to improve their resilience, especially for female nursing interns with low academic performance.
实习护生的复原力教育对护理人才队伍的发展与提升具有重要意义。临床实习阶段是增强复原力的关键时期。
评估中国护理实习生的复原力水平，探索职业生涯早期影响复原力的因素，重点关注职业适应能力在临床学习环境与复原力之间的中介作用。
采用横断面研究设计。2022年3月至2023年5月，对三级甲等医院的512名护理实习生进行在线调查，使用康纳-戴维森复原力量表、护士临床学习环境量表和职业适应能力量表。采用结构方程模型来阐明这些因素之间的关系。使用自抽样置信区间检验间接效应。
护理实习生表现出中等偏高的复原力水平[M(SD)=70.15(19.90)]。性别、学业成绩、奖学金、职业适应能力和临床学习环境是护理实习生复原力的影响因素。学业成绩良好的男性实习生表现出更高的复原力水平。职业适应能力和临床学习环境对其复原力水平有正向直接影响(β分别为0.62、0.18，p<0.01)。职业适应能力也受到临床学习环境的正向影响(β=0.36，p<0.01)，并在临床学习环境对复原力的影响中起中介作用(β=0.22，p<0.01)。
临床学习环境可对护理实习生的复原力水平产生积极影响。职业适应能力既能直接影响复原力，也在临床学习环境与复原力之间起中介作用。因此，提升职业适应能力和临床教学环境应是护理实习生提高复原力的潜在策略，尤其是对于学业成绩较低的女性护理实习生。
