Educational Department, Gansu Provincial Hospital, Lanzhou, China.
Nursing Department, Ningxia Hui Autonomous Region Hospital of Integrated Traditional Chinese and Western Medicine, China.
Nurse Educ Today. 2024 Nov;142:106327. doi: 10.1016/j.nedt.2024.106327. Epub 2024 Aug 5.
Nursing students are often subjected to bullying during their clinical practices, but few study has examined associations of bullying with psychological status among these groups, and how they cope with the bullying.
This study aimed to evaluate the experience and psychological status of clinical placement setting bullying among nursing students attending clinical practices, and explore students' coping strategies when bullied.
A mixed methods.
Six tertiary hospitals in Northwest China.
A total of 687 nursing students completed the questionnaire survey, of which 18 nursing students participated in the qualitative interview.
A two-phase hybrid study was produced. During first phase, data were collected by using the Bullying Behavior Scale in Nursing Education (BNEQ) and the Depression, Anxiety and Stress Scale (DASS-21). Subsequently, those who have experienced bullying in the workplace were invited to participate in a face-to-face interview (second phase) which focused on exploring students' deeper insights.
Of the 687 students involved, 72.19 % had experienced various types of bullying. Of them, 92.11 % experienced implicit violence. Those with higher education levels and from rural were more likely to experience bullying. Students were prone to greater psychological stress when exposed to bullying. "Pretending not to see" (33.16 %), "reporting to superiors" (30.10 %), and "doing nothing" were the most common ways students responded. Four themes were obtained from the qualitative interviews: (a) impaired self-esteem; (b) career rejection; (c) psychological stress; and (d) the decline of humanistic care.
Our findings suggest that senior nursing students experience multiple types of bullying during the clinical practices, leading to a high level of psychological stress, which further effect students' professional approval and self-esteem. To prevent such incidents, we need to call on university and hospitals' support to help students successfully cope with bullying.
护理学生在临床实习中经常遭受欺凌，但很少有研究调查欺凌与这些群体的心理状态之间的关系，以及他们如何应对欺凌。
本研究旨在评估护理学生在临床实习中经历的临床环境欺凌体验和心理状态，并探讨学生在受到欺凌时的应对策略。
混合方法研究。
中国西北地区的六所三级医院。
共有 687 名护理学生完成了问卷调查，其中 18 名护理学生参加了定性访谈。
采用两阶段混合研究方法。第一阶段，使用护理教育中的欺凌行为量表（BNEQ）和抑郁、焦虑和压力量表（DASS-21）收集数据。随后，邀请在工作场所经历过欺凌的学生参加面对面访谈（第二阶段），重点探讨学生的深入见解。
在参与的 687 名学生中，72.19%的学生经历过各种类型的欺凌。其中，92.11%的学生经历过隐性暴力。文化程度较高和来自农村的学生更容易遭受欺凌。学生在遭受欺凌时更容易产生较大的心理压力。“视而不见”（33.16%）、“向上级报告”（30.10%）和“不作为”是学生最常见的应对方式。从定性访谈中得出了四个主题：（a）自尊心受损；（b）职业拒绝；（c）心理压力；和（d）人文关怀的下降。
我们的研究结果表明，高年级护理学生在临床实习中经历多种类型的欺凌，导致高度的心理压力，进一步影响学生的专业认可和自尊。为了防止此类事件发生，我们需要呼吁大学和医院提供支持，帮助学生成功应对欺凌。
