Nursing students' perceived stress, social support, self-efficacy, resilience, mindfulness and psychological well-being: A structural equation model.

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.

Resilience and academic motivation's mediation effects in nursing students' academic stress and self-directed learning: A multicenter cross-sectional study.

AIMS: To investigate the mediating role of resilience and academic motivation between academic stress and self-directed learning. BACKGROUND: Academic stress in nursing students is a well-reported concept that affects resilience, academic motivation and self-directed learning. However, there is a dearth of studies investigating the mediating role of resilience and academic motivation between academic stress and self-directed learning. DESIGN: Cross-sectional study and mediation analysis. METHODS: Nursing students (n = 718) were recruited from five nursing schools via convenience sampling. Four self-report scales (Perception of Academic Stress Scale, Connor and Davidson Resilience Scale, Short Academic Motivation Scale and Self-directed Learning Instrument) were used to collect data from August to December 2022. Pearson's r, bivariate analysis and multistage regression analyses were employed to analyze the data. RESULTS: Academic stress negatively influences nursing students' resilience, academic motivation and self-directed learning. Resilience and academic motivation have a positive impact on self-directed learning. Resilience and academic motivation mediate the relationship between academic stress and self-directed learning, as evidenced by a reduction in the negative impacts of academic stress on nursing students. CONCLUSION: Resilience and academic motivation, as mediators, reduce the effects of academic stress on self-directed learning. Nursing educators and administrators should promote programs that strengthen resilience and academic motivation. Thus, improving educational and clinical performance.

Structural equation modelling of ethicomoral values and competence of nurses during the COVID-19 pandemic.

Background: The COVID-19 pandemic is a global health crisis that affected nurses' professional values and competence. Aim: Our study examined the relationship between nurses' professional values and competence in Saudi Arabia during the COVID-19 pandemic. Methods: This study used a descriptive cross-sectional design with 748 nurses from Saudi Arabia. Two self-report instruments were used to collect data. Structural equation modelling was conducted to analyse the data. Findings: The emerging model showed acceptable model-fit indices. Two dimensions of nurse professional values significantly affected professional competence: professionalism and activism. Professionalism significantly affected the other four facets (e.g., caring, activism, trust, and justice) of nurse professional values. The dimension of caring had a strong direct effect on activism. Justice had a moderate direct impact on trust, while activism had a weak direct impact on trust. Professionalism and caring had strong indirect effects on professional competence by mediating the dimension of activism. Discussion: The study's findings highlight the need for strategies to evaluate and strengthen the various areas of professional values to foster professional competence among nurses. Moreover, nurse administrators should encourage nurses to participate in continuing nursing education programs or provide in-service educational training to promote professional values and competence. Conclusion: This study provides a structural model of the interaction between nurses' professional values and competence during the pandemic. Nurse administrators can leverage the presented model to develop policies and strategies to evaluate and strengthen nurses' professional values and competence.

Structural Equation Modelling of Professional Values and Competency of Nurses During the COVID-19 Pandemic

Background The COVID-19 pandemic is a global health crisis that affected nurses' professional values and competence. Aim Our study examined the relationship between nurses' professional values and competence in Saudi Arabia during the COVID-19 pandemic. Methods This study used a descriptive cross-sectional design with 748 nurses from Saudi Arabia. Two self-report instruments were used to collect data. Structural equation modelling was conducted to analyse the data. Findings The emerging model showed acceptable model fit indices. Two dimensions of nurse professional values significantly affected professional competence: professionalism and activism. Professionalism significantly affected the other four facets (e.g., caring, activism, trust, and justice) of nurse professional values. The dimension of caring had a strong, direct effect on activism. Justice had a moderate, direct impact on trust, while activism had a weak, direct impact on trust. Professionalism and caring had strong, indirect effects on professional competence by mediating the dimension of activism. Discussion The study's findings highlight the need for strategies to evaluate and strengthen the various areas of professional values to foster professional competence among nurses. Moreover, nurse administrators should encourage nurses to participate in continuing nursing education programs or provide in-service educational training to promote professional values and competence. Conclusion This study provides a structural model of the interaction between nurses' professional values and competence during the pandemic. Nurse administrators can leverage the presented model to develop policies and strategies to evaluate and strengthen nurses' professional values and competence.

Adherence to COVID-19 health protocols in an online news context in the Philippines: A manifest content analysis.

OBJECTIVES: Globally, adherence to COVID-19 health and safety protocols played a crucial role in preventing the spread of the virus. Thus, this study analyzed online news articles reporting adherence to COVID-19 health and safety protocols in the Philippines. DESIGN: Manifest content analysis. SAMPLE: News articles (n = 192) from three major online news portals in the Philippines. MEASUREMENT: Published online news articles were collected during the peak of the COVID-19 pandemic (March 2020 to March 2021). Bengtsson's content analysis approach was used to analyze the data. Member-checking and intercoder reliability validated the study's results. RESULTS: Three main themes emerged: (a) adherence, (b) non-adherence, and (c) partial adherence. The subthemes were labeled who, what, when, where, and why. The same behavior, social distancing, was the most adhered to and non-adhered COVID-19 health protocol. This protocol has the highest occurrences in political protest, religious-related activities, and self-initiated quarantine. Leisure activities both showed non-adherence and partial adherence. CONCLUSIONS: Online news articles depicted Filipinos' adherence to health and safety protocols. Their adherence was primarily determined by one's group or community, social norms, and values. The government and its public health agencies should strengthen current efforts and continuously re-evaluate existing policies to modify ineffective and confusing safety health protocols.

Academic stress, COVID-19 anxiety, and quality of life among nursing students: The mediating role of resilience.

AIM: This study investigated the mediating role of resilience in the relationship between academic stress, COVID-19 anxiety, and quality of life (QoL) among Filipino nursing students during the COVID-19 pandemic. BACKGROUND: The COVID-19 pandemic has impacted the QoL of nursing students who are experiencing mental health issues. The mediating role of resilience in mitigating the effects of academic stress and COVID-19 anxiety on nursing students' QoL remains understudied. METHODS: This study employed a correlational cross-sectional design, with a convenience sample of 611 Filipino nursing students. Data were collected using the scales Connor and Davidson Resilience, Brunnsviken Brief Quality of Life, COVID-19 Anxiety, and Perception of Academic Stress and analyzed using Pearson's r, bivariate analysis, and multistage regression analyses. RESULTS: Academic stress and COVID-19 anxiety negatively correlated with QoL and resilience. Resilience was positively associated with QoL and reduced the effect of academic stress on QoL, indicating that resilience is a crucial mediating variable between academic stress and QoL. Finally, resilience had a significant mediating influence on QoL, as evidenced by a reduction in the effect of COVID-19 anxiety on QoL among nursing students. CONCLUSIONS: Filipino nursing students' QoL was affected by academic stress and COVID-19-related anxiety. However, resilience mediated this impact, preserving QoL. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Nursing colleges and affiliated hospitals must collaborate to monitor academic stress and pandemic-related anxiety. Nursing students should be provided with programs such as seminars and team-building activities to enhance their resilience.

Nursing staff's compliance and adherence to standard precautions during the COVID-19 pandemic: A cross-sectional study.

This study investigated the compliance and adherence of nurses, midwives, and nursing assistants to standard precautions (SPs). A cross-sectional design while adhering to STROBE guidelines was used for this study. Nursing staff (nurses, nursing assistants, and midwives) from a government tertiary hospital (n=515) were recruited and completed the Compliance with Standard Precautions Scale (CSPS) and Factors Influencing Adherence to Standard Precautions Scale (FIASPS). Analysis of variance (ANOVA), Pearson correlation, and linear regression analysis were used to analyze the data. The overall average compliance with the SPs of the nursing staff was suboptimal, and the disposal of sharps domain had the lowest compliance. Nurses are more compliant with sharps disposal than nursing assistants with waste disposal. Contextual cues were the most influential aspect of participants' adherence to SPs. All CSPS domains were significantly correlated with the contextual cues factor of FIASPS. Finally, service years and educational attainment were significant predictors of SPs adherence. The findings underscore the organization's critical responsibility to actively enforce policies using monitoring systems and contextual cues in the workplace to ensure staff compliance and adherence with SPs.

Filipinos' COVID-19 vaccine hesitancy comments in TikTok videos: A manifest content analysis.

OBJECTIVES: Vaccine hesitancy is one of the top 10 threats to world health. The ongoing pandemic highlighted this health threat. The COVID-19 vaccine hesitancy remains underreported in the Philippines. Thus, this study aimed to describe and analyze the comments of Filipinos in TikTok videos about COVID-19 vaccine hesitancy. DESIGN: Manifest content analysis. SAMPLE: A total of 25 TikTok videos and their comments (n = 4564) were analyzed. METHODS: We collected data between July 2021 and October 2021. Bengtsson's approach to content analysis was utilized to analyze the data. Data were validated using member-checking and intercoder reliability. RESULTS: This study afforded three themes of COVID-19 vaccine hesitancy: (a) fear and mistrust (subthemes: influence of Dengvaxia vaccine, the influence of people who refuse to be vaccinated, lack of trust in the government, lack of trust in healthcare workers, doubts on vaccines' effectiveness), (b) misinformation and disinformation (subthemes: misbeliefs, insufficient knowledge), and (c) adamant attitudes (subthemes: unwillingness to be vaccinated, picky on vaccine brand). CONCLUSION: Our study established Filipinos' diverse reasons for COVID-19 vaccine hesitancy. TikTok, as a social media platform, is used for COVID-19 vaccine discussions and the dissemination of misinformation. To prepare for the next pandemic or public health disaster, the government, HCWs, and the public must efficiently convey timely, accurate health information and dispel misinformation on social media platforms.

Filipino Nursing Students' Use of Low-cost Simulators During the COVID-19 Pandemic: A Summative Content Analysis of YouTube Videos.

Introduction: : This study examined Filipino nursing students' use of household materials as low-cost simulators and how they aid in online return demonstrations. Methods: : Summative content analysis guided this study. We collected uploaded YouTube videos (n=14) depicting Filipino nursing students using low-cost simulators in their skills demonstration. We used Bengtsson's approach to content analysis to analyze the data. Findings: : Four themes of low-cost simulators were identified: home and hardware, health and beauty, creative articles, and entertainment. The categories under home and hardware were tools, containers, furniture, and packaging. Health and beauty low-cost simulators were toiletries and medical supplies. Creative articles included fabrics, clothing accessories, and stationeries. Entertainment low-cost-simulators had toys and computer accessories. Discussion: : During the COVID-19 pandemic, our research uncovered home equipment employed as low-cost simulators to help nursing students' online simulation of skills demonstration. We recommend further investigation of whether students learned using low-cost simulators.

The moderating effect of burnout on professionalism, values and competence of nurses in Saudi Arabia amidst the COVID-19 pandemic: A structural equation modelling approach.

AIM: To examine the moderating effect of burnout on the relationship between nurses' competence, professional competence and professional values. BACKGROUND: There is a preponderance of burnout studies of nurses before and during the COVID-19 pandemic. However, little is known about burnout's moderating influence on nurses' professionalism, competence and values during the ongoing pandemic. METHODS: This study used a correlational, cross-sectional design and convenience sampling to recruit 809 Saudi nurses employed in four government hospitals. Four self-report instruments were used to collect data from August 2021 to March 2022. Spearman Rho, structural equation modelling and multi-group moderation analysis were used to analyse the data. RESULTS: Most of the participants had high burnout. There was a moderate to high correlation between the dimensions of professional competence, nurse professional values, burnout and nurse competence. Both professional competence and nurse professional values significantly affected nurse competence. Nurse professional values also had a direct effect on professional competence. Professional competence and nurse professional values on nurse competence may vary among those with low, moderate and high levels of burnout, suggesting the moderating effect of burnout. CONCLUSIONS: The positive impacts of nurse professional values and professional competence on nursing competence were validated in this study, as was the evidence of burnout's moderating effect on the studied connections. To avoid burnout, it is necessary to increase organizational knowledge and support for nurses, their working conditions and the environment through strategies that promote well-being and empowerment. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers can implement policies to help nurses minimize burnout and improve their professional values and competence. Management policies may be considered include increased staffing, opportunities to improve technical abilities through education and vocational training programs, and increased diversity of job assignments.

Nurses' professional values and competency in Saudi Arabia: A structural equation modelling approach.

AIMS AND OBJECTIVES: To explore the relationship between Saudi nurses' professional values and competence. BACKGROUND: Professionals are bound by ethical standards specific to their profession. Accordingly, the COVID-19 pandemic is the most significant event that has impacted nurses' professional values and competency. DESIGN: A descriptive cross-sectional design adhering to STROBE guidelines. METHODS: Clinical nurses from four tertiary government hospitals (n = 659) participated and completed two self-report instruments. Study variables were analysed using the structural equation modelling approach. RESULTS: The emerging model displayed acceptable model fit indices. Professionalism and activism were two dimensions of nurse professional values that significantly impacted professional competency. Professionalism significantly impacted the four other aspects of nurse professional values: caring, activism, trust, and justice. Caring had a significant and direct impact on activism. Activism had a weak, direct effect on trust, whereas justice had a moderate, direct effect on trust. Through the mediation of the dimension of activism, both the dimensions of professionalism and caring had a strong, indirect impact on professional competency. CONCLUSIONS: This research presents a structural model of the interrelationship between nurse professional values and competency. Nurse administrators can use the proposed model to develop approaches and policies for assessing, improving and evaluating professional values among nurses. RELEVANCE FOR CLINICAL PRACTICE: Nursing professionals are committed to upholding their ethical and moral standards while performing their caregiver roles. Nurse administrators can implement activities and strategies to develop nurses' professional competence further, as professional values represent the ideal values expected of nurses providing patient care.

Nursing competency inventory and professional competence of graduating students in six Asian countries: A cross-sectional study.

AIMS: To investigate graduating nursing students' nursing and professional competencies and the predictors of their competencies. BACKGROUND: Across Asian countries, there is a paucity of literature that explores graduating nursing students' competency and professional competence during the ongoing COVID-19 pandemic. DESIGN: Descriptive, cross-sectional, and predictive approaches. METHOD: Convenience sampling was used among graduating nursing students from the six Asian countries (n = 375). The STROBE guidelines for cross-sectional studies were used. Two self-report instruments were utilized to collect data. We conducted multiple linear regression analyses to assess the predictors of nursing competency and professional competence domains. RESULTS: Country of residence and general point average (GPA) showed statistically significant multivariate effects. Value-based nursing care and critical thinking and reasoning domains recorded the highest in professional competence and competency inventory for nursing students, respectively. Country of residence, GPA, and preferred nursing major were significant predictors of graduating nursing students' nursing competency and professional competence domains. CONCLUSION: Our study's findings revealed a high level of diversity among nursing students regarding ethical care obligations, caring pedagogies, and lifelong learning, all of which may be ascribed to their distinct culture, background, and belief systems.

Quality of life and academic resilience of Filipino nursing students during the COVID-19 pandemic: a cross-sectional study.

OBJECTIVES: Studies on quality of life (QoL) and academic resilience among nursing students during the Coronavirus disease (COVID-19) pandemic remain underreported. This study investigated the relationship between nursing students' QoL and academic resilience and their predictors during the COVID-19 pandemic. METHODS: A descriptive survey, cross-sectional study that used two self-reported questionnaire scales to evaluate the QoL and academic resilience of Filipino nursing students (n=924). Chi-squared test and multiple regression were used to analyze the data. RESULTS: There was no significant association between the QoL and academic resilience to participants' profile variables. Gender and year level of nursing students were significant predictors of QoL and academic resilience. CONCLUSIONS: Our study concludes that a better understanding of the QoL and academic resilience, which are two distinct concepts critical in developing a student's mental well-being, will help stakeholders in nursing education establish effective psychoeducation programs for nursing students.

Filipinos' health information-seeking behaviors and their implications for COVID-19 vaccination.

OBJECTIVES: This study examined Filipinos' health information-seeking behaviors, specifically their information engagement and apprehension of getting the COVID-19 vaccine, the reasons for vaccination, and how these factors influenced their decision to get vaccinated. DESIGN: Quantitative, cross-sectional, and predictive approaches. SAMPLE: This study conducted a national online survey using convenience sampling (n = 2709). MEASUREMENT: The Health Information Orientation Scale (HIOS) and Statista.com's "reasons for not getting a COVID-19 vaccination" were used to collect data. Demographic characteristics that predict information engagement and apprehension were identified using multivariate linear regression analysis. RESULTS: Responses to information engagement and apprehension revealed "often true" and "sometimes true," respectively. The majority of participants intended to receive the COVID-19 vaccine. "Concerned about the vaccine's safety" is the most common reason for not getting vaccinated. Female gender, college graduate, employed, and using social media to obtain COVID-19 vaccine information were all significant predictors of information engagement and apprehension. Information engagement and apprehension were predicted by age and religion, respectively. CONCLUSIONS: Policymakers should consider how people seek information regarding the COVID-19 vaccine and why some people refuse to get vaccinated. Additionally, public health nurses should educate the public about the safety of COVID-19 vaccines.

The multidimensionality of anxiety among nursing students during COVID-19 pandemic: A cross-sectional study.

BACKGROUND: Over the past year, healthcare workers constantly report their COVID-19 anxiety. However, this concept remained understudied among nursing students (NSs). AIM: This study investigated the difference between NSs' three types of anxiety and their profile variables during the COVID-19 pandemic. METHODS: This study used a cross-sectional, descriptive-correlational design. Three instruments were used: COVID-19 anxiety scale (CAS), COVID-19 anxiety syndrome scale (COVID-19ASS), and short health anxiety inventory (SHAI) to collect data from 484 Saudi NSs. We applied the Mann-Whitney U test and linear regression to analyze the data. RESULTS: Across the three instruments; CAS, Item 1 "I feel bad when thinking about COVID-19"; COVID-19ASS, Item 11 "I have imagined what could happen to my family members if they contracted COVID-19"; and SHAI, Item 17 "A serious illness could ruin many aspects of my life" yielded the highest means. COVID-19ASS showed a significant difference for the profiles "known positive" (p = 0.05) and "action taken after with testing" (p = 0.05). NS, who knew someone with COVID-19, was the only predictor of CAS. CONCLUSION: Our study concludes NSs experience anxiety symptoms. Anxiety is specific to COVID-19 or a set of similar anxiety symptoms. Further research is needed to explore the anxiety state of NSs during the pandemic.

Association Between Perceived Resilience and Mental Well-Being of Saudi Nursing Students During COVID-19 Pandemic: A Cross-Sectional Study.

Purpose: This study investigated the relationship between nursing students' profile variables and their state of mental well-being and resilience during the coronavirus disease-19 (COVID-19) pandemic and how this impacts their understanding of holistic nursing care provision. Design: This study used a cross-sectional design and total enumeration sample (n = 439) from all enrolled nursing students in the College of Nursing of a state-run university. Method: The 10-item Connor-Davidson Resilience Scale (CD-RISC) and 14-item Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) were used to collect data from the participants. A correlational analysis was employed to determine the relationship between the responses of the participants to their profile variables. Findings: There were no significant differences in age, gender, and year level in the 10-item CD-RISC and WEMWBS. Regarding the WEMWBS, the mean total score of those with 61-100% of the allowed units was significantly higher than those with 31-60%. Finally, the CD-RISC scores revealed that participants with a general point average (GPA) of A were significantly higher than those with a GPA of B+ or B. Conclusion: Academically performing students (those with a GPA of B and above) are more resilient. In addition, there is an existing linear relationship between high mental well-being and the ability to pursue higher academic loads.

Predictors of quality of life of nursing internship students from five Saudi universities.

OBJECTIVES: This study investigated the quality of life (QoL) of nursing internship students (NISs) and the predictive variables for the QoL of NISs during the COVID-19 pandemic. The correlates of QoL of NISs with their gender, age, prior nursing experience, and grade point average (GPA) from the previous semester are also assessed. METHODS: This study used a quantitative cross-sectional design through an electronic survey form for the collection of required data. The 22-item Quality of Life Evaluation Scale (QOLES) was adopted as the survey instrument. A total of 283 NISs from five public universities in KSA completed the survey. RESULTS: The students' age, gender, and nursing-related experience prior to their internship were all found to be significantly associated with the overall QOLES score (p values of 0.001, 0.001, and 0.01, respectively). The NISs GPA was found to be marginally significant (p = 0.08). A significant difference was identified in the overall QOLES score based on age (p = 0.02), gender (p = 0.02), and GPA (p = <0.001). Finally, as estimated by the regression analysis, only age (p = 0.002) was found to be a significant predictor of NISs' QoL. CONCLUSION: In this study, the QoL of Saudi NISs was positively correlated with their age and gender. Male NISs had greater QoL than females, while a high QoL was observed among students with high GPAs before the internship year. Only the age of the NISs was found to be a reliable predictor of QoL.

Quality of life of nursing internship students in Saudi Arabia during the COVID-19 pandemic: A cross-sectional study.

BACKGROUND: The COVID-19 pandemic caused an unprecedented negative impact on the usual way of life. The fight against this fatal virus demands the united force of healthcare workers, including nurse interns (NIs). Therefore, being unprepared for a crisis of this magnitude which never happened in a century, nurses and NIs experience stress, trauma, and mental health issues that affect their quality of life (QoL). OBJECTIVES: This study inquired the demographic of the NIs, the responses of the participants to the domains of Quality of Life Evaluation Scale (QOLES), and the relationship between the participants' responses to the scale to each of their demographic profiles. METHODS: This study used a quantitative cross-sectional design through an electronic survey form in the collection of data. Utilizing total enumeration as sampling technique, 152 NIs in Saudi Arabia completed the survey. RESULTS: Across the 22-item questionnaire, the NIs still feel safe being in the hospital, clinic, or other healthcare facilities with a mean of 3.32; while item 8, which is having abundant energy, had the lowest mean of 1.91. The overall mean is 2.61, interpreted as 'important,' signifying that the participants 'agree to some extent.' CONCLUSION: The QoL of the NIs focused more on their psychological wellbeing and social relationships while the environmental and physical domains had lesser emphasis. In terms of enhancing specificity, comprehensiveness, and generalizability of future studies in QoL, a larger sample and more rigorous design is recommended.