Stress, mental health, and protective factors in nursing students: An observational study.

BACKGROUND: Nursing students suffer high levels of stress, especially in the first year. OBJECTIVES: to compare academic stress at the beginning and end of nursing studies; to analyse the relationships between academic stress, mental health, and protective factors; and to examine whether resilience mitigates the effect of academic stress on psychological well-being. DESIGN: A cross-sectional study. SETTING AND PARTICIPANTS: Sample was 370 first- and fourth-year nursing students from Spain (University of Castilla-La Mancha, University of Cantabria, and University of Sevilla). VARIABLES AND DATA COLLECTION: We assessed academic and clinical stress, coping skills, anxiety, depression, psychological well-being, and resilience were measured. DATA ANALYSIS: We performed a descriptive analysis of the study sample, as well as correlation and hierarchical regression models. Additionally, mediation models were estimated. RESULTS: First-year students presented higher academic stress than fourth-year students. Clinical stress, anxiety, depression, and emotional coping predicted academic stress, while academic stress, depression, and coping skills predicted psychological well-being. Mediation models showed a significant path between academic stress, resilience, depression, and psychological well-being. CONCLUSION: Academic stress has a detrimental effect on the mental health. Coping strategies and resilience may be protective factors that should be encouraged in interventions designed to improve psychological well-being.

Cross-cultural validation of the Spanish version of the mini cambridge-exeter repetitive thought scale (Mini-CERTS) in two Spanish-speaking populations.

The Mini Cambridge-Exeter Repetitive Thoughts Scale (Mini-CERTS) captures constructive and unconstructive aspects of repetitive thinking, but there is a need to revise and improve it given its novelty. For this reason, we present a validation and factor analysis of the Spanish version of the Mini-CERTS. Given that it is important to take cultural issues into account in instrument adaptation, we also assess its measurement invariance across Spanish (N = 430) and Peruvian (N = 394) populations. After deleting conflictive items, a 9-items version of the Mini-CERTS showed a two-factor model distinguishing constructive and unconstructive repetitive thinking, although this solution was not invariant across groups. Results also showed that the unconstructive factor was positively associated with anxiety, depression and stress measures. Despite its acceptable internal consistency, the absence of measurement invariance across groups does not recommend its use in cross-group comparisons in these populations. Cultural issues that could explain this result are discussed. Our findings highlight the importance of performing cross-cultural adaptations of assessment instruments even with the same language.