Nursing students' personality (Temperament and Character), burnout symptoms, and health and well-being.

Background: About 9 million nurses will be needed by 2030. To face these unprecedented times, governments/institutions focus on educating as many nursing students as possible. This strategy is clouded by burnout and lack of both health and well-being among students and by the fact that personality is one of the major determinants of these health outcomes. Nevertheless, recent findings show that personality is a complex adaptive system (i,e., nonlinear) and that combinations of people's temperament and character traits (i.e., joint personality networks) might provide further information to understand its development, academic burnout, and lack of health and well-being. Aims: Our aims were to investigate the linear relationship between nursing students' personality, burnout, health, and well-being; investigate the linear mediational effects of personality and burnout on health and well-being; and investigate differences in these health outcomes between/within students with distinct joint personality networks (i.e., nonlinear relationships). Method: Swedish nursing students (189 women, 29 men) responded to the Temperament and Character Inventory, The Maslach Burnout Inventory-General Survey for Students, and the Public Health Surveillance Well-Being Scale. We conducted correlation analyses and Structural Equation Modeling and, for the nonlinear relationships, Latent Profile Analysis and Latent Class Analysis for clustering and then Analyses of Variance for differences in health outcomes between/within students with distinct personality networks. This study was not pre-registered. Results: High levels of health and well-being and low burnout symptoms (low Emotional Exhaustion, low Cynicism, and high Academic Efficacy) were associated with low Harm Avoidance and high Self-Directedness. Some personality traits were associated with specific health outcomes (e.g., high Self-Transcendence-high Emotional Exhaustion and high Persistence-high Academic Efficacy) and their effects on health and well-being were mediated by specific burnout symptoms. Cynicism and Emotional Exhaustion predicted low levels of health and well-being, Academic Efficacy predicted high levels, and Cynicism lead both directly and indirectly to low levels of health and well-being through Emotional Exhaustion. We found two joint personality networks: students with an Organized/Reliable combination who reported being less emotionally exhausted by their studies, less cynical towards education, higher self-efficacy regarding their academic work/skills, and better health and well-being compared to nursing students with an Emotional/Unreliable combination. Conclusions: The coherence of temperament-character, rather than single traits, seems to determine students' health outcomes. Thus, nursing education might need to focus on helping students to develop professional skills and health-related abilities (e.g., self-acceptance and spiritual-acceptance), by supporting self-awareness.

The personality of newly graduated and employed nurses: Temperament and character profiles of Swedish nurses.

Background: One of the challenges of the 21st century is the high turnover rate in the nursing profession due to burnout and mental illness. From a biopsychosocial perspective, an individual's personality is an important vulnerability-resilience factor that comprises four temperament traits (i.e., a person's emotional reactions) and three character traits (i.e., self-regulation systems). Indeed, different personality profiles are associated to different coping strategies and health outcomes. Objective: We investigated and mapped the temperament and character of Swedish newly graduated and employed nurses' in relation to the Swedish general population and an age-matched sub-sample. Design: In this cross-sectional study, nurses self-reported their personality (Temperament and Character Inventory) at the beginning of their employment. Setting: The data collection was conducted at a hospital in the South of Sweden. Participants: A total of 118 newly graduated and employed nurses (Mage = 25.95±5.58) and 1,564 individuals from the Swedish general population participated in the study. Methods: We calculated T-scores and percentiles for all seven personality dimensions using the Swedish norms (N = 1,564). The profiles were calculated by combining high/low percentiles scores in three temperament dimensions (Novelty Seeking: N/n, Harm Avoidance: H/h, and Reward Dependence: R/r) and in the three character dimensions (Self-Directedness: S/s, Cooperativeness: C/c and Self-Transcendence: T/t). Results: Regarding T-scores, the nurses reported moderately lower Novelty Seeking (> 0.5 SD), slightly higher Harm-Avoidance (about 0.5 SD), moderately higher Persistence (> 0.5 SD) and Reward Dependence (> 0.5 SD), and extremely lower Self-Directedness (> 1 SD). The prevalence of the most common temperament profiles among the nurses (Swedish general population in brackets) were: 39.80% [10.90%] Cautious (nHR), 21.20% [10.90] Reliable (nhR), and 15.30% [16.50%] Methodical (nHr). The prevalence of the most common character profiles among the nurses were: 31.40% [4.90%] Dependent (sCt), 25.40% [14.40%] Apathetic (sct), and 19.50% [8.80%] Moody (sCT). Conclusions: The analyses of the personality profiles showed that Low Novelty Seeking (79%), high Harm Avoidance (65%) high Reward Dependence (80%), low Self-Directedness (95%), and low Self-Transcendence (60%) were more prevalent among the newly graduated and employed nurses. This may partially explain newly graduated nurses' difficulties at work and high turnover rate. After all, a well-developed character is of special importance when working with patients with serious and terminal illness or under large global crises, such as the current pandemic. Hence, both education at universities and development at work need to be person-centered to reduce stress levels and promote positive self-regulation strategies.

Psychometric properties of the Swedish version of the satisfaction with life scale in a sample of individuals with mental illness.

BACKGROUND: Health assessment among individuals with mental health problems often involves measures of ill-being (e.g., anxiety, depression). Health is, however, defined as a state of physical, mental and social well-being and not merely the absence of disease (WHO, 1948, 2001). Hence, in order to address mental illness during the 21st century, we need to develop methods for the prevention, identification and treatment of mental illness; but also, for the promotion, identification, and maintenance of well-being. In this context, over three decades of subjective well-being research have resulted in the development of measures of positive aspects of human life, such as the Satisfaction with Life Scale (Diener et al., 1985). Our aim was to investigate the psychometric properties of the Satisfaction with Life Scale in a Swedish population of individuals with mental illness using both Classical Test Theory (CTT) and Item Response Theory (IRT). METHOD: A total of 264 participants (age mean = 43.46, SD = 13.31) diagnosed with different types of mental illness answered to the Swedish version of the Satisfaction with Life Scale (five items, 7-point scale: 1 = strongly disagree, 7 = strongly agree). RESULTS: We found positive and significant relationships between the five items of the scale (r ranging from 0.37 to 0.75), good reliability (Cronbach's alpha = 0.86), and that the one-factor solution had best goodness of fit (loadings between 0.52-0.88, p < 0.001). Additionally, there were no significant differences in comparative fit indexes regarding gender and occupation status. All items had high discrimination values (between 1.95-3.81), but item 5 ("If I could live my life over, I would change almost nothing"); which had a moderate discrimination value (1.17) and the highest estimated difficulty on response 7 (3.06). Moreover, item 2 ("The conditions of my life are excellent") had less discrimination and redundant difficulty with both item 1 ("In most ways my life is close to my ideal"; 2.03) on response 7 and with item 3 ("I am satisfied with my life"; -1.21) on response 1. The five items together provided good information, with especial good reliability and small standard error within -1.00 up to about 2.00 and the highest amount of test information at 0.00 of the level of life satisfaction within this population. CONCLUSIONS: Consistent with previous research, the scale had good reliability and provided good information across most of the latent trait range. In addition, within this population, sociodemographic factors such as gender and occupation status do not influence how individuals respond to the items in the scale. However, the items couldn't measure extreme levels of low/high life satisfaction. We suggest replication of these findings, the test of additional items, and the modification of items 2 and 5 in order to use the scale among individuals with mental illness.

Occupation and life satisfaction among individuals with mental illness: the mediation role of self-reported psychophysiological health.

BACKGROUND: Unemployment can diminish physical, psychological and social health. In this context, research shows that people with mental illness have even more difficulties finding occupation. Thus, some countries, such as Sweden, strive after creating job opportunities for this specific group. We investigated the effect of having an occupation on life satisfaction among individuals with mental illness and whether self-reported physical and psychological health mediated the relationship between being (un)employed and life satisfaction. METHOD: Two-hundred eighty-seven individuals (148 males, 134 females, and 5 missing information) with mental illness, who received support and services from Swedish Municipalities in Blekinge, self-reported occupation, life satisfaction, and physical and psychological health. RESULTS: Participants who reported having an occupation reported also significantly higher levels of life satisfaction, physical health, and psychological health compared to those without occupation. Nevertheless, these differences were rather small (Eta2 < 0.06). Moreover, the indirect effect of having an occupation on life satisfaction through physical and psychological health was significant. Finally, the total indirect effect of physical and psychological health (i.e., psychophysiological health) accounted for 53% of the total effect of having an occupation on life satisfaction. CONCLUSION: For individuals with mental illness there seems to be an almost equal importance of indirect and direct effects of having an occupation on their levels of life satisfaction. More specifically, while there are differences in life satisfaction within this population in relation to having an occupation, having an occupation leads to the sense of good psychophysiological health, which in turn helps individuals with mental illness to feel satisfied with their lives.

Modus operandi and affect in Sweden: the Swedish version of the Regulatory Mode Questionnaire.

BACKGROUND: The Regulatory Mode Questionnaire (RMQ) is the most used and internationally well-known instrument for the measurement of individual differences in the two self-regulatory modes: locomotion (i.e., the aspect of self-regulation that is concerned with movement from state to state) and assessment (i.e., the comparative aspect of self-regulation). The aim of the present study was to verify the independence of the two regulatory modes, as postulated by the Regulatory Mode Theory (Kruglanski et al., 2000), and the psychometric properties of the RMQ in the Swedish context. Furthermore, we investigated the relationship between regulatory modes (locomotion and assessment) and affective well-being (i.e., positive affect and negative affect). METHOD: A total of 655 university and high school students in the West of Sweden (males = 408 females = 242, and five participants who didn't report their gender; agemean = 21.93 ± 6.51) responded to the RMQ and the Positive Affect Negative Affect Schedule. We conducted two confirmatory factor analyses using structural equation modeling (SEM). A third SEM was conducted to test the relationship between locomotion and assessment to positive affect and negative affect. RESULTS: The first analyses confirmed the unidimensional factor structure of locomotion and assessment and both scales showed good reliability. The assessment scale, however, was modified by dropping item 10 ("I don't spend much time thinking about ways others could improve themselves".) because it showed low loading (.07, p = .115). Furthermore, the effect of locomotion on positive affect was stronger than the effect of assessment on positive affect (Z = -15.16, p < .001), while the effect of assessment on negative affect was stronger than the effect of locomotion on negative affect (Z = 10.73, p < .001). CONCLUSION: The factor structure of the Swedish version of the RMQ is, as Regulatory Mode Theory suggests, unidimensional and it showed good reliability. The scales discriminated between the two affective well-being dimensions. We suggest that the Swedish version of the RMQ, with only minor modifications, is a useful instrument to tap individual differences in locomotion and assessment. Hence, the present study contributes to the validation of the RMQ in the Swedish culture and adds support to the theoretical framework of self-regulatory mode.

Understanding Group and Leader (UGL) trainers' personality characteristics and affective profiles.

BACKGROUND: The Understanding Group and Leader (UGL), provided by the Swedish National Defense College and mentored by UGL-trainers, is one of the most popular management programs among civilians in Sweden. However, there is a lack of scientific evidence regarding the training. We used the affective profile model (i.e., the combination of positive, PA, and negative affect, NA) to mapp important markers of empowerment, self-awareness, adaptive coping skills, and maturity among the UGL-trainers. The aims were: (1) to compare profiles between UGL-trainers and managers/supervisors and (2) to investigate differences in personal characteristics. METHOD: UGL-trainers (N = 153) and the comparison group (104 Swedish Chiefs of Police) completed an online survey on optimism, self-esteem, locus of control, and affect. The four profiles are: self-fulfilling (high PA, low NA), high affective (high PA, high NA), low affective (high PA, low NA), and self-destructive (low PA, high NA). RESULTS: The self-fulfilling profile was more common among UGL-trainers (25.70%) than among Chiefs of Police (19.20%). UGL-trainers, compared to Chiefs of Police, were more likely to express a self-fulling than a low affective profile (OR = 2.22, p < 0.05) and a high affective than a low affective profile (OR = 1.43, p < 0.001). UGL-trainers with a self-fulfilling profile, compared to those with a self-destructive profile, scored higher in optimism, higher in self-esteem, and lower in external locus of control. CONCLUSIONS: The probability of self-fulfillment rather than low affectivity was higher among UGL-trainers. Self-fulfillment was associated to markers of self-awareness and adaptive coping skills. However, the most common profile was the low affective, which is associated to low performance during stress, low degree of personal development, low degree of purpose in life, and low resilience. Hence, it might be important for UGL-trainers to have a continuous training in awareness after certification.