A Study Of Stressors,Self-efficacy And Mental Health Status Of Nursing Students During Internship

ObjectivesThe questionnaire survey was used to understand the general information,stressors and mental health status of nursing students at different levels of internship,to analyze the factors influencing the mental health status of nursing students during internship,and to provide a reference basis for improving the mental health status of nursing students during internship and proposing effective psychological interventions.MethodsFrom December 2021 to April 2022,a survey was conducted on all 2022 nursing students in a medical college,covering two levels,that is undergraduate,specialized nursing and technical secondary school nursing.A unified questionnaire was used to investigate the general data of nursing professional interns,including educational background,internship hospital grade,gender,age and other issues.Intern nursing student stressor scale was used to investigate the stressors of nursing interns.The scale was divided into 9 dimensions and 35 entries.Using the likert 5-level scoring method,the average score of each dimension entry was used to indicate the degree of pressure.The DASS-21 scale was used to investigate the mental health status of nursing professional trainees.There are 21 entries in the scale.To measure three negative psychological emotions,that is,depression,anxiety and stress,the 4-level scoring method was adopted.The higher the score,the stronger negative emotions.The general self-efficacy scale was used to investigate the self-efficacy of nursing students.The scale was a unit scale and a 4-point scoring system was adopted.The higher the total score,the higher the self-efficacy.The collected data were entered into Excel,and data statistical analysis was performed using SPSS 22.0 software.The frequency and percentage of counting data were expressed by mean±standard deviation(x±S)and t-test was used to compare measurement data and analysis of variance was used for comparison between two groups.Meanwhile,Pearson correlation analysis was used to evaluate the correlation between various dimensions of stressors,self-efficacy and mental health status.Variables with P<0.05 in the univariate analysis results and stressor dimensions and self-efficacy with P<0.05 in the correlation analysis were included in the influencing factors of the multiple linear regression model analysis.The mediation effect was analyzed using PROCESS 3.2,using a two-sided test in test level of α=0.05.Results1.This survey included 531 undergraduate and specialized nursing interns and 261 technical secondary school nursing interns,with a total of 792 nursing interns.2.Stressors of nursing interns at different levels:(1)Among undergraduate and specialized nursing interns,the three dimensions with the highest total score of stressors were employment and examination(3.82±0.71 points),clinical assessment and evaluation(3.80±0.71 points),and clinical environment and interpersonal relationship(3.76±0.75 points).The dimension with the lowest score was the psychological gap of internship nursing students(3.22 ± 0.81 points).(2)Among nursing interns in technical secondary school,the three dimensions with the highest total score of stressors were clinical environment and interpersonal relationship(3.80±0.74 points),teaching attitude(3.73±0.85 points),and clinical assessment and evaluation(3.72±0.77 points),and the dimension with the lowest score was the psychological gap of nursing students(3.27± 0.84 points).3.Analysis results of abnormal mental health status of nursing interns at different levels:(1)Among undergraduate and specialized nursing interns,207 were detected with depression,accounting for 38.98%;235 were detected with anxiety,accounting for 44.26%;and 131 were detected with stress,accounting for 24.67%.(2)Among the nursing interns in technical secondary school,47 were detected with depression,accounting for 18.00%;106 were detected with anxiety,accounting for 40.60%;47 were detected with stress,accounting for 18.00%.4.Results of the correlation analysis of stressors,self-efficacy and mental health status of nursing interns at different levels:(1)Among the undergraduate and specialized nursing interns,self-efficacy and stress sources,clinical environment and interpersonal relationship,patient attitude and evaluation,clinical assessment and evaluation,practice teacher teaching attitude,nature and content of nursing work,personal knowledge and skills,employment and examination were positively correlated(P<0.01),while having a negative correlation with low degree with depression,anxiety and stress(P<0.01).Depression and stressors were positively correlated with the psychological gap between internship nursing students(P<0.01),which was negatively correlated with the nature and content of nursing work,clinical environment and interpersonal relationship,patients ’attitude and evaluation,clinical assessment and evaluation,employment and examination,and practice teachers’ teaching attitude(P<0.01).Among anxiety and stressors,the psychological gap between nursing students(P<0.05),and presented a negative correlation with the nature and content of nursing work,clinical environment and interpersonal relationship,patient attitude and evaluation,clinical assessment and evaluation,employment and examination,and low teaching attitude of practice teachers(P<0.01).Among stress and stressors,the psychological gap between nursing students was low(P<0.05),and presented a negative correlation with the nature and content of nursing work,clinical environment and interpersonal relationship,patients’ attitude and evaluation,clinical assessment and evaluation,employment and examination,and low teaching attitude of practice teachers(P<0.01).(2)Among the nursing professional interns in the technical secondary school,the nature and content of nursing work in self-efficacy,clinical environment,attitude and interpersonal relationship of patients,clinical assessment and evaluation,employment and examination,practice teachers’ teaching attitude,own knowledge and skills,psychological gap between nursing students during internship,and the role positioning of clinical practice nursing students were positively correlated(P<0.01)and presented a negative correlation with depression and stress(P<0.05).Depression and stressors,the psychological gap between practice nursing students showed low positive correlation(P<0.01),and low negative correlation with clinical environment and interpersonal relationship,patient attitude and evaluation,clinical assessment and evaluation,and practice teachers’ teaching attitude(P<0.05).Among stress and stressors,the psychological gap between nursing students and the role orientation of nursing students were low(P<0.01),which was negatively associated with patient attitude and evaluation,clinical assessment and evaluation,and low teaching attitude of trainee teachers,(P<0.05).5.Results of the factors influencing the mental health status of nursing interns at different levels:(1)Mental health status of university nursing interns:Depression status:The P<0.05 factors in the univariate analysis andP<0.05 stressor of each dimension in the correlation analysis,as well as self-efficacy,taken as the independent variables,were incorporated into the multivariate linear regression model,with results showing that the degree of concern,nursing professional passion degree,students’learning attitude,teaching attitude of teachers and depression had significant negative influence.Anxiety status:The P<0.05 factors in the univariate analysis and P<0.05 stressor of each dimension in the correlation analysis,as well as self-efficacy,taken as the independent variables,were incorporated into the multivariate linear regression model,with results showing that the degree of concern,students’ learning attitude,teaching attitude of teachers and the occurrence of anxiety showed negative effects.Stress status:The P<0.05 factors in the univariate analysis and P<0.05 stressor of each dimension in the correlation analysis,as well as self-efficacy,taken as the independent variables,were incorporated into the multivariate linear regression model,with results showing that nursing professional passion degree,the degree of concern,students’ learning attitude,teaching attitude of teachers and self efficacy and stress had a negative effect.(2)Mental health status of nursing interns in the technical secondary school:Depression status:The P<0.05 factors in the univariate analysis and P<0.05 stressor of each dimension in the correlation analysis,as well as self-efficacy,taken as the independent variables,were incorporated into the multivariate linear regression model,with results showing that the degree of concern,family help and clinical assessment and evaluation and depression had a negative influence,while clinical role of nursing students had a positive impact on depression.Anxiety status:The P<0.05 factors in the univariate analysis and P<0.05 stressor of each dimension in the correlation analysis,as well as self-efficacy,taken as the independent variables,were incorporated into the multivariate linear regression model,with results showing that the degree of concern,family help and patients’attitude and evaluation had a negative influence on anxiety,while clinical role of nursing students showed a positive impact on anxiety.Stress status:The P<0.05 factors in the univariate analysis and P<0.05 stressor of each dimension in the correlation analysis,as well as self-efficacy,taken as the independent variables,were incorporated into the multivariate linear regression model,with results showing that the degree of concern,clinical assessment and evaluation and family help had a negative influence on stress,while clinical role of nursing students had a significant positive influence on stress.6.The results of the mesomeric effect analysis revealed that self-efficacy played a mesomeric role in the teaching attitude and anxiety of teachers.The mesomeric effect value was-0.476,and the 95%CI interval was(-0.938,-0.030)excluding 0.So the mesomeric effect took hold,accounting for 17.99%of the total effect,which was partially mesomeric.Self-efficacy played a mesomeric role between the teaching attitude and stress degree of teachers.The mesomeric effect value was-0.620,and the 95%CI interval was(-1.075,-0.180),excluding 0.Then the mesomeric effect took hold,accounting for 26.25%of the total effect,which was partially mesomeric.ConclusionsAmong nursing interns of different levels,the main sources of pressure are clinical assessment and evaluation,clinical environment and interpersonal relationship,and the detection rate of abnormal mental health status of university nursing interns is higher than that of technical secondary school nursing interns.The main factors affecting the mental health of nursing interns at different levels are the degree of care and the attitude of teaching teachers.For university nursing interns,the factors affecting their mental health status include professional preference and students’ learning attitude in school,while for technical secondary school nursing interns,the factors affecting their mental health status involve the psychological gap of nursing students,clinical assessment and evaluation,clinical role positioning for nursing students and the attitude and evaluation of patients.Furthermore,self-efficacy has a mesomeric effect in stressors and mental health status.