Higher Vocational Nursing Students' Professional Identity In The Late Stage Internship And Its Influencing Factors

PurposeTo explore higher vocational nursing students' professional identity status, and analyze the related factors targeted interventions among nursing students may improve their professional identity so as to stabilize the nursing team and improve the quality of nursing.MethodsFrom March to April 2016, the convenience sampling method was used to recruit 223 full-time higher vocational nursing students as the research subjects. Self-designed demographic questionnaire, professional identity questionnaire for nurse students(PIQNS),professional self-efficacy questionnaire for nurse students(PSQNS), stress rating scale for nurse students, simple coping style questionnaire and social support rating scale(SSRS) were used to collect data. SPSS 19. 0 was used for data statistical analysis.Results1.The lowest score of higher vocational nursing students' professional identity was 21, highest score was 83, average score was 62.04±11.49, and was in the medium level. The average score of vocational self-concept was 22.19±5.01, average score of benefit of retention and turnover risk was 13.86±3.32, average score of social comparison and self reflection was 11.09±2.27, average score of career choice autonomy was 7.04±1.59, and average score of social persuasion was 7.84±1.90.2. Professional identity score of higher vocational nursing students who have voluntary choice of nursing professional, outgoing personality and believe to find a suitable job was higher than that who are influenced by other to choose nursing, adjust professional, introverted, and do not want to engage in clinical nursing(P< 0.05).3. Score of higher vocational nursing students'self-efficacy in the late stage internship was 62.04±11.49, average score was 3.54±0.55, average score of dimensions from high to low ranking followed by professional attitude and belief, problem solving ability, career choice, career cognition, collect information vocational and career planning capacity, professional value.Score of self-efficacy was positively correlated with professional identity and its four dimensions (vocational self concept and benefit of retention and turnover risk, social comparison and self reflection, social persuasion) (P< 0.01), and was also positively correlated with professional identity another dimension (career choice autonomy) (P< 0.05).The average score of the stress among higher vocational nursing students in the late stage internship was 1.48±0.51. Low level of pressure (less thanl) accounted for 17.5%, the average level of pressure (from 1.01 to 2.0) accounted for 67.7%, high level of pressure (from 2.01 to 3.0) accounted for 14.8%. The highest score of the dimension was the nature of work (1.85±0.57) and work support (1.46±0.69), the lowest score was interpersonal dimension (1.20±0.64). For higher vocational nursing students in the late stage internship, the top three sources of stress followed by patients with sharp changes or death (2.45±0.75), death of patient (2.22±0.92), taking care of infectious disease patients such as AIDS, tuberculosis, hepatitis B, hepatitis C (2.03±0.84). There was no significant correlation between the score of pressure source and professional identity total score and the scores of professional identity dimensions, but negatively correlated with self-efficacy score (P< 0.05).5. The average score of positive coping for higher vocational nursing students in the late stage internship when encountered setback was 1.95±0.47, and was higher than the national norm (1.78±0.52), and the average score of negative coping was 1.24±0.57 and was lower than the national norm (1.59±0.66), and score of positive coping was higher than the score of negative coping. The score of positive coping was positively correlated with professional identity and its dimensions (P< 0.05), except for the autonomy of career choice.6. The total score of social support among higher vocational nursing students in the late stage internship was 37.43±5.79, which was in medium level, higher than domestic norm (healthy people,34.56±3.73). Score of social support was significantly positively correlated with professional identity and its dimensions (P< 0.01).7. Multiple regression analysis showed that, the influencing factors of professional identity of higher vocational nursing students in the late stage internship included seven variables:occupational self-efficacy, pressure source, positive coping, social support, choice of professional willingness, personality, employment outlook.Seven variables accounted for 57.1% of the variance in professional identity(Adjusted R2=0.571).8. Mediating effect of career self-efficacy in social support, positive coping and professional identity by applying Baron and Kenny step test regression coefficient analysis showed that, relationship between social support and professional identity was fully mediated by professional self-efficacy (P< 0.001 changed to P=0.195). The relationship between positive coping and professional identity was partly mediated by the professional self-efficacy (P<0.001 changed to P=0.018, both P<0.05).Conclusions1. The total score of higher vocational nursing students' professional identity is in the middle level. Higher vocational teachers and clinical teachers should take relevant measures to promote nursing students' professional identity. In particular, we should pay attention to higher vocational nursing students who did not voluntarily choose nursing as profession, being introverted personality, and do not want to engage in clinical nursing.2. Seven variables including occupational self-efficacy, stress, positive coping, social support, professional willingness, personality and employment outlook were influencing factors of professional identity among higher vocational nursing students in late-stage of clinical practice.3. Nursing students' positive coping can be directly or indirectly (through career self-efficacy) influence on their professional identity. And the social support of nursing students can only indirectly (through the role of career self-efficacy) influence the professional identity of nursing students.4. Nursing teachers in higher vocational colleges and clinical nursing teachers can enhance nursing students' self-efficacy, reduce their pressure source, promote their positive coping, increase their social support to improve higher vocational nursing students' professional identity.