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Predicting self-compassion in UK nursing students: Relationships with resilience, engagement, motivation, and mental wellbeing

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Self-compassion, being kind towards oneself, has been identified as a key protective factor of mental health. This is consistent with students’ experiences in the study of nursing, which attracts a large number of students in the United Kingdom. Despite the importance of self-compassion, knowledge in how to enhance self-compassion is under-researched. Self-compassion interventions are commonly related to meditative exercises. In order to suggest alternative approaches, relationships between self-compassion and more established constructs need to be appraised. Accordingly, this study evaluated predictors of self-compassion, examining its relationships with more established constructs examined in other healthcare student populations: resilience, engagement, motivation and mental wellbeing. An opportunity sample of 182 UK nursing students at a university in East Midlands completed self-report measures about these constructs. Correlation and regression analyses were conducted. Self-compassion was positively related to resilience, engagement, intrinsic motivation and mental wellbeing, while negatively related to amotivation. Resilience and mental wellbeing were identified as significant predictors of self-compassion. As resilience and mental wellbeing are relatively familiar to many nursing lecturers and students, educators can incorporate a self-compassion component into the existing resilience training and/or mental wellbeing practices.
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PREDICTING SELF-COMPASSION IN UK NURSING STUDENTS:
RELATIONSHIPS WITH RESILIENCE, ENGAGEMENT, MOTIVATION, AND
MENTAL WELLBEING
Yasuhiro Kotera1*, Vicky Cockerill1, James Chircop1, Greta Kaluzeviciute1, Sue Dyson1
1University of Derby, Kedleston Road, Derby DE22 1GB, United Kingdom
Citation
Kotera, Y., Cockerill, V., Chircop, J., Kaluzeviciute, G. & Dyson, S. (2021). Predicting self-
compassion in UK nursing students: Relationships with resilience, engagement, motivation,
and mental wellbeing. Nurse Education in Practice.
Acknowledgement
We thank Polly Barnes for her support in this project.
Highlights
Resilience and mental wellbeing were significant predictors of self-compassion.
Resilience was most strongly associated with self-compassion in all of our analyses.
Self-compassion can be embedded in existing resilience training in nursing education.
Existing mental wellbeing practices can also enhance self-compassion.
1
Abstract
Self-compassion, being kind towards oneself, has been identified as a key protective factor of
mental health. This is consistent with students’ experiences in the study of nursing, which
attracts a large number of students in the United Kingdom. Despite the importance of self-
compassion, knowledge in how to enhance self-compassion is under-researched. Self-
compassion interventions are commonly related to meditative exercises. In order to suggest
alternative approaches, relationships between self-compassion and more established
constructs need to be appraised. Accordingly, this study evaluated predictors of self-
compassion, examining its relationships with more established constructs examined in other
healthcare student populations: resilience, engagement, motivation and mental wellbeing. An
opportunity sample of 182 UK nursing students at a university in East Midlands completed
self-report measures about these constructs. Correlation and regression analyses were
conducted. Self-compassion was positively related to resilience, engagement, intrinsic
motivation and mental wellbeing, while negatively related to amotivation. Resilience and
mental wellbeing were identified as significant predictors of self-compassion. As resilience
and mental wellbeing are relatively familiar to many nursing lecturers and students, educators
can incorporate a self-compassion component into the existing resilience training and/or
mental wellbeing practices.
Keywords: self-compassion, resilience, nursing students, mental wellbeing, cross-
sectional study, regression analysis
2
Introduction
Mental Health and Mental Wellbeing of Nursing Students
Nursing is related to offering care for people at points of illness and vulnerability. In
order to provide quality care consistently, mental wellbeing of nurses is important as it helps
them to feel good and function well (Tennant et al., 2007), therefore the importance of mental
wellbeing in nurses has been emphasised (Xie et al., 2020). Mental wellbeing is commonly
regarded as a positive facet of mental health, relating to the subjective experience of
happiness and life satisfaction (hedonic perspective) and psychological functioning and self-
realisation (eudaimonic perspective) (Ryan and Deci, 2001). High stress can damage mental
wellbeing, leading to poor mental health (Tennant et al., 2007), which has been recognised in
nursing populations (Ogińska-Bulik and Michalska, 2020; Xin, Jiang and Xin, 2019). For
example, burnout is widely documented in nursing literature (Hofmeyer, Taylor and
Kennedy, 2020; Jarrad and Hammad, 2020; Waddill-Goad, 2019). Poor mental health of
nurses is a cause of concern for the healthcare sector (Kinman, Teah and Harriss, 2020).
Mental health education in the university has been identified as one solution for
improving poor mental health in the workplace (Geirdal, Nerdrum and Bonsaksen, 2019).
Accordingly, mental health and mental wellbeing of nursing students have been substantially
researched (Cilar et al., 2019; Kotera et al., 2020; Oates et al., 2020). Studying nursing is
often regarded as more stressful than other healthcare studies, leading to compromised mental
wellbeing in students (Tung et al., 2018; Turner and McCarthy, 2017; Walker and Mann,
2016). In addition to common stressors in higher education—pressure of academic work and
personal life factors—, nursing students are exposed to realities of clinical practice (Edwards
et al, 2015), such as offering care for the critically-ill in a short-staffed context (Zhao et al.,
2015), and intense fear for making errors (Yıldırım et al., 2017). Balancing academic work
3
and clinical work is stressful to many nursing students. For example, in the United Kingdom
(UK), the current standards for nursing programmes denote that student nurses will complete
2300 hours of theory and practice respectively during training (Nursing and Midwifery
Council [NMC], 2018). Such high demands for practice can damage nursing students’ mental
wellbeing (Edwards et al., 2010).
Taken together, the low levels of mental wellbeing in nursing students are
increasingly recognised by the key governing bodies. Development of mental health
awareness for student nurses is regarded as a central part of their proficiency standards
(NMC, 2018). Despite these policy-level changes (e.g., NMC’s standards for mental
wellbeing), little information is offered on how this should occur within the academic
curriculum.
Self-Compassion as Key for Mental Health
Self-compassion, commonly regarded as the ability to notice suffering in oneself and
others with a commitment to eliminate the suffering (Neff, 2003a), is strongly related to
positive mental health experiences in many healthcare student populations (Kotera, Green
and Sheffield, 2019b; Kotera and Ting, 2019b). Three components of self-compassion are (i)
being kind and understanding towards oneself (self-kindness), (ii) acknowledging that
suffering is part of human life (common humanity), and (iii) being present in the here and
now (mindfulness). Self-compassion is recognised as a significant element in cultivating
compassion for others, particularly in terms of seeing failure and suffering as an inherent part
of human experience.
Self-compassion has been strongly related to improving mental health in UK
university students, where students who were more kind towards themselves demonstrated
4
better mental health (Kotera et al., 2018b, 2019a). The positive relationship between self-
compassion and mental health has been seen in professional nurses (Dev et al., 2018) and
nursing students (Luo et al., 2019).
Challenges in Cultivating Self-Compassion
Though numerous psychological benefits of self-compassion have been reported,
interventions to cultivate self-compassion remain unexplored. Common interventions (e.g.,
the Mindfulness Self-Compassion programme; Neff and Germer, 2013) are predominantly
associated with meditative exercises, failing to support people who are not suited for this
approach. For example, some people do not engage with meditation because of its non-
directiveness (i.e., they feel drowsy or sleepy) (Bojic and Becerra, 2017). People who have
recurrent trauma may be scared to practice meditation as it can expose them to traumatic
memory (Zeldin, 2015). In order to suggest alternative approaches for self-compassion, this
study aimed to identify predictors of self-compassion from more established psychological
constructs, namely emotional resilience (hereafter ‘resilience’), academic engagement
(hereafter ‘engagement’), motivation and mental wellbeing. These variables were chosen as
they were particularly associated with mental wellbeing and self-compassion in previous
research (Kotera, Green and Sheffield, 2019a, 2019c).
Resilience
Resilience is associated with self-compassion (Kotera and Ting, 2019). Although
there is still no agreed definition, resilience is commonly regarded as a construct where
internal resources and behaviours are embraced in order to cope with difficulties and
challenges, thus leading to a strengthened personality and psychological coping mechanisms
(Grant and Kinman, 2014). Resilience drives one’s attention to strengths and opportunities,
5
rather than weaknesses and vulnerability, through reframing one’s perspectives (Russ, Lonne
and Darlington, 2009; Harrison, 2013). Resilient individuals may be affected by difficulties
(e.g., trauma, loss); however they are not lastingly overwhelmed by these experiences
(Tugade and Fredrickson, 2004). Resilient people cope with these challenges by acquiring
new skills (Carver, 1998). Resilience is associated with better mental health, potentiating
compassion, self-efficacy, and mindfulness (Robertson et al., 2015).
Resilience has also been underlined as a potential factor to help nurses cope with
professional difficulties without impacting one’s mental wellbeing (NMC, 2018b). However,
to date, no studies empirically investigated the effect of resilience on self-compassion in
nursing students.
Engagement
Engagement can be defined as the time and physical energy that students spend on
relevant activities. Engagement can be defined as the culmination of effort experienced by
students to study, practice, obtain feedback, analyse, and solve problems (Kuh, 2003).
Engagement is a common construct in academic research as it is related to positive
educational outcomes such as higher student achievement, higher grades and successful
obtainment of an academic degree (Kuh, 2003). Engagement is also related to positive
psychological outcomes including better mental health (Suárez-Colorado et al., 2019; Datu,
2018; Kotera and Ting, 2019), resilience (Turner, Scott-Young and Holdsworth, 2017), and
higher intrinsic motivation (Armbruster et al., 2009). Despite these diverse positive
relationships between engagement and other psychological constructs, the impact of
engagement on self-compassion has not been appraised in nursing students.
Motivation
6
One of the most established motivation theories, the Self-Determination Theory
(SDT) maintains that each individual has an inherent tendency to express their psychological
energy into self-actualisation and social adjustment. Intrinsic motivation can be expressed in
activities that are inherently interesting and fulfilling (i.e., undertaking the activity itself is a
reward) (Deci and Ryan, 1985). Intrinsic motivation is associated with better performance
(Baard, Deci and Ryan, 2006), mental wellbeing (Bailey and Phillips, 2016), improved life
satisfaction (Locke and Latham 2004), increased prosocial behaviour (Gagne, 2003) and
ethical judgment (Kotera et al., 2018b). In higher education, students’ intrinsic motivation is
associated with meaningfulness (Utvær, 2014) and improved academic performance
(Khalaila, 2015).
Extrinsic motivation, on the other hand, can be observed in activities that are means to
an end, such as money and status (Deci and Ryan, 1985). Extrinsic motivation is associated
with burnout (Houkes et al., 2003), shame (Kotera et al., 2018a), depression (Blais et al.,
1993), limited performance (Vallerand, 1997), and unethical judgment (Kotera et al., 2018b).
The third category of motivation, amotivation, is when individuals do not feel interest or
value in a certain activity such as going to university (Shen et al., 2010).
Self-compassion’s impact on motivation has been identified; self-compassion expands
beliefs about a personal weakness, which motivates students to make amends and allocate
more study time for a difficult test following an initial failure (Breines and Chen, 2012).
However, the impact of motivation on self-compassion has not been evaluated.
Mental Wellbeing
Mental wellbeing can be defined as a state of equilibrium between an individual’s
resource pool and the challenges faced through events or challenges (Dodge et al., 2012).
Mental wellbeing relates to the experiences of happiness, life satisfaction, fulfilment,
7
functioning and purpose in life (Henderson and Knight, 2012). Furthermore, mental
wellbeing is understood as the foundation for optimal psychological development, learning
effectiveness, social connectedness, and physical health (Barry et al., 2013; Clarke,
Kuosmanen and Barry, 2015). It is a multi-dimensional measure of mental health, indicating
not just the presence of a positive psychological state but also suggesting the degree with
which individuals are able to realise their potential, cope with life’s challenges, and thrive
mentally (Slade, 2010). A recent cross-cultural study about nursing students’ mental
wellbeing between Slovenia (n=90) and Northern Ireland (n=109) reported that most of the
students (61% and 71%, respectively) had average level of mental wellbeing (Cilar et al.,
2019). However, the study also noted that the rates of nursing students whose mental
wellbeing was ‘below average’ or ‘very low’ were not modest (10% for Slovenian and 26%
for Northern Irish), suggesting a need for evaluation.
In the UK and Canada, where mental health research and policy have attracted
increasing attention, focus has shifted towards promoting mental wellbeing rather than
eliminating mental health problems (Department of Health, 2009; Mental Health Commission
of Canada, 2009). The relationship between mental health and mental wellbeing has been
investigated in Malaysian university students, where the need for student support has been
highlighted as a measure to reduce negative mental health symptoms (Mey and Yin, 2015).
Mental wellbeing was used as a key construct in order to predict large variances in students’
mental health experiences (Kotera and Ting, 2019). In the UK, midwifery students’ mental
wellbeing was investigated, and the importance of regular contacts with peers and academics
were highlighted (Oates et al., 2020), whereas interpersonal conflicts and lack of professional
support were identified as detrimental factors to their mental wellbeing (Oates et al., 2019).
Moreover, mental wellbeing of healthcare trainees, including nursing students, has been
challenging in light of the COVID-19 pandemic. An open culture of trust and resilience has
8
been highlighted as a key factor in maintaining good mental wellbeing in these challenging
times (Shaw, 2020). Despite the fact that these findings suggest a need to examine mental
wellbeing in greater detail, the impact of mental wellbeing on self-compassion, another key
contributor to good mental health, has not been examined in UK nursing students, one of the
most stressed student populations in higher education.
Accordingly, this study aimed to appraise relationships of self-compassion through
experiences of resilience, engagement, motivation and wellbeing in UK nursing students.
Methods
Study Design
We employed a cross-sectional design in order to generate timely output, and to
examine all variables altogether. Correlation and regression analyses were performed.
Participants
Participants were 18 years old or older and enrolled in a nursing programme at an
East Midlands (UK) university. Nursing students who were not present on the day of the
study were excluded. Paper-based questionnaires, comprising 58 items to be completed
approximately in 10 minutes, were distributed in July 2019 by the programme tutors instead
of the researchers to avoid bias. Opportunity sample of 198 full-time students who were
informed of the study, of which 182 (92% response rate) completed five psychological scales:
self-compassion, mental wellbeing, engagement, motivation and resilience. Our sample size
exceeded the required sample size calculated by power analysis (84: two tails, p H1 = 0.30, α
= 0.05, Power = 0.80, p H0 = 0; Faul et al., 2009). Among 182 participants, 144 were female
students (79%), 30 were male students (16%), and 8 did not respond (4%); their ages ranged
9
from 18 to 52 years old (M ± SD = 30.04 ± 8.31 years old); 146 were undergraduate students
(80%) and 36 were postgraduate students (20%); 164 were British students, 10 were African
students (e.g., Zimbabwean), 6 were other European students (e.g., Spanish), and 2 did not
respond. Coloured paper was prepared for visually impaired students, however none of the
participants used it. Our sample included slightly more male students (16%) than the general
UK nursing students (10%; Office for Students, 2020). No compensation was awarded for
participation. Following the ethical guidelines, the withdrawn 16 students were not asked for
the reason; no reason nor complaint was received.
Ethical Considerations
Ethical approval was granted by the University Research Ethics Committee (Ref:
011017YK). The same participants were also included in a parallel study by the authors.
Anonymity was maintained throughout the study. The participants were asked to create a
unique participation code, which would be used if they had decided to withdraw. Participants
were able to withdraw from the study up to two weeks after completing the survey, by
emailing the lead author and noting the participation code and their intention to withdraw.
Should the participants experience distress during the study, the contact information of
mental health services inside and outside the university was provided.
Instruments
Self-compassion was assessed using the Self-Compassion Scale-Short Form (SCS-
SF), a shortened version of the 26-item Self-Compassion Scale (Neff, 2003), comprising 12
five-point Likert items (e.g., ‘I try to be understanding and patient towards those aspects of
my personality I don’t like’; 1=‘Almost never’ to 5=‘Almost always’; scores for items 1, 4, 8,
9, 11 and 12 are reversed). The mean score of the 12 items was regarded as the self-
10
compassion score (Raes et al., 2011). Cronbach’s alpha was high (α=.86; Raes et al., 2011
and α=.87 in our sample).
Brief Resilience Scale (BRS; six items) was used to measure the level of resilience
(Smith et al., 2008). The six items including ‘I have a hard time making it through stressful
events’ are responded on the five-point Likert scale (1=‘Strongly disagree’ to 5=‘Strongly
agree’; scores for the items 2, 4, and 6 are reversed). The mean score of all six items was
identified as the resilience score (Smith et al., 2008). BRS had high internal consistency
(α=.80-.91; Smith et al., 2008 and α=.86 in our sample).
Engagement was assessed using the Utrecht Work Engagement Scale for Students
(UWES-S), a 17-item scale appraising how active and confident students feel towards their
academic activities (Schaufeli and Bakker, 2004). The 17 items consider three subscales:
vigour (vitality that leads to substantial effort in academic work; six items, e.g., 'I feel fit and
vigorous when I'm studying or I'm in class'), dedication (commitment to academic work; five
items, e.g., ‘My study inspires me’), and absorption (positive immersion in academic work;
six items, e.g., ‘When I am studying, I forget everything else around me’), which are rated on
a seven-point Likert scale (0=‘Never’ to 6=‘Always (everyday)’) (Schaufeli et al., 2002).
UWES-S had high internal consistency (α=.63-.81; Schaufeli and Bakker, 2004). In this
study, the average of the total score for the engagement measure was used (Schaufeli and
Bakker, 2004; α=.90 in our sample).
Academic Motivation Scale (AMS; Vallerand et al., 1992) was used to assess
motivation. AMS consists of 28 items that refer to three types of motivation: intrinsic
motivation (12 items, e.g., 'For the pleasure I experience when I discover new things never
seen before'), (b) extrinsic motivation (12 items, e.g., 'Because eventually it will enable me to
enter the job market in a field that I like'), and (c) amotivation (four items, e.g., 'I can't see
why I go to university and frankly, I couldn't care less.'). Students are asked why they go to
11
university
1
, and respond on a seven-point Likert scale (1=‘Does not correspond at all’ to
7=‘Corresponds exactly’). AMS demonstrated adequate to high internal consistency
(α=.62-.91; Vallerand et al., 1992 and α=.81-.92 in our sample). Each type of motivation was
calculated by averaging the scores in all relevant items (Vallerand et al., 1992).
Lastly, mental wellbeing was measured using the Short Warwick-Edinburgh Mental
Wellbeing Scale (SWEMWBS; Ng Fat et al., 2017), the shortened version of the Warwick-
Edinburgh Mental Wellbeing Scale (WEMWBS; 14 items; Stewart-Brown and Janmohamed,
2008). SWEMWBS consists of seven positively worded items (e.g., ‘I’ve been feeling
relaxed’) responded on a five-point Likert scale (1=‘None of the time’ to 5=‘All of the time’)
reflecting the previous two weeks. The score was calculated by summing all items (Ng Fat et
al., 2017). The internal consistency of SWEMWBS was high (α=.84; Ng Fat et al., 2017 and
α=.89 in our sample).
Procedure
After securing ethical approval, an opportunity sample of nursing students was
recruited, as noted in the Participants section. Tutors of nursing modules, who were not the
researchers, announced about the study approximately two weeks in advance, and distributed
the paper-based questionnaire in the beginning of their lectures. Once filled, the
questionnaires were collected by the tutor, and handed to a research assistant (not the
researcher of this study), who converted the data into a digital format.
Data Analyses
1
The original AMS used the word ‘college (CEGEP)’ however to adjust to the UK settings, it was changed to
‘university’.
12
Analyses were conducted using IBM SPSS version 25.0. First, using Little’s Missing
Completely at Random (MCAR; Little, 1988), incomplete responses of p > .05 were
recovered (n=7). As noted in the Instrument section, all scales used in this study were
validated with high reliability. Prior to this study, the same study design was used to explore
mental wellbeing of other healthcare students (Kotera, Green and Sheffiled, 2019a, 2019c).
Second, the collected data were screened for outliers and the assumptions of parametric tests.
Third, correlations between their self-compassion, resilience, engagement, motivation and
mental wellbeing were calculated. Lastly, regression analyses predicting self-compassion by
resilience, engagement, motivation and mental wellbeing were conducted. As all motivation
variables and resilience were not normally distributed (Shapiro-Wilk’s test, p < .05), data
were square-root-transformed to satisfy the assumption of normality (Field, 2017).
Results
No outliers were identified. All variables demonstrated good internal reliability in our
sample (α=.81-92; Table 1).
Table 1. Descriptive statistics: Self-compassion, resilience, engagement, motivation and
mental wellbeing in UK nursing students (n=182)
Scale (Construct)
Subscale (Range)
Mean
SD
Self-Compassion Scale-Short Form (Self-Compassion)
Self-Compassion (1-5)
2.68
.70
Brief Resilience Scale (Resilience)
Resilience (1-6)
3.17
.97
Utrecht Work Engagement Scale for Students
(Engagement)
Engagement (0-6)
3.68
.96
Academic Motivation Scale (Motivation)
Intrinsic Motivation (1-7)
4.39
1.21
Extrinsic Motivation (1-7)
5.14
1.04
Amotivation (1-7)
1.66
1.01
Short Warwick-Edinburgh Mental Wellbeing Scale
(Mental Wellbeing)
Mental Wellbeing (7-35)
22.81
5.40
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Relationships among Self-compassion, Resilience, Engagement, Motivation and Mental
Wellbeing
Pearson’s correlation was calculated (Table 2). Self-compassion was positively
related to age, resilience, engagement, intrinsic motivation and mental wellbeing, while
negatively related to amotivation. Students who had high levels of self-compassion tended to
be older, more resilient, engaged, intrinsically motivated, and have better mental wellbeing
and lower levels of amotivation. Resilience was positively associated with age, engagement,
and mental wellbeing while negatively associated with gender and amotivation. Students who
were resilient tended to be older, male, more engaged, and have better mental wellbeing and
lower levels of amotivation. Engagement was positively related to age, intrinsic motivation
and mental wellbeing, while negatively associated with amotivation. Students who were
engaged tended to be older, intrinsically motivated, have better mental wellbeing and lower
levels of amotivation. Intrinsic motivation was positively associated with extrinsic motivation
and mental wellbeing. Intrinsically motivated students tended to be also extrinsically
motivated and have better mental wellbeing. Extrinsic motivation was negatively related to
age. Extrinsically motivated students tended to be younger. Lastly, mental wellbeing was
positively related to age and negatively related to amotivation. Students who had good mental
wellbeing tended to be older and have lower levels of amotivation.
14
Table 2. Correlations among self-compassion, resilience, engagement, motivation and mental
wellbeing in UK nursing students (n=182).
1
2
3
4
5
6
7
8
9
1
Gender (1=M, 2=F)
-
2
Age
-.18*
-
3
Self-Compassion
-.14
.15*
-
4
Resilience
-.17*
.18*
.69**
-
5
Engagement
-.01
.28**
.36**
.26**
-
6
Intrinsic Motivation
.04
.06
.23**
.10
.48**
-
7
Extrinsic Motivation
.10
-.17*
-.08
-.13
.07
.56**
-
8
Amotivation
-.13
-.04
-.23**
-.19**
-.37**
-.15
-.07
-
9
Mental Wellbeing
.05
.23**
.61**
.55**
.49**
.28**
.05
-.23**
-
*p < .05, **p < .01. Point-biserial correlation coefficients were reported for gender.
Predictors of Self-Compassion
To explore the relative contribution of resilience, engagement, motivation and mental
wellbeing to self-compassion, multiple regression analyses were performed (Supplemental
Materials). First, gender and age were entered to adjust for their effects (step one), and then
resilience, engagement, motivation and mental wellbeing were entered (step two). Extrinsic
motivation was removed from this analysis as it was not significantly correlated to self-
compassion. Multicollinearity was not a concern (VIF<10). Adjusted coefficient of
determination (Adj. R2) were reported.
Resilience, engagement, motivation and mental wellbeing accounted for 52% of the
variance in self-compassion indicating a large effect size (Cohen, 1988). Resilience and
mental wellbeing were significant predictors of self-compassion, where resilience (β = .50;
one unit increase on the resilience scale is associated with .50 unit increase on the self-
compassion scale) predicted self-compassion more strongly than mental wellbeing (β = .29;
one unit increase on the mental wellbeing scale is associated with .29 unit increase on the
self-compassion scale).
15
Discussion
This study aimed to elucidate relationships between self-compassion, resilience,
engagement, motivation and mental wellbeing in nursing students. Our analysis revealed that
self-compassion was positively related to resilience, engagement, intrinsic motivation and
mental wellbeing, while negatively related to amotivation. Furthermore, resilience and mental
wellbeing were identified as significant predictors for self-compassion, with resilience being
the strongest predictor.
Most notable finding from the present study is that resilience was strongly related to
self-compassion consistently. This may help educators place self-compassion (a rather new
construct) in the context of their education curriculum, linking it with resilience (a more
established construct). In nursing education, resilience has been introduced with its tailored
definition: nursing student resilience, a developmental process, which occurs when a student
successfully copes with stress and difficulties using the relevant coping mechanisms
(Stephens, 2013). Resilience in nursing students was found important in positive educational
outcomes such as academic success and empowerment (Thomas and Revell, 2016). It can be
promoted in several ways including classroom training (Pines et al., 2014), social media
(Stephens, 2012), as well as reflection and coaching (Hodges, Keeley and Grier, 2005).
Reflective or coaching practice was also found useful in reframing students’ negative
experience into positive one by focusing on what they have learned (Hodges et al., 2005;
Stephens, 2013). Our findings suggest that these practical interventions can also be used to
cultivate students’ self-compassion. As critical resilience (keen self-awareness in relation to
one’s impact to the society; Traynor, 2018) is highlighted in the current nursing practice—
encouraging nurses to understand themselves and recognise their resilience more holistically
(Traynor, 2018)—, connecting resilience with the self-compassion can be useful to nursing
16
education. Educators can incorporate a self-compassion component into their existing
resilience training.
In addition, a strong relationship between mental wellbeing and self-compassion
identified in both correlation and regression analyses suggests that supporting nursing
students’ mental wellbeing can also help cultivate their self-compassion. Previous studies
reported that the social factor is especially important to nursing students’ mental wellbeing:
good social support can enhance their mental wellbeing, while a lack of social support can
harm it (Oates et al., 2019, 2020). Social support, including the quality of relationships with
peers, was negatively associated with burnout (Lee et al., 2019), suicidal behaviours (Leal
and Santos, 2016) and general health (Fang, Fang and Fang, 2020) in nursing students.
Students’ evaluation for social support can be increased through social and recreational
activities (Leal and Santos, 2016), and cultivating a caring culture in the programme and
placement (Fang et al., 2020). These social approaches can also cultivate self-compassion in
nursing students, via supporting their mental wellbeing. Future research needs to evaluate the
effects of social approaches on self-compassion in nursing students.
Limitations
Several limitations to this study should be noted. First, opportunity sample was
recruited at one university for participant recruitment, limiting the generalisability of the
findings. Second, SCS-SF was used to measure self-compassion; however, there is an
ongoing discussion about its accuracy (Kotera and Sheffield, 2020). Third, self-report
measures were used, which may contain response biases (Kotera, Van Laethem and Ohshima,
2020). Fourth, our data were not normality distributed. Fifth, other possibly relevant
constructs such as grid or hardiness were not explored. Lastly, the causality of these variables
has not been elucidated. Longitudinal data would be needed to understand the temporal
17
patterning of the observed relationships, which may help identify effective approaches in
cultivating self-compassion in nursing students.
Conclusion
The importance of self-compassion has been increasingly reported, however,
knowledge on how to cultivate self-compassion is still under-researched. Our findings
indicate that resilience and mental wellbeing were consistently and closely related to self-
compassion. Nursing educators and practitioners may be able to incorporate self-compassion
into the existing resilience training and/or mental wellbeing practices to help cultivate nursing
students’ self-compassion. In addition to the classroom teaching, coaching practice to
develop resilient reframing skills and social approaches to enhance mental wellbeing may
improve nursing students’ self-compassion as well. Our findings can help to inform
alternative approaches for cultivating nursing students’ self-compassion.
18
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Supplemental Material
Multiple regression: Resilience, engagement, motivation and mental wellbeing to self-compassion
among nursing students (n = 182).
Self-Compassion
B
SEB
β
Step 1
Gender (1=M, 2=F)
-.06
.04
-.11
Age
.003
.002
.13
Adj. R2
.02
Step 2
Gender (1=M, 2=F)
-.04
.03
-.07
Age
-.001
.001
-.03
Resilience
.38***
.05
.50
Engagement
.05
.06
.07
Intrinsic Motivation
.03
.04
.04
Amotivation
-.04
.04
-.06
Mental Wellbeing
.11***
.03
.29
Δ Adj. R2
.52
B=unstandardised regression coefficient, SEB=standard error of the coefficient, β=standardised
coefficient; ***p<.001.
... In the present study, a positive relationship between self-compassion, gender, age, resilience, engagement and intrinsic motivation was noted, consistent with previous findings showing the positive impact of self-compassion in academic settings [25,[83][84][85]. Students who cultivate self-compassion are likely to be more motivated [86], resilient and engaged [83]. ...
... In the present study, a positive relationship between self-compassion, gender, age, resilience, engagement and intrinsic motivation was noted, consistent with previous findings showing the positive impact of self-compassion in academic settings [25,[83][84][85]. Students who cultivate self-compassion are likely to be more motivated [86], resilient and engaged [83]. Moreover, self-compassion is directly related to academic performance [87] and mental wellbeing [82]. ...
... The relationship between the positive psychological constructs of motivation, engagement, resilience and self-compassion is key to achieving academic success. Moreover, we identified that resilience and intrinsic motivation were significant predictors of self-compassion, echoing previous findings: students who are able to bounce back from difficulties (i.e., resilience) and are passionate about their studies (i.e., intrinsic motivation) tend to have higher levels of kindness towards themselves [83,91,92]. In a recent study by Edgar et al. [93], student success is influenced by self-belief, which has been identified as a key dimension of motivation. ...
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... Mental health shame is feeling ashamed for having a mental health problem (Kotera et al. 2019d), and has been associated with poor mental health in business, psychotherapy, occupational therapy, social work, and nursing students in the UK [10,11,17,18]. One explanation for this association is that mental health shame reduces the likelihood that an individual will seek help for their mental health problems [19]. ...
... Findings indicate that individuals with higher levels of self-compassion may be more resilient [50], thus lowering levels of anxiety, depression, and stress-related illnesses [51,52]. However, our study found that external and internal shame negatively predicted self-compassion in postgraduate education students, which is consistent with previous research on self-compassion and mental health shame [11,18]. Shame is linked to psychopathology in various ways, evoking negative feelings across a range of mental health issues, such as anxiety and depression [48,53]. ...
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Although students in education have high rates of mental health problems, many of them do not ask for help, which can exacerbate their symptoms. One reason for their low help-seeking is shame associated with mental health problems. As education students aspire to provide care for chil-dren, they may feel ashamed to care for themselves as the role identity theory suggests. Self-compassion is reported to reduce shame and mental health problems. This study explored the relationships between mental health problems, mental health shame, self-compassion and care-giver identity among UK education students. One hundred nine postgraduate students completed four self-report scales regarding those constructs. Correlation and regression analyses were per-formed. Mental health problems were positively associated with shame and identity, while nega-tively associated with self-compassion. Self-compassion was the only significant predictor of mental health problems. Findings will help educators and education students to develop effective approaches for their mental health problems.
... Green & Sheffield, 2019, 2020; Kotera & Maughan, 2020), nursing students (Kotera, Cockerill, Chircop & Forman, 2020;Kotera, Cockerill, Chircop, Kaluzeviciute & Dyson, 2021), and psychotherapy and occupational therapy students . ...
... Our studies found that mental health problems were positively associated with mental health shame and caregiver identity, and negatively associated with self-compassion Kotera & Maughan, 2020). Moreover, self-compassion has been consistently the strongest predictor of mental health problems (Kotera, Cockerill, Chircop, Kaluzeviciute & Dyson, 2021;. In line with Trompetter et al.'s findings (2017), our findings also indicated that healthcare students who are kind and understanding towards themselves tend to have better mental health, suggesting that self-compassion is a protective factor for their mental health. ...
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This chapter seeks to identify common predictors of mental health problems in university students studying healthcare subjects by synthesising our research findings, and to suggest helpful approaches for these issues. Poor mental health of students is a cause of concern in many universities, being associated with higher dropout rates and poor academic performance. In particular, students studying healthcare subjects are known to suffer from a wide range of stressors including academic pressure and stress experienced in practice. Accordingly, our research, recruiting various healthcare student groups, explored the mental health status of this student group, and found that self-compassion was consistently identified as the strongest predictor of good mental health. Students who were kind and understanding towards themselves and their weaknesses, tended to have better mental health. Our findings indicate that cultivating self-compassion is an effective way to protect the mental health of healthcare students. Strategies centred around increasing self-compassion are discussed. Social marketing and digitalisation approaches may be particularly useful to incorporate into the current curriculum in healthcare studies. Self-compassion needs to be cultivated in order to protect the mental health of this future key worker group.
... Green & Sheffield, 2019, 2020; Kotera & Maughan, 2020), nursing students (Kotera, Cockerill, Chircop & Forman, 2020;Kotera, Cockerill, Chircop, Kaluzeviciute & Dyson, 2021), and psychotherapy and occupational therapy students . ...
... Our studies found that mental health problems were positively associated with mental health shame and caregiver identity, and negatively associated with self-compassion Kotera & Maughan, 2020). Moreover, self-compassion has been consistently the strongest predictor of mental health problems (Kotera, Cockerill, Chircop, Kaluzeviciute & Dyson, 2021;. In line with Trompetter et al.'s findings (2017), our findings also indicated that healthcare students who are kind and understanding towards themselves tend to have better mental health, suggesting that self-compassion is a protective factor for their mental health. ...
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This chapter seeks to identify common predictors of mental health problems in university students studying healthcare subjects by synthesising our research findings, and to suggest helpful approaches for these issues. Poor mental health of students is a cause of concern in many universities, being associated with higher dropout rates and poor academic performance. In particular, students studying healthcare subjects are known to suffer from a wide range of stressors including academic pressure and stress experienced in practice. Accordingly, our research, recruiting various healthcare student groups, explored the mental health status of this student group, and found that self-compassion was consistently identified as the strongest predictor of good mental health. Students who were kind and understanding towards themselves and their weaknesses, tended to have better mental health. Our findings indicate that cultivating self-compassion is an effective way to protect the mental health of healthcare students. Strategies centred around increasing self-compassion are discussed. Social marketing and digitalisation approaches may be particularly useful to incorporate into the current curriculum in healthcare studies. Self-compassion needs to be cultivated in order to protect the mental health of this future key worker group.
... However, these components may contribute differently to personal strengths. Researchers generally agree that resilience is related to positive psychological resource capacities including optimism, hope, and self-efficacy [52,53]. Individuals with optimistic viewpoints, high self-efficacy, and hope are more likely to find solutions to problems, rather than ruminating on the problems and past mistakes or errors [32]. ...
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Abstract Background Due to changes in family policy in China, pregnancy at advanced age (30 years old or above) is prevalent. Advanced maternal age is known to be related to a variety of negative health outcomes, including antenatal depression. Family relationship quality might be an important factor for antenatal depressive symptoms among Chinese women with advanced maternal age. However, the underlying mechanisms in which family relationship quality can affect antenatal depressive symptoms among this population and how positive psychological capital (PsyCap) intervenes in this impact are not clear. Objectives To describe the prevalence and demographic characteristics of antenatal depressive symptoms among Chinese pregnant women with advanced maternal age, and to explore the mediation effect of PsyCap in the associations between family relationship quality and antenatal depressive symptoms. Methods We conducted a cross-sectional survey at a tertiary hospital in China. A total of 192 women with maternal age of 30 years or older completed the questionnaires. Data on antenatal depressive symptoms, PsyCap, family relationship quality and demographic characteristics were collected. The multiple mediation models in SPSS’s PROCESS macro were used to test whether PsyCap mediated the relationship between family relationship quality and antenatal depressive symptoms. Results Approximately 28.6% of participants had antenatal depressive symptoms and 6.8% reported poor family relationship quality. Participants with higher education (p = .02) and better family relationship quality (p = .00) were less likely to have antenatal depressive symptoms. PsyCap collectively (β = 1.14, p
... Research shows that self-compassion can enhance resilience [28], engagement, and mental well-being, and reduce distress [29,30] and burnout [31,32]. In addition, it has shown to be a predictor of increased mental wellbeing [33,34] and engagement [35,36]. Since self-compassion is an important resource for coping with negative emotions and cognitions resulting from stressors and adversity, it may buffer the relationship between job demands and distress. ...
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The job demands-resources (JD-R) model has hardly been studied in volunteer organizations and there is a scarcity of studies evaluating self-compassion as a personal resource within the JD-R model. The present study addresses these gaps in current knowledge, first by examining the applicability of the JD-R model in a crisis line volunteer organization. Second, self-compassion is examined, both in terms of its moderating role on the exhaustion process as well as its role on the motivation process. Structural equation modelling was used for the analyses. The influence on the organizational outcome ‘compassion towards others’ was examined using a multiple regression analysis. The results showed that the JD-R model has an acceptable fit on this sample and supports the central assumption that exhaustion and motivation are two independent but related processes. This study provides evidence that self-compassion is a valuable addition to the JD-R model, as it has an indirect effect on both processes, and increases the explained variance in compassion towards others by 7% through the exhaustion process and by 3% through the motivational process. These findings point to the importance of focusing on self-compassion in training and supervision in volunteer organizations.
... Resilience, a psychological coping construct that embraces one's internal quality and behaviours (Grant & Kinman, 2014), is essential to cope with stress and other emotional difficulties (Kotera et al., 2021a). In order to foster students' resilience, we created online discussion board threads focusing on resilience, helping them identify their strengths in relation to learning and practice. ...
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Online education has been regarded as a lifeline for many education institutions during the COVID-19 pandemic, offering students a means to advance their education and career. While face-to-face teaching universities convert their education curricula to the online settings, many institutions lack effective online teaching strategies, leading to reduced student enrolment and satisfaction. Contrarily, we have been receiving an ever-increasing number of healthcare professional students in our learning department since the outbreak, while maintaining high satisfaction. These students work as registered professional key workers and study online. Among numerous measures taken to support this student group, this short paper reports four effective teaching practices we have implemented: (a) active use of adaptive learning, (b) Padlet discussions, (c) wellbeing webinars, and (d) resilience building. These teaching strategies are deemed to address weaknesses of online learning and offer emotional support to students. Our teaching practices will be useful to many universities supporting this crucial group of students in the online environment. Citation Kotera, Y., Spink, R., Brooks-Ucheaga, M., Green, P., Rawson, R., Rhodes, C., Chircop, J., Williams, A., Okere, U. & Lyte, G. (2021). Teaching healthcare professional students in online learning during covid-19: Reflection of university lecturers. Journal of Concurrent Disorders. https://concurrentdisorders.ca/2021/05/13/teaching-healthcare-professional-students-in-online-learning-during-covid-19-reflection-of-university-lecturers/
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Due to the increase the elderly population, issues related to the health and quality of life of this age group are worse than any other age group. The purpose of the present study was «Comparison of Effectiveness of the Four -Factor Model of Mindfulness and Self-Compassion on Life Satisfaction and Resilience of Elderly Women». Research method was semi-experimental with pre-test and post-test design with control and follow-up groups. The statistical population consisted of 473 elderly women who were under rehabilitation, education and care with welfare -organizationʼs supervision in Guilan province in 2020 in nursing homes, rehabilitation, education and care centers. A sample of 45 individuals were selected by purposeful sampling method and divided into three groups of 15 member each. For first experimental group, 8 sessions of Kabat – zinn's mindfulness training and for the other experimental group, 8 sessions of Gilbert's self-compassion training were performed. There was no intervention in the control group. Participants were evaluated in three groups at pre-test, post-test and follow-up stages using Diner et al's Life Satisfaction Questionnaire.and Conner & David Son's Resilience Questionnaire. multi-variate Analysis of variance was used to analyze the results. The results showed that the 4-factor model of mindfulness had an effect on life satisfaction and resilience of older women in the post-test (p <0.05), and this effect was permanent in the follow up phase (p <0.05). The results also showed that self-compassion had an effect on life satisfaction and resilience of elderly women in the post-test (p <0.05), and this effect was lasting in the follow-up phase (p <0.05). The results also showed that the effectiveness of the four-factor model of mindfulness and self-compassion was different on resilience and life satisfaction of older women and the contribution of the four-factor model of mindfulness was greater in the variance of resilience and life satisfaction rather than self-compassion. Therefore, these interventions can be used effectively in nursing homes as part of treatment programs. Therefore, these interventions can be used effectively in nursing homes. Key Words: Mindfulness, Self - Compassion, Satisfaction with Life, Resilience, Elderly Women
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Student nurses' well-being is essential to achieving academic targets and goals. This scoping review article aimed to explore the well-being among student nurses, its antecedence and consequences, as well as interventions that could help maintain and improve the well-being. PRISMA-ScR was used as a guideline, and a literature search was retrieved from four databases: Scopus, Web of Science, CINAHL, and PubMed. Fifty-four of 1104 articles were included and analyzed in this review. The review results indicated that the internal factors of well-being include the student's personality, psychological perceptions, sociodemographic, and health conditions. In contrast, the external factors were university location, facilities, graduate program, services, support, and learning environment. In addition, physical activity is considered a major intervention to improve well being. Therefore, this review serves as an input for universities, nursing schools, and nurse educators to pay attention to internal and external factors as well as to provide a physical activity intervention and good learning environment that make the students feel confident to achieve academic goals as a foundation to good nursing practice.
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Academic motivation is recognised as a key factor for academic success and wellbeing. Highly motivated students actively engage with academic activities and maintain higher levels of wellbeing. Despite the importance of motivation in education, its relationship with engagement and wellbeing remains to be evaluated. Accordingly, this study explored the relationships between motivation, engagement, self-criticism and self-compassion among UK education postgraduate students. Of 120 postgraduate students approached, 109 completed three self-report scales regarding those constructs. Correlation, regression and moderation analyses were performed. Intrinsic and extrinsic motivation were positively associated with engagement, whereas amotivation was
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Aims: To explore relationships between mental health problems, mental health shame, self- compassion and average length of sleep in UK nursing students. The increasing mental health problems in nursing students may be related to a strong sense of shame they experience for having a mental health problem. Self-compassion has been identified as a protective factor for mental health and shame in other student populations. Further, studies highlight the importance of sleep relating to mental health. Design: A cross‐sectional design. Methods: A convenient sampling of 182 nursing students at a university in the East Midlands completed a paper-based questionnaire regarding these four constructs, from February to April 2019. Correlation, regression and mediation analyses were conducted. Results: Mental health problems were positively related to shame, and negatively related to self- compassion and sleep. Mental health shame positively predicted, and self-compassion negatively predicted mental health problems: sleep was not a significant predictor of mental health problems. Lastly, self-compassion completely mediated the impacts of sleep on mental health problems (negative relationship between mental health problems and sleep was fully explained by self-compassion). Conclusion: The importance of self-compassion was highlighted as it can reduce mental health problems and shame. Self-compassion can protect nursing students from mental distress when they are sleep-deprived. Impact: Nurses and nursing students are required to work irregular hours (e.g., COVID-19), and mental distress can cause serious consequences in clinical practice. Our findings suggest that nurturing self-compassion can protect their mental health, and the negative impacts of sleep deprivation on mental health.
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Purpose From the perspective of positive psychology, our study aimed to explore depressive symptoms and psychological well-being among Chinese nurses and analyze the impacts of character strengths, self-efficacy and social support on the mental health of nurses. Methods A cross-sectional and descriptive design using five self-reported questionnaires was utilized to investigate a cohort of 4238 nurses during 2018. A structural equation modeling analysis was used to verify a hypothetical model linking character strengths, self-efficacy, social support, depressive symptoms and psychological well-being. Results The prevalence of depression among this cohort of Chinese nurses was 58.1%. The mean scores for caring, inquisitiveness, and self-control were 19.93 (SD=2.82), 15.94 (SD=3.00), and 16.34 (SD=2.95), respectively. The hypothesized model was a good fit of the data (χ²/df =1.77, p=.183, root mean square error of approximation =.04, goodness of fit index =1.00, comparative fit index =1.00, Tucker-Lewis index =1.00). Except for the path from self-control to depression, the other hypothetical paths investigated were statistically significant. Conclusion Character strengths were directly and positively associated with psychological well-being. Inquisitiveness was the strongest direct protective factor for depression. In addition, character strengths indirectly alleviated depression and increased psychological well-being through mediating variables of social support and self-efficacy. This study should alert nurse managers that more attention should be paid to the character strengths and mental health of nurses. This study provides evidence for interventions based on character strengths as a management strategy to support the mental health of nurses.
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Purpose: The primary purpose of this descriptive study was to compare the levels of, and relationships among mental health problems, mental health shame, self-compassion, work engagement, and work motivation between workers in Japan (collectivistic and success-driven culture) and the Netherlands (individualistic and quality-oriented culture). Design/methodology/approach: A cross-sectional design, where convenience samples of 165 Japanese and 160 Dutch workers completed self-report measures about mental health problems, shame, self-compassion, engagement and motivation, was used. Welch t-tests, correlation and regression analyses were conducted to compare i) the levels of these variables, ii) relationships among these variables, and iii) predictors of mental health problems, between the two groups. Findings: Dutch workers had higher levels of mental health problems, work engagement and intrinsic motivation, and lower levels of shame and amotivation than Japanese workers. Mental health problems were associated with shame in both samples. Mental health problems were negatively predicted by self-compassion in Japanese, and by work engagement in Dutch employees. Originality/value: The novelty of this study relates to exploring differences in work mental health between those two culturally contrasting countries. Our findings highlight potential cultural differences such as survey responding (Japanese acquiescent responding vs Dutch self-enhancement) and cultural emphases (Japanese shame vs Dutch quality of life). Job crafting, mindfulness and enhancing ikigai (meaningfulness in life) may be helpful to protect mental health in these workers, relating to self-compassion and work engagement. Findings from this study would be particularly useful to employers, managers, and staff in human resources who work with cross-cultural workforce. Keywords: cross-culture, Japanese workers, Dutch workers, work mental health, self-compassion, work engagement
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Objectives The Self-Compassion Scale-Short Form (SCS-SF) was developed as an economical alternative for the Self-Compassion Scale (SCS), one of the few scales to assess self-compassion. Despite the active use of the SCS-SF, a psychometric evaluation of this scale remains limited. This study analysed the factor structure, reliability, and construct validity of the SCS-SF in UK university student populations. Methods Of 365 students approached, 333 completed the SCS-SF, and other measures including negative psychological constructs (mental health problems, self-criticism, and mental health shame) and positive psychological constructs (self-reassurance, resilience, and wellbeing). Data were analysed through confirmatory factor analyses and correlations. Results CFA revealed that the six-factor structure, reported in the validation paper, was not replicated. The positive factor, consisting of the three positive subscales, was not strongly related to any variable, but moderately related to reassured-self, resilience, wellbeing, and inadequate-self. The negative factor, consisting of the three negative subscales, was strongly related to inadequate-self, and moderately related to resilience, reassured-self, stress, wellbeing, depression, and internal shame. Coefficients in the negative factor were in general larger than those in the positive factor. The total SCS-SF score was most strongly related to inadequate-self, followed by resilience. Inter-correlations of the six subscales did not follow Neff (2003b)'s theoretical model of self-compassion nor the full-scale factor solution. Conclusions Findings do not accord with the common use of the global SCS-SF score as an assessment of six factors of self-compassion, and suggest a two factor solution assessing self-criticism and self-compassion.
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Background: For oncology nurses, compassion fatigue, burn out and compassion satisfactions are frequently experienced psychosocial consequences of the oncology work environment. Surveying such phenomena helps to understand how nurses feel and behave when cancer care is provided. Besides, tracking the evolving nature of those three concepts can lend a hand for the early detection of personal and professional suffering of nurses while offering some healing remedies to their struggling bodies and souls. Purpose: The purpose of this study was to explore the level of compassion fatigue, burn out and compassion satisfaction among a group of specialized oncology nurses. Besides, this study aimed to detect some probable interesting inferences between compassion satisfaction and the concept of rest and leisure. Correlations between compassion fatigue, burn out and compassion satisfaction were investigated. Correlations between oncology nurses' scores on the three subscales and a group of demographic, organizational and leisure-related variables were examined. Methods: This study adopted a descriptive correlation design to survey compassion fatigue, burn out and compassion satisfaction among a convenient sample of 100 oncology nurses who work in a specialized cancer care centre. Participants completed compassion fatigue self-test developed by Figely (Compassion fatigue, New York: Brunner/Mazel. B. HudnallStamm, Traumatic Stress Research Group; 1995-1998. http://www.dartmouth.edu/~bhstamm/index.htm, 1995) and a literature-based demographic survey. Analysis of data included descriptive statistics and Pearson correlation co-efficient. Results: Nurses reported a low level of compassion satisfaction, moderate risk for burn out and an extremely high risk for compassion fatigue. Results revealed significant negative relationships among compassion satisfaction and the number of dependents per nurse. Additionally the correlation between compassion satisfaction and the nurses' number of hours slept was positive. Only two components of the concept rest and leisure yielded statistical significance when correlated to the concept of compassion satisfaction. A significant negative relationship was observed between compassion satisfaction and compassion fatigue while a strong positive relationship was observed between compassion fatigue and burn out. Conclusions: The studied oncology nurses sample had evidently low level of compassion satisfaction when contrasted to the significantly increased risks of burn out and compassion fatigue. Thus, health authorities and management are advised to care, in a holistic approach, for nurses who work in oncology departments. Staff-oriented services that offer comfort, reward, leisure, screening, consultation and support are urgently recommended.
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Highlights: • The COVID-19 pandemic may put the mental wellbeing of trainees at risk. • Hopelessness, helplessness and burnout are important to be aware of. • We need to foster an open culture of trust and support. • We need to promote resilience in colleagues/trainees where possible. Key words: Hopelessness; Helplessness; Burnout; Resilience; Doctors; Trainees; COVID-19; Coronavirus.
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Objective : midwifery student mental wellbeing is an important consideration for the sustainability of the profession, however it has seldom been the subject of empirical research. Previous studies of the lived experience of midwifery students have focused on the impact of transition experiences and student satisfaction, rather than specifically on mental health and students’ views on support for their mental wellbeing. Design : a qualitative descriptive study using semi-structured interviews. Setting : a midwifery undergraduate programme in one university in the South of England. Participants : 20 BSc midwifery students. Findings : two inductive themes were developed from our analysis. The theme of ‘the rollercoaster’ encapsulated students’ experience over the length of the course, characterised by multiple culture shocks of being in different worlds, from one clinical placement to the next, from university to clinical placement. This experience was emotionally taxing. The theme of ‘being noticed, feeling connected’ encapsulated midwifery students’ views on what could help them enjoy their training. They wanted to be seen as individuals by at least one educator, they wanted opportunities to connect with their peers and they wanted the support available to them to be consistent. Conclusions : listening to students’ insights into the lived experience of being a midwifery student can enable midwifery educators to improve the way courses are designed and support structures are put in place. The importance of having consistent contact with peers and educators cannot be underestimated. Implications for practice : The emotional demands of midwifery training must be acknowledged. Educators should identify ways in which they can provide students with consistent individualised support and regular opportunities to meet with their peers.
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Working with terminally ill patients is regarded as a stressful or traumatic event and may lead to negative outcomes, including job burnout and secondary traumatic stress (STS). Psychological resilience might protect employees from the negative consequences of stress. The aim of this study was to determine the mediating role of job burnout in the relationship between psychological resilience and STS. The study included 72 nurses aged from 22 to 72 years old (M = 46.01, SD = 10.69), working with terminally ill patients. The recipients completed 3 questionnaires: the Secondary Traumatic Stress Scale, the Oldenburg Burnout Inventory, and the Resilience Measurement. The results reveal negative associations between resilience, job burnout, and secondary traumatic stress, and a positive correlation between secondary traumatic stress and job burnout. Mediation analysis showed that job burnout plays a mediating role in the relationship between psychological resilience and secondary traumatic stress. Our findings highlight the role played by job burnout in the manifestation of STS. Professional and nonprofessional interventions for individuals experiencing work-related traumatic stress would benefit from interventions that build personal resources. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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The aim of this study was to explore the stressors and coping of nursing students with differing levels of resilience and burnout during clinical placement. A qualitative descriptive study was conducted with twenty-four final-year baccalaureate nursing students, who were identified in the quantitative phase of the study as having scores indicating either: a) low resilience and high burnout; or b) high resilience and low burnout. Ten focus group interviews were conducted using a semi-structured interview guide. A thematic analysis of the data identified two main themes: a) stressors arising from the students aligning their expectations with the demands of the clinical placement (i.e., practice demands in busy wards, striving for learning opportunities, and discovering the social rules), and b) coping as a process of fitting into the ward culture. Those students with high resilience and low burnout scores had self-directed goals and coped by using self-regulation strategies. Those with low resilience and high burnout adopted external orientation and self-blame strategies. As suggested by the findings, the following approaches are recommended: offering interventions to enable students to fit actively into the clinical environment; encouraging engagement in reflection to facilitate self-awareness; and encouraging flexible use of personal and external resources.