Resilience, Stress and Well-Being in Undergraduate Nursing Students in China and the UK

Abstract

To test the differences of resilience, stress and well-being and explore the correlations between nursing students in China and United Kingdom. Globally nursing is considered a demanding profession and increasing attention has been placed on the psychological well-being and resilience of undergraduate nursing students. Limited international comparative research of the interaction between resilience, stress and wellbeing has been reported. A cross-sectional correlational design was adopted with a purposive sample of 444-second year nursing students, recruited from two universities, located in the United Kingdom and China. Resilience, stress and psychological well-being were assessed via selfreported questionnaires (Connor Davidson Resilience Scale; WHO 5 wellbeing Index; The Perceived Stress Scale) and a demographic inventory. Findings show the average scores of resilience revealed for UK and Chinese nursing students (26.70±5.11 and 25.18±5.61), stress (20.94±3.87 and 21.54±3.64) and well-being (15.43±4.38 and 14.93±4.00) respectively. Differing levels of resilience between the two countries affected by age and intention to leave was reported. The interaction between resilience and stress influences the psychological well-being of the undergraduate nursing students in both countries. Nursing students are experiencing stress, which is affecting their psychological well-being, but resilience is a protective factor. Intervention studies are required to ensure student nurses, especially younger students, are equipped with strategies to cope with stress during their education. The high prevalence of stress among nursing student is of concern. In response, educational, government and employing hospitals should develop measures and policies to support student nurses to help reduce stress and enhance resilience.

Stress and resilience and associated factors among nursing undergraduates in the early stages of the COVID-19 pandemic

“…It is similar to many other studies where the majority of students experienced a low level of stress [33], a mild level of stress [38] and moderate stress [10], [15], [23], [27]. In contrast, higher mean stress scores have been reported in other studies conducted among nursing undergraduates in Australia [6], China [11], [17] and the UK. Stress-related symptoms such as disturbed sleep patterns, loss of appetite and feeling nausea and vomiting were among nursing undergraduates in the present study.…”

“…This was inconsistent with another study where a significant negative correlation between perceived stress level and resilience was found [41]. In contrast, some studies found resilience score was associated with age and intention to leave [11].…”

“…This was consistent with other studies where the resilience level was low [31], [40] and moderate [17]. But inconsistent with the findings of the China and UK study where the resilience score was high [11]. There was no significant difference in resilience score and the PSS level and other demographic factors among the undergraduates in the present study.…”

“…The PSS consists of 10 items on a 5-point Likert scale ranging from 0 (never) to 4 (very often), indicating how often they have felt or thought a certain way within the past month. Scores can range from 0 to 40, with the higher the score indicating the more perceived stress [11]. The internal consistency reliability was Cronbach's alpha 0.89 [6].…”

“…The way nursing undergraduates cope with stress and stressors lead to positive or negative outcomes. A low or moderate level of stress may enhance students' motivation [9], [10] or on the other hand, a high level of stress can have negative influences such as depression and poor academic performance [11]. "Resilience is the process of adapting well in the face of adversity, trauma, tragedy, threats, or significant sources of stress" [12].…”