Journal of Practical Engineering Education (실천공학교육논문지)

Korean Institute for Pratical Engineering Education (한국실천공학교육학회)
권호 표지
DOI QR코드

DOI QR Code

Mediating Effect of Depression on the Relationship between Academic Burnout and Clinical Practice Stress among Nursing Students in the Post-COVID-19 Era

COVID-19 이후 간호대학생의 학업소진과 임상실습 스트레스 간의 관계에서 우울의 매개효과

  • Jin-Hee Jeong (Baekseok Culture University Department of Nursing) ;
  • Mi- Hyeon Park (Baekseok Culture University Department of Center for Teaching and Learning)
  • 정진희 (백석문화대학교 간호학과) ;
  • 박미현 (백석문화대학교 교수학습개발원)
  • Received : 2024.09.21
  • Accepted : 2024.10.09
  • Published : 2024.10.31
Download PDF
⟨ Previous Next ⟩

Abstract

This study aimed to test a hypothetical model explaining the mediating effect of depression on the relationship between academic burnout and clinical practice stress among nursing students in the post-COVID-19 era. A cross-sectional survey was conducted with 200 senior nursing students from two universities in C province, South Korea, from December 1 to 9, 2023. Data were analyzed using descriptive statistics, Pearson's correlation, and structural equation modeling with SPSS/WIN 26.0 and AMOS 26.0. The hypothesized model explained 75.6% of the variance in clinical practice stress among nursing students. Depression did not mediate the relationship between academic burnout and clinical practice stress (β=.06, p=.160). However, both academic burnout (β=.77, p=.004) and depression (β=.23, p=.005) directly affected clinical practice stress. In the post-COVID-19 era, academic burnout significantly influences nursing students' clinical practice stress. While depression does not mediate this relationship, it directly affects clinical practice stress. These findings suggest the need for interventions focusing on reducing academic burnout through mentoring programs and stress management strategies, alongside depression management, to alleviate clinical practice stress among nursing students. Future nursing education should implement an integrated approach to manage students' academic burden and support mental health following clinical practice.

본 연구는 COVID-19 이후 간호대학생의 학업소진과 임상실습 스트레스 간의 관계에서 우울의 매개효과를 설명하는 가설적 모델을 검증하기 위해 시행되었다. 연구기간은 2023년 12월 1일부터 12월 9일까지이었고, 연구대상자는 C도에 위치한 2곳의 4학년 간호대학생 200명을 대상으로 하였으며 수집된 자료는 SPSS/WIN 26.0, AMOS 26.0을 사용하여 기술적 통계, Pearson correlation, 구조방정식모델분석을 실시하였다. 학업소진과 임상실습 스트레스 간의 관계에서 우울의 매개효과를 확인한 결과 우울(β=.06, p=.160)는 학업소진(β=.77, p=.004)과 임상실습 스트레스(β=.23, p=.005) 간의 관계에서 매개효과가 없는 것으로 확인 되었으나 학업소진, 우울은 임상실습 스트레스에 직접적인 영향을 미쳤다. 가설모델은 간호대학생의 임상실습 스트레스에 대한 설명력은 75.6%로 나타났다. 본 연구결과, COVID-19 이후 간호대학생의 임상실습 스트레스에 학업소진이 주요한 영향을 미치는 것으로 확인되었으며 우울은 매개효과를 보이지 않았지만 임상실습 스트레스에 직접적인 영향을 미치는 것으로 나타났다. 따라서 간호대학생의 임상실습 스트레스를 경감시키기 위해서는 학업소진 완화를 위한 멘토링프로그램 및 스트레스 관리 중재와 함께 우울에 대한 중재가 필요함을 시사한다. 향후 간호교육 과정에서 임상실습 후 학생들의 학업 부담 관리와 정신 건강 지원에 대한 통합적 접근이 요구된다.

Keywords

References

  1. WHO. World Health Organization Coronavirus disease 2019 (COVID-19) situation report - 66. [Online] Available: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200326-sitrep-66-covid19.pdf?sfvrsn=81b94e61_2
  2. G. Dewart, L. Corcoran, L. Thirsk, and K. Petrovic, "Nursing education in a pandemic: Academic challenges in response to COVID-19," Nurse Education Today, vol. 92, p. 104471, 2020.
  3. S. Y. You and M. Y. Cho, "Nursing students' experiences of online adult nursing practicum in COVID-19," Journal of Learner-Centered Curriculum and Instruction, vol. 21, no. 10, pp. 385-398, 2021.
  4. H. Y. Kim and E. H. Lee, "Clinical practice experience of nursing students in the context of the COVID-19 pandemic," Journal of Korean Academy of Fundamentals of Nursing, vol. 29, no. 1, pp. 45-56, 2022.
  5. U. Langegard, K. Kiani, S. J. Nielsen, and P.-A. Svensson, "Nursing students' experiences of a pedagogical transition from campus learning to distance learning using digital tools," BMC Nursing, vol. 20, pp. 1-10, 2021.
  6. S. I. Kim and M. K. Park, "Class experience of nursing students in the post COVID-19 Age," Journal of the Korea Academia-Industrial Cooperation Society, vol. 20, no. 8, pp. 97-107, 2022.
  7. M. R. Park, E. S. Park, and N. J. Je, "The impact of interpersonal skills, psychosocial health, and confidence in performing nursing skills on clinical performance of nursing students who experienced clinical practice after COVID-19," Journal of the Convergence on Culture Technology, vol. 10, no. 4, pp. 159-168, 2024.
  8. S. Alghtany, A. Madhuvu, E. Fooladi, and K. Crawford, "Assessment of academic burnout and professional self-concept in undergraduate nursing students: A cross-sectional study," Journal of Professional Nursing, vol. 52, pp. 7-14, 2024.
  9. S. J. Whang, "The relationship between clinical stress, self-efficacy, and self-esteem of nursing college students," The Journal of Korean Academic Society of Nursing Education, vol. 12, no. 2, pp. 205-213, 2006.
  10. S. Shalaby and S. AlDilh, "Exploring the relationship between perceived stress and academic achievement among critical care nursing students," Athens Journal of Health, vol. 2, no. 4, pp. 283-296, 2015.
  11. L. J. Labrague, D. M. McEnroe-Petitte, D. Gloe, L. Thomas, I. V. Papathanasiou, and K. Tsaras, "A literature review on stress and coping strategies in nursing students," Journal of Mental Health, vol. 26, no. 5, pp. 471-480, October 2017.
  12. E. J. Lim and M. H. Lee, "Convergence relationship among interpersonal competence, clinical stress and clinical competence in nursing students," Journal of Digital Convergence, vol. 17, no. 5, pp. 279-286, 2019.
  13. E. H. Hwang and J. H. Kim, "Factors affecting academic burnout of nursing students according to clinical practice experience," BMC Medical Education, vol. 22, no. 1, p. 346, 2022.
  14. Y. X. Zheng, J. R. Jiao, and W. N. Hao, "Stress levels of nursing students: A systematic review and meta-analysis," Medicine, vol. 101, no. 36, p. e30547, 2022.
  15. A. Alsolais, N. Alquwez, K. A. Alotaibi, A. S. Alqarni, M. Almalki, F. Alsolami, J. Almazan, and J. P. Cruz, "Risk perceptions, fear, depression, anxiety, stress and coping among Saudi nursing students during the COVID-19 pandemic," Journal of Mental Health, vol. 30, no. 2, pp. 194-201, April 2021.
  16. K. Golonka, J. Mojsa-Kaja, M. Blukacz, M. Gawlowska, and T. Marek, "Occupational burnout and its overlapping effect with depression and anxiety," International Journal of Occupational Medicine and Environmental Health, vol. 32, no. 2, pp. 229-244, April 2019.
  17. P. Koutsimani, A. Montgomery, and K. Georganta, "The relationship between burnout, depression, and anxiety: A Systematic Review and Meta-Analysis," Frontiers in Psychology, vol. 10, p. 284, 2019.
  18. R. S. Lazarus and S. Folkman, Stress, appraisal, and coping. Springer publishing company, 1984.
  19. M. S. Kim and J. A. Park, "Effects of incivility experienced nursing student, clinical practice satisfaction, burnout on stress of clinical practice," Journal of Learner-Centered Curriculum and Instruction, vol. 18, no. 10, pp. 811-828, 2018.
  20. K. Park, "Effects of nursing students' depression, fatigue and clinical practice satisfaction on stress of clinical practice in the COVID-19," Journal of Learner-Centered Curriculum and Instruction, vol. 13, no. 5, pp. 3287-3300, 2022.
  21. J. K. Park and M. Y. Choi, "The relation between stress of clinical practice and burnout among nursing students: the mediation effect of spiritual well-being," The Journal of Korean Academic Society of Nursing Education, vol. 23, no. 3, pp. 300-308, 2017.
  22. P. Zhu, T. Xu, H. Xu, Q. Ji, W. Wang, M. Qian, and G. Shi, "Relationship between anxiety, depression and learning burnout of nursing undergraduates after the COVID-19 epidemic: The mediating role of academic selfefficacy," International Journal of Environmental Research and Public Health, vol. 20, no. 5, p. 4194, 2023.
  23. J. P. Yu, The concept and understanding of structural equation modeling. Seoul: Hannare Publishing Co, 2012, pp. 567.
  24. S. H. Lee and D. Y. Lee, "Validation of the MBI-SS scales-based on medical school students," Asian Journal of Education vol. 14, no. 2, pp. 165-187, 2013.
  25. L. S. Radloff, "The CES-D scale: A self-report depression scale for research in the general population," Applied Psychological Measurement, vol. 1, no. 3, pp. 385-401, 1977.
  26. G. G. Jeon, S. J. Choi, and B. J. Yang, "Development of an integrated Korean version of CES-D," Korean Journal of Health Psychology, vol. 6, no. 1, pp. 59-76, 2001.
  27. D. L. Beck and R. Srivastava, "Perceived level and sources of stress in baccalaureate nursing students," Journal of Nursing Education, vol. 30, no. 3, pp. 127-133, 2013.
  28. J. E. Lee and S. L. Kim, "Relationship among stress, coping strategies, and self-esteem in nursing students taking clinical experience," The Journal of Korean Academic Society of Nursing Education, vol. 11, no. 1, pp. 98-106, 2005.
  29. B. R. Bae, In: Structural equation modeling with AMOS 21. Seoul: Chungram Publishing, 2014.
  30. X. Song, N. Ding, N. Jiang, H. Li, and D. Wen, "Time use in out-of-class activities and its association with self-efficacy and perceived stress: data from second-year medical students in China," Medical Education Online, vol. 25, no. 1, p. 1759868, December 2020.
  31. K. Maenpaa, H. Jarvenoja, J. Peltonen, and K. Pyhalto, "Nursing students' motivation regulation strategies in blended learning: A qualitative study," Nursing Health Science, vol. 22, no. 3, pp. 602-611, September 2020.
  32. Y. H. Kim, "The effects of clinical practice stress and academic burnout of nursing student on depression in the ongoing COVID-19 situation," The Journal of Humanities and Social Sciences 21, vol. 13, no. 13, pp. 519-534, 2022.
  33. R. Meng, X. Luo, S. Du, Y. Luo, D. Liu, J. Chen, Y. Li, W. Zhang, J. Li, and C. Yu, "The mediating role of perceived stress in associations between self-compassion and anxiety and depression: further evidence from Chinese medical workers," Risk Management and Healthcare Policy, vol. 13, pp. 2729-2741, 2020.
  34. M. Sanchez de Miguel, A. Orkaizagirre-Gomara, J. Ortiz de Elguea, A. Izagirre Otaegi, and A. Ortiz de Elguea-Oviedo, "Factors contributing to stress in clinical practices: A proposed structural equation model," Nursing Open, vol. 7, no. 1, pp. 364-375, 2020.
  35. S. H. Kim, J. H. Lee, and M. R. Jang, "Factors affecting clinical practicum stress of nursing students: using the Lazarus and Folkman's stress-coping model," Journal of Korean Academy of Nursing, vol. 49, no. 4, pp. 437-448, 2019.