doi: 10.56294/hl202329

 

ORIGINAL

 

Level of resilience in nursing students doing their pre-professional internships at a university in northern Lima

 

Nivel de resiliencia en estudiantes de enfermería que realizan sus prácticas pre-profesionales de una universidad en Lima Norte

 

Lucia Asencios-Trujillo1  *, Lida Asencios-Trujillo1  *, Carlos La Rosa-Longobardi1  *, Djamila Gallegos-Espinoza1  *, Livia Piñas-Rivera1  *

 

1Universidad Nacional de Educación Enrique Guzmán y Valle, Escuela de Posgrado. Lima, Perú.

 

Cite as: Asencios-Trujillo L, Asencios-Trujillo L, La Rosa-Longobardi C, Gallegos-Espinoza D, Piñas-Rivera L. Level of resilience in nursing students doing their pre-professional internships at a university in northern Lima. Health Leadership and Quality of Life. 2023;2:29. https://doi.org/10.56294/hl202329

 

Submitted: 25-07-2023          Revised: 06-10-2023          Accepted: 29-12-2023          Published: 30-12-2023

 

Editor: Dra. Mileydis Cruz Quevedo  

 

ABSTRACT

 

Resilience is a capacity for adaptation and coping that nursing students have during their pre-professional training period, therefore, the objective of the study is to determine the level of resilience in nursing students doing their pre-professional internship at a university in North Lima. It is a quantitative, descriptive, cross-sectional and non-experimental study, with a population of 80 nursing students, who completed a questionnaire of sociodemographic data and the Connor-Davidson resilience scale. In their results, 14 % (n=11) of the students have low resilience, 21 % (n=17) medium resilience and 65 % (n=52) high resilience. In conclusion, it is necessary the implementation of psychoemotional support programs when students perform their pre-professional internships, since this allows the strengthening of well-being generates and thus strengthens their resilience.

 

Keywords: Resilience; Mental Health; Nursing Student; Clinical Practice.

 

RESUMEN

 

La resiliencia es una capacidad de adaptación y afrontamiento que tienen los estudiantes de enfermería durante su periodo de formación preprofesional, por lo tanto, el objetivo del estudio es determinar el nivel de resiliencia en estudiantes de enfermería que realizan sus prácticas preprofesionales en una universidad de Lima Norte. Es un estudio cuantitativo, descriptivo, transversal y no experimental, con una población de 80 estudiantes de enfermería, quienes completaron un cuestionario de datos sociodemográficos y la escala de resiliencia de Connor-Davidson. En sus resultados, el 14 % (n=11) de los estudiantes tienen resiliencia baja, el 21 % (n=17) resiliencia media y el 65 % (n=52) resiliencia alta. En conclusión, es necesaria la implementación de programas de apoyo psicoemocional cuando los estudiantes realizan sus prácticas pre-profesionales, ya que esto permite el fortalecimiento del bienestar genera y por lo tanto fortalece su resiliencia.

 

Palabras clave: Resiliencia; Salud Mental; Estudiante de Enfermería; Práctica Clínica.

 

 

 

INTRODUCTION

Mental health has recently been accepted, given that it plays a vital role in achieving objectives that contribute to global development. Therefore, students, especially health students, who begin the pre-professional internship stage must have an adequate way of facing different adversities or difficulties, such as the first contact with patients and the management of theory in the introductory nursing course, among others, since many of the students who begin their pre-professional internships are aged between 18 years (late adolescents) and over 12 years old.(1,2)

The Pan American Health Organization (PAHO) implemented a mental health project aimed at carrying out activities to strengthen and reduce psychological illnesses in order to promote mental health.(3) It also held an event called "Mental health problems are the main causes of disability in the world," in which mental health specialists from Latin America participated and indicated that every 40 seconds, late adolescents take their own lives, with suicide being the second leading cause of death worldwide and the third leading cause in the Americas.(4)

Latin America has a population of more than 140 million young people between the ages of 15 and 29, which includes our population of late adolescents; it mentions that poverty affects 39 % of these adolescents who do not have the possibility of continuing with their higher education due to the lack of economic resources that limit them to continue with their projects.(5) The country with the highest number of cases of depression is Brazil, where 5,8 % of its population suffers from depression, most of whom are adolescents in their late teenage years and whose university studies and relationships with their friends are affected.(6)

In Peru, according to the Ministry of Education (MINEDU), university students are more prone to suffer from some mental illness; anxiety ranks first with 82 % of cases in adolescents, followed by stress, affecting 79 % of university students, many of them are subjected to divide their time between studies, work, and home responsibilities, 52 % suffer from violence either physical or psychological.(7)

Although all types of mental health in people are caused in different ways, generating problems at the physical, psychological, and social levels, however, if they present different ways to solve it, the term to conceptualize it would be resilience, which can be evidenced in all types of population and ages, since it can be used by a person or also in collective, describing it in how the possibilities are taken to overcome risks and go against pessimistic forecasts, looking for opportunities to highlight their strengths and overcome situations and problems, with evidently downbeat endings.(10,11)

The debates on how the term resilience is defined or used are extensive since they are defined in many aspects of psychology. Resilience is useless even though, in the research, you have objectives and findings. It is not possible to define who first proposed the term, but resilience is a term that has been in use for more than five years, leaving words that were taken as synonyms of resilience, this being the most accurate.(12)

One of the qualities of resilience is the positive correlation to resistance, self-esteem, and satisfaction with life and work; it is also related to negative qualities such as depression and exhaustion either from work or studies. It was also demonstrated that the variety of factors that influence people is different since the ages and processes that people go through intervene; that is to say, the resilience perspective of a child will be very different from that of a young person, and in the same way, it will also be different for an adult because we do not have studies that demonstrate specific parameters that can determine the qualities for each age.(13)

In a study carried out in Cuba, with the participation of 63 students, they interpreted in their results that 27 % had high resilience, 52,4 % normal levels of resilience, and 20,6 % had low levels of resilience, so 79,4 % of the students have had resilient behavior. In conclusion, health students have been a critical element in facing the pandemic, which is why, as a consequence of everything they are facing, high levels of stress and low levels of resilience are evidenced.(14)

In another study carried out in Cuba, with the participation of 59 students, they interpreted in their results that 50 % of the participants had a medium level of resilience in their satisfaction dimension, 44,44 % in their dimension of feeling good alone, and self-confidence 38,88 %; and low levels of equanimity with 41,66 % and perseverance with 47,22 %. In conclusion, in order to increase resilience in students, it is necessary to develop different methodological actions on the part of teachers to help students.(15)

In a study carried out in Peru, with the participation of 70 students, the results showed that 74,29 % of the students presented high resilience, 24,29 % regular resilience, and 1,43 % low resilience. They concluded that resilience is positively related to student engagement.(16)

Therefore, the research objective is to determine the level of resilience in nursing students doing their pre-professional internships at a university in North Lima.

 

METHODS

In the study, according to its properties it is quantitative, with respect to its methodology it is descriptive-cross-sectional, non-experimental.(17)

 

Population

The population is made up of a total of 80 nursing students.

 

Inclusion Criteria

·      Students who are in their third semester or more.

·      Students who agree to participate in the research.

·      Students who sign the informed consent form

 

Technique and Instrument

The data collection technique was the survey, in which sociodemographic data and the Connor-Davidson Resilience Scale (CD-RISC 10) instrument were presented.

The CD-RISC 10 is an instrument in which a version proposed by Campbell-Sills and Stein is presented; the authors used the items of the original version since it presented favorable psychometric evidence when it was applied to Peruvian university students in 2019; this new version evaluates resilience in a unidimensional way and has 10 items where the Likert scale is from "0=not at all" to "4=always".(18) The structure of the scale comprises five dimensions, which are persistence-tenacity-self-efficacy, control under pressure, adaptability and support networks, control and purpose, and spirituality. In this case, the Connor-Davidson Resilience Scale, reduced variant (CD-RISC10), contains the items (1, 4, 6-8, 11, 14, 16, 17, and 19). In the same way, the score of each item is summed, and it is understood that the higher the score in each of the dimensions, the higher the indicator of resilience presented by the person and that the sum of the items provides the global measure of resilience, which increases in direct proportion to the scores.(19)

As for its validity, the Kaiser-Meier-Olkin test of sample adequacy obtained favorable results of 0.910 (KMO > 0.6), as well as Bartlett's test of sphericity (X2 = 641.549; gl = 45; p < 0.05). Likewise, the reliability by means of Cronbach's Alpha test, where a coefficient of 0.939 (α > 0.6) was obtained, indicating a very high degree of reliability.

 

Place and Application of the Instrument

First, prior coordination was made for data collection in November 2022, and the objectives of the study were explained to each student.

 

RESULTS

In Figure 1, we can see that 14 % of the participants have low resilience, 21 % medium resilience and 65 % high resilience.

 

Figure 1. Level of resilience in nursing students doing their pre-professional internships at a university in northern Lima.

 

In Figure 2, with respect to the persistence-tenacity-self-efficacy dimension, in their results, 65 % of the participants have a high level of persistence-tenacity-self-efficacy, 20 % medium level, and 15 % high level of persistence-tenacity-self-efficacy.

 

 

 

Figure 2. Level of resilience in its persistence-tenacity-self-efficacy dimension in nursing students doing their pre-professional internships at a university in North Lima

 

In Figure 3, as for the dimensions adaptability to change and control under pressure, 65 % present a high level, 19 % a medium level and 16 % a low level.

 

Figure 3. Level of resilience in its dimensions adaptability to change and control under pressure in nursing students doing their pre-professional internships at a university in northern Lima

 

In Figure 4, with respect to the dimensions of spirituality and support networks, 50 % present a high level, 30 % a medium level, and 20 % a low level.

 

 

Figure 4. Level of resilience in the dimensions of spirituality and support networks in nursing students doing their pre-professional internships at a university in northern Lima

 

DISCUSSIONS

Resilience is the ability to face risks in various life situations, to go against pessimistic predictions, and to successfully overcome problems despite the circumstances. When people do not have resilient capacities, they may present different mental health alterations, such as anxiety, depression, and not knowing how to cope with situations that generate stress.

Resilience in nursing students has yet to be studied much in Peru, and the few studies that have been found show that resilience in nursing students or students in the health area is relatively high; students present different deficiencies to be able to create resilient capacities more effectively.

Regarding the general objective, we observe that 65 % have a high level of resilience, which shows that more than half of the students are resilient in the face of the adverse circumstances they face, either in daily life or in pre-professional practices. The study by Espinoza and collaborators 14 obtained similar results, where 79,4 % of health sciences students demonstrated resilient behavior. However, they mention that all students have two constructive ways of facing any situation: one is to deal with problems, and the second way is to deal with emotions. We consider that circumstances such as going through a pandemic, which is a current problem in the world, they lived in a circumstance where they did not know the necessary strategies to cope with emotions, and this may have repercussions with future psychological problems such as anxiety, depression and especially stress, also considering the isolation and all the measures that were taken during the pandemic. Another study with similar results is that of Medina and collaborators 16, who showed that the level of resilience of nursing students was high, 74,29 %; this study supports that both works present high levels of resilience in the majority of nursing students.

Regarding the dimension persistence - tenacity - self-efficacy, it is observed that 65 % show a high level. Espinoza and collaborators 14, in their study, indicate that more than 50 % have a high and medium level of self-efficacy - tenacity - and persistence, which shows that they have resilient behavior, and this is very positive for them since they will be able to face different circumstances such as starting the pre-professional practices, thus progressively recovering their work as students.

As for their dimension of adaptability to change and control under pressure, it is observed that 65 % have a high level; as for their dimension of spirituality and support networks, it is observed that 50 % have a high level. In the study by Medina and collaborators 16, they emphasize that students are capable of creating resilient behaviors in relation to their commitment to their careers, which they can continue to strengthen during the university stage.

Resilience is one of the safest ways to define the strength that nursing students have to have; many kinds of research have shown that relationships between human beings based on trust and respect generate new teachings. This would allow students to acquire more confidence and greater self-confidence, and with this, they would gradually find favorable conditions in life and improve their expectations in the future.(10)

It is of utmost importance that after going through such a complicated moment in the world as the pandemic generated by COVID-19, the emotional states of nursing students are evaluated due to the isolation time, the change that was generated in the study method from face-to-face to virtual and even more in students who begin their pre-professional practices; Because all these events could increase fears, insecurities, among other situations and the students would not be able to perform adequately in their practices and this would affect them not only in the academic side, as they would be affected later at the end of the career and in their performance as professionals.

That is why teachers and tutors have to positively help to develop resilient behavior (coping and adapting) in students during the pre-professional internship. Therefore, institutions should develop strategies that enhance resilient skills to reduce stress and thereby improve mental health. Early prevention should be carried out in students and be able to help them improve negative behaviors.

 

CONCLUSIONS

In conclusion, we see that nursing students have a high rate of resilience so that in the future, they will be able to adapt and face challenges according to their professional training.

In addition, it is concluded that being resilient is a quality in health, since during the pre-professional practices, we are trained under pressure, contributing to academic and professional success.

Finally, it is necessary to implement psycho-emotional support programs when students perform their pre-professional internships since this allows the strengthening of well-being and thus strengthens their resilience.

 

REFERENCES

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2. Atencia D, Plaza Gómez M, Hernández Riaño H. Resiliencia, burnout y fracaso académico en estudiantes de Ingeniería de la Universidad de Córdoba, Colombia. Revista Espacios 2020;41:23.

 

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FINANCING

There is no external financing.

 

CONFLICT OF INTEREST

The authors declare that there are no conflicts of interest.

 

AUTHORSHIP CONTRIBUTION

Conceptualization: Lucia Asencios-Trujillo, Lida Asencios-Trujillo, Carlos La Rosa-Longobardi, Djamila Gallegos-Espinoza, Livia Piñas-Rivera.

Research: Lucia Asencios-Trujillo, Lida Asencios-Trujillo, Carlos La Rosa-Longobardi, Djamila Gallegos-Espinoza, Livia Piñas-Rivera.

Methodology: Lucia Asencios-Trujillo, Lida Asencios-Trujillo, Carlos La Rosa-Longobardi, Djamila Gallegos-Espinoza, Livia Piñas-Rivera.

Writing - original draft: Lucia Asencios-Trujillo, Lida Asencios-Trujillo, Carlos La Rosa-Longobardi, Djamila Gallegos-Espinoza, Livia Piñas-Rivera.

Writing - proofreading and editing: Lucia Asencios-Trujillo, Lida Asencios-Trujillo, Carlos La Rosa-Longobardi, Djamila Gallegos-Espinoza, Livia Piñas-Rivera.