The relationship between spiritual health, health-promoting behaviors, depression and resilience: A longitudinal study of new nurses

• Published in: Nurse education in practice Vol. 56; p. 103219
• Main Authors: Chiang, Yi-Chien, Lee, Hsiang-Chun, Chu, Tsung-Lan, Wu, Chia-Ling, Hsiao, Ya-Chu
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.10.2021; Elsevier Limited
• Subjects: Curricula; Depression; Depression (Psychology); Economic Status; Emotional support; Family Characteristics; Health behavior; Health promotion; Health-promoting behaviors; Individual Characteristics; Individual Development; Intention; Job Satisfaction; Labor Force; Longitudinal studies; Mental depression; Mental Health; Nurse; Nurses; Nursing; Nursing education; Nursing Students; Occupational stress; Practice placements; Questionnaires; Religious Factors; Resilience; Resilience (Psychology); Response rates; Self report; Spiritual well being; Spirituality; Students; Symptoms; Workplaces; Taiwan; Spirituality; Depression; Health-promoting behaviors; Nurse; Resilience
• ISSN: 1471-5953; 1873-5223; 1873-5223
• DOI: 10.1016/j.nepr.2021.103219

To determine if levels of spiritual health, health-promoting behaviors, depressive symptoms and resilience change over time and determine if any variables have an impact on resilience among new nurses. Nurses provide patients with medical care and emotional support in high-stress environments. Resilience is a characteristic that allows one to adjust to these adverse situations. Resilience can help new nurses withstand the emotional stress of the workplace and improve nurse retention. The study was conducted from 2017 to 2019 with a convenience sample of nursing students (N = 195). Data were collected at four timepoints with self-report questionnaires on spiritual health, health-promoting behaviors, resilience and the Beck Depression Inventory-II from 2017 to 2019. Three timepoints were collected during the fourth year of the student stage: fall semester (T1), spring semester (T2) and just prior to graduation (T3); the fourth timepoint was the novice stage (T4), after at least 3 months as a registered nurse. General estimating equations determined predictors of resilience. A total of 124 new nurses completed all questionnaires (63% response rate). Although mean scores fluctuated slightly during the student stage, the scores at T4 were significantly worse for spiritual health (Wald χ2 = 30.23, p < .001), health-promoting behaviors (Wald χ2 = 34.89, p < .001), depressive symptoms (Wald χ2 = 46.75, p < .001) and resilience (Wald χ2 = 21.54, p < .001). Spiritual health, health-promoting behaviors were positively correlated with resilience (p < .001); depressive symptoms were negatively correlated (p < .001). Controlling for the effect of time, resilience of novice nurses was positively associated with nursing school practicum grade, spiritual health and health-promoting behaviors (β = 10.30, p < .001; β = 12.14, p < .001; and β = 14.62, p < .001, respectively) and negatively associated with depressive symptoms (β = − 0.53, p < .001). Scores for all variables were similar over the three timepoints of the student stage. However, the significant changes at T4 compared with the student stage suggest the novice stage of nursing was challenging. Increasing resilience could reduce the challenges of transitioning to a hospital environment. Nursing educators and administrators could increase nursing students’ resilience by restructuring the educational curricula. This could include helping nurses increase their spirituality and health-related behaviors and providing psychological support to reduce depressive symptoms. Increasing levels of resilience could reduce nurses’ emotional stress and improve retention of new nurses. •The spiritual health and resilience of nurses gets worse after graduation.•The resilience of nurses was positively associated with spiritual health.•The resilience of nurses was positively associated with health-promoting behaviors.•The resilience of nurses was negatively associated with depressive symptoms.