kjan Korean Journal of Adult Nursing Korean J Adult Nurs 1225-4886 2288-338X Korean Society of Adult Nursing 10.7475/kjan.2019.31.3.303 kjan-31-303 Original Article Conditional Effect of Years Employed in Self-efficacy and Stress among Studying Clinical Nurses: An Exploratory Mixed Method Study Yu Soo-Young 1 Suh Eunyoung E. 2 Doctoral Student, College of Nursing, Seoul National University, Seoul, Korea Professor, College of Nursing, Research Institute of Nursing Science, Seoul National University, Seoul, Korea Corresponding author: Suh, Eunyoung E. https://orcid.org/0000-0002-2866-0911 College of Nursing, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul 03080, Korea. Tel: +82-2-740-8484, Fax: +82-2-742-7324, E-mail: esuh@snu.ac.kr 62019 2162019 313 303314 26022019 07052019 21052019 Copyright © 2019 Korean Society of Adult Nursing 2019 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Purpose

Although many studies have reported the high-stress levels of clinical nurses, there are few studies regarding the stress of clinical nurses who are concurrently working and studying as graduate students. This study investigated the stress, self-efficacy, and context of stress experienced by clinical nurses in graduate school.

 Methods

Explanatory sequential strategy of mixed method was used. Stress and self-efficacy were quantitatively analyzed by general and academic characteristics of 61 nurses. The effect of self-efficacy on stress and the conditional effect of the years employed were investigated through conditional process analysis. Stress and related contextual aspects were explored through focus group interviews, differentiated by the number of years employed, with 22 nurses in June of 2018.

 Results

The average score of self-efficacy was 3.42±0.53, and stress was 2.88±0.60, out of 5 points. There were no differences in self-efficacy and stress according to demographics and academic characteristics. The moderation effect of the number of years employed on stress was present for those nurses with under 8.88 years of experience. Nurses who had under 9 years of work experience endured a busy schedule full of study and work. On the other hand, participants with more than 9 years of work experience reported having household chores or childcare, so their academic career was less of a priority, and they faced incrementally increasing physical illness or strain in their family life.

 Conclusion

Since graduate school provides clinical nurses with the opportunity to further advance within the nursing field, a supportive environment is imperative.

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The Demographic and Job-related Characteristics of Participants (N=61)

Characteristics Categories n (%) M± SD
Gender Women 60 (98.4) 　
Men 1 (1.6)
Marital status Unmarried 33 (54.1) 　
Married 28 (45.9)
Age (year) 24~29 23 (37.7) 31.24±4.09
30~34 26 (42.6)
≥35 12 (19.7)
Course Master course 34 (55.7) 　
BSN to PhD 10 (16.4)
Doctoral course 17 (27.9)
Major Adult Nursing 34 (55.7) 　
CHNS 10 (16.4)
MCPM 17 (27.9)
Position Clinical staff nurse 53 (86.9) 　　
Charge nurse 2 (3.3)
Head nurse 4 (6.5)
Advanced practice nurse 2 (3.3)
Years employed 5 15 (24.6) 7.90±3.98
5~9 24 (39.3)
10~14 19 (31.2)
15~20 3 (4.9)
Future job Doctoral course (domestic) 3 (4.9) 　
Doctoral course (international) 8 (13.1)
Professor 10 (16.4)
Clinical nurse 33 (54.1)
Public organization 6 (9.9)
Unplanned 1 (1.6)
A biggest problem Health risk 6 (9.8) 　
A lack of room for personal life 24 (39.4)
Not being to committed to graduate school 16 (26.2)
Not being able to spend time with family 4 (6.6)
Getting a day off to get to school 11 (18.0)
Degree of support Low (1~2) 30 (49.2) 2.38±0.93
High (3~4) 31 (50.8)
Satisfaction Low (1~3) 33 (54.1) 3.38±0.77
　 High (4~5) 28 (45.9)

BSN to PhD=bachelors of science degree in nursing to philosophy of doctoral degree; CHNS=community health & nursing system; MCPH=maternal, child and psychiatric-mental health.

Level of Perceived Stress and Self-Efficacy according to Demographic Characteristics of Participants (N=61)

Characteristics Categories n (%) Perceived stress Self-efficacy
M± SD t or F p M± SD t or F p
Gender Women 60 (98.4) 2.79±0.55 - - 3.45±0.46 - -
Men 1 (1.6) 3.60 3.20
Marital status Unmarried 33 (54.1) 2.85±0.56 0.48 .492 3.37±0.46 1.85 .179
Married 28 (45.9) 2.75±0.54 3.53±0.46
Age (year) 24~29 23 (37.7) 2.72±0.59 .336† 3.60±0.41 2.62 .081
30~34 26 (42.6) 2.92±0.60 3.31±0.47
≥35 12 (19.6) 2.69±0.28 3.42±0.47
Course Master course 34 (55.7) 2.78±0.47 0.89 .413 3.45±0.42 0.10 .904
BSN to Ph. D 10 (16.4) 3.00±0.63 3.38±0.69
Doctoral course 17 (27.9) 2.71±0.66 3.46±0.40
Major Adult Nursing 34 (55.7) 2.80±0.55 1.18 .313 3.51±0.43 0.13 .329
CHNS 10 (16.4) 3.01±0.68 3.28±0.60
MCPM 17 (27.9) 2.67±0.46 3.39±0.43
Position Staff nurse 53 (86.9) 2.82±0.57 0.37 .543 3.44±0.48 0.01 .918
Managers 8 (13.1) 2.69±0.36 3.43±0.32
Years employed 5 15 (24.6) 2.87±0.58 0.24 .786 3.58±0.46 1.05 .360
5~9 24 (39.3) 2.75±0.56 3.43±0.45
≥10 22 (36.1) 2.81±0.54 3.35±0.47
Degree of support Low (1~2) 30 (49.2) 2.80±0.58 2.30 .132 3.45±0.48 0.00 .965
High (3~4) 31 (50.8) 2.97±0.57 3.45±0.52
Satisfaction Low (1~3) 33 (54.1) 2.93±0.62 1.03 .312 3.35±0.58 2.26 .135
High (4~5) 28 (45.9) 2.82±0.57 3.49±0.46

CHNS=community health & nursing system; MCPH=maternal, child and psychiatric-mental health;

Kruskal- Wallis H.

The Effect of Self-efficacy on Stress controlled by Years Employed of Participants (N=61)

Variables Model I Model II Model III
β SE t (p) β SE t (p) β SE t (p)
(Constant) 42.55 5.03 8.46 (＜.001) 44.93 5.43 8.28 (＜.001) 64.61 12.51 5.16 (＜.001)
GSE 0.35 0.14 -2.92 (.005) -0.37 0.14 -3.06 (.003) -1.00 0.34 -2.86 (.005)
Years employed -0.14 0.17 -1.14 (.256) -2.76 1.48 -1.86 (.068)
GSE × Years employed 0.07 0.04 1.73 (.087)
F (p) 8.52 (.005) 4.94 (.010) 4.41 (.007)
R2 0.12 0.11 0.18
Adjusted R2 0.11 0.12 0.15
R2 change 0.13 0.02 0.04

SE=standard error; GSE=general self-efficacy.

Main Themes on the Aspects of Life Stresses among Clinical Nurses in Graduate School

Core stress of clinical nurses ＜9 years† Theme A-1. Repetitive daily life of school, work, and home
Enduring busy schedule with full of work and study Theme A-2. Taking an additional role of studying RN in the unit
≥9 years‡ Theme B-1. Studying is pushed back on the priority list
Barely putting up with the stressed life with family Theme B-2. Being the most stressed person in family

Stress of clinical nurses with less than 9 years of clinical experiences;

Stress of clinical nurses with over 9 years of clinical experiences.