Effects of Bullying Experience on Psychological Well-Being Mediated by Conflict Management Styles and Psychological Empowerment among Nursing Students in Clinical Placement: A Structural Equation Modeling Approach

Liping Ren; Hyunli Kim

doi:10.4040/jkan.2017.47.5.700

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Ren and Kim: Effects of Bullying Experience on Psychological Well-Being Mediated by Conflict Management Styles and Psychological Empowerment among Nursing Students in Clinical Placement: A Structural Equation Modeling Approach

Original Article

J Korean Acad Nurs 2017;47(5):700-711.

Published online: 15 January 2017

DOI: https://doi.org/10.4040/jkan.2017.47.5.700

Effects of Bullying Experience on Psychological Well-Being Mediated by Conflict Management Styles and Psychological Empowerment among Nursing Students in Clinical Placement: A Structural Equation Modeling Approach

Liping Ren¹, Hyunli Kim^2,

¹College of Nursing, Jining Medical University, Jining, Shandong, China

²College of Nursing, Chungnam National University, Daejeon, Korea

Address reprint requests to : Kim, Hyunli College of Nursing, Chungnam National University, 266 Munhwa-ro, Jung-gu, Daejeon 35015, Korea Tel: +82-42-580-8330 Fax: +82-42-580-8322 E-mail: hlkim@cnu.ac.kr

Received 10 March 2017 Revised 29 August 2017 Accepted 31 August 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

Abstract

Purpose

This study aimed to test a proposed structural equation model in which bullying experience, conflict management styles and psychological empowerment predict psychological well-being among Chinese nursing students in clinical placement.

Methods

Three hundred and sixty-six nursing students recruited from five hospitals in J city and Y city were assessed with self-report questionnaires on bullying experience, conflict management styles, psychological empowerment and psychological well-being including depression, self-esteem, and academic major satisfaction. Data were analyzed using SPSS version 20.0 and AMOS version 22.0.

Results

The evaluation parameters included the comparative fit index at .90, the goodness of fit index at .93, the root mean square error of approximation at .07, and c²/df ratio at 2.66, indicating that the proposed structural equation model provided a good fit to the data. Experience of being bullied during clinical placement, conflict management styles and psychological empowerment explained 93.0% of the variance and had significant effects on psychological well-being, with conflict management styles and psychological empowerment mediating the association between bullying and psychological well-being.

Conclusion

The findings indicated that mediation by conflict management styles and psychological empowerment alleviated the negative influence of bullying on psychological well-being. To limit bullying and its negative effects, development of effective guidelines to deal with bullying will be a critical tool for both Chinese nursing students and their instructors. Further research should incorporate conflict management styles and psychological empowerment into the specific intervention strategies for handling bullying behaviors among nursing students and staff nurses and promoting nursing students’ psychological well-being.

Keywords: Nursing students, Bullying, Depression, Self concept, Personal satisfaction

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Figure 1.

Conceptual framework.

Figure 2.

Path diagrams for the hypothetical model.

Table 1.

Sample Characteristics (N=366)

Characteristics	Categories	n (%)
Gender	Female	352 (96.2)
	Male	14 (3.8)
Ethnicity	The Han nationality	291 (79.5)
	The ethnic Korean	51 (13.9)
	Other nationality	24 (6.6)
Education program	Technical secondary school	68 (18.6)
	Junior college	120 (32.8)
	Undergraduate	178 (48.6)
Perceived academic performance	Bad	72 (19.7)
	Middle	175 (47.8)
	High	119 (32.5)
Bullying management class	No	247 (67.5)
	Yes	119 (32.5)
Teacher’s help to deal with bullying	No	159 (43.4)
	Yes	207 (56.6)
Nurse’s help to deal with bullying	No	249 (68.0)
	Yes	117 (32.0)
Relationship between nurses and	Bad	128 (35.0)
students	Neutral	132 (36.0)
	Good	106 (29.0)

Table 2.

Descriptive Statistics of Variables (N=366)

Variables	Categories	Range	M±SD	Skewness	Kurtosis	Tolerance	VIF
Bullying experience	Work-related bullying	0~16	2.98±1.82	1.06	0.47	0.50	1.99
	Person-related bullying	0~24	3.95±1.72	1.56	1.86	0.46	2.20
	Physically intimidating bullying	0~12	4.27±2.85	0.20	−0.63	0.57	1.76
Conflict management styles	Competing	0~12	6.56±2.32	0.15	−0.73	0.39	2.55
	Collaborating	0~12	5.95±1.99	0.03	−0.24	0.54	1.84
	Compromising	0~12	6.70±2.25	0.07	−0.65	0.79	1.26
	Avoiding	0~12	7.36±2.19	−0.18	−0.67	0.80	1.25
	Accommodating	0~12	6.15±2.00	−0.20	−0.78	0.35	2.87
Psychological empowerment	Meaning	4~12	6.03±2.47	1.10	1.73	0.53	1.88
	Competence	4~12	7.99±2.45	0.35	0.17	0.52	1.94
	Self-determination	4~12	6.75±2.31	0.79	0.85	0.45	2.25
	Impact	4~12	10.25±2.66	−0.12	−0.49	0.76	1.32
Psychological well-being	Depression	0~60	22.01±1.75	−0.40	−0.12	0.25	4.06
	Self-esteem	10~40	20.60±5.05	0.13	−0.07	0.63	1.59
	Academic major satisfaction	6~30	15.90±4.07	0.27	0.16	0.38	2.62
Multivariate					4.08

VIF=Variance inflation factor.

Table 3.

Standardized Direct, Indirect, and Total Effects of the Hypothetical Model

Endogenous variable	Exogenous variable	β	CR (p)	SMC	Standardized direct effect	Standardized indirect effect	Standardized total effect
Conflict management styles	Bullying experience	.66	5.24 (<.001)	.43	.66 (.006)
Psychological empowerment	Bullying experience	−.46	−5.26 (<.001)	.21	−.46 (.008)
Psychological well-being	Bullying experience	−.01	−.05 (.957)	.93	−.01 (.983)	−.69 (.025)	−.68 (.009)
	Conflict management styles	−.80	−3.49 (<.001)		−.80 (.034)		−.80 (.034)
	Psychological empowerment	.36	4.73 (<.001)		.36 (.009)		.36 (.009)

β=Standardized regression weight; CR=Critical ratio; SMC=Squared multiple correlation (R²).

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