Effect of Incivility, Resilience, and Social Support Experienced by Nursing Students on Burnout in Clinical Practice

Eun Jung Lee; Mi-Hae Sung; Hye-Kyong Ahn; Yun Ah Kim

doi:10.4069/kjwhn.2019.25.1.86

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Lee, Sung, Ahn, and Kim: Effect of Incivility, Resilience, and Social Support Experienced by Nursing Students on Burnout in Clinical Practice

Original Article

Korean Journal of Women Health Nursing 2019; 25(1): 86-98.

Published online: 14 March 2019

DOI: https://doi.org/10.4069/kjwhn.2019.25.1.86

Effect of Incivility, Resilience, and Social Support Experienced by Nursing Students on Burnout in Clinical Practice

Eun Jung Lee¹

, Mi-Hae Sung²

, Hye-Kyong Ahn³

, Yun Ah Kim⁴

¹Graduate Student, Inje University, Gimhae, Korea.

²Professor, Department of Nursing, Inje University College of Medicine, Institute of Health Science, Busan, Korea.

³Graduate Student, Inje University, Gimhae, Korea.

⁴Assistant Professor, Gaya University, Gimhae, Korea.

Corresponding author: Mi-Hae Sung. Department of Nursing, Inje University College of Medicine, Institute of Health Science, 75 bokji-ro, Busanjin-gu, Busan, Korea. Tel: +82-51-890-6825, Fax: +82-51-896-9840, nursmh@inje.ac.kr

Received 18 January 2019 Revised 25 February 2019 Accepted 27 February 2019

Korean Society of Women Health Nursing

(open-access):

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of the study was to determine effect of incivility, resilience, and social support experienced by nursing students on burnout in clinical practice.

Methods

Subjects were 140 nursing students who agreed to participate in this study. Collected data were analyzed using descriptive statistics, t-test, analysis of variance, Pearson's correlation and stepwise multiple regression with SPSS WIN 23.0 program.

Results

Burnout showed significantly positive correlation with incivility but significantly negative correlations with resilience and social support. Factors affecting burnout were satisfaction with major-dissatisfaction, satisfaction with major-average, social support, grade, and relationship with peers. Satisfaction with major (dissatisfaction) had the greatest effect on burnout, explaining 41% of the total variance.

Conclusion

According to this study, dissatisfaction with major was identified as the most significant factor influencing burnout of nursing students in clinical practice. Therefore, it is important to develop and implement programs that can reduce dissatisfaction with major and increase social support and relationship with peers in order to lower burnout of nursing students. In addition, a systemic management of fourth-grade students with a high level of clinical practice is necessary to reduce the level of clinical practice. The authors declared no conflict of interest.

Keywords: Nursing students, Incivility, Resilience, psychological, Social support, Burnout

Figures and Tables

Table 1

General Characteristics of Subjects (N=140)

Variables	Categories	n(%)	M±SD
Sex	Male	8 (5.7)
Sex	Female	132 (94.3)
Age (year)	≤21	63 (45.0)	22.6±3.1
	22–23	50 (35.7)
	≥24	27 (19.3)
Grade	Junior	83 (59.3)
Grade	Senior	57 (40.7)
Religion	Yes	41 (29.3)
Religion	No	99 (70.7)
Residence	With parents	87 (62.1)
	With single parent	6 (4.3)
	With grandparents or relatives	3 (2.1)
	Self-catering	44 (31.4)
Academic achievement	≤3.0	22 (15.7)
	3.01–4.0	105 (75.0)
	≥4.01	13 (9.3)
Motivation for admission	High school record	13 (9.3)
	Recommendation of others	34 (24.3)
	Volunteer spirit	19 (13.6)
	Employment rate	60 (42.9)
	Nurse's good image	14 (10.0)
Satisfaction with major	Dissatisfaction	15 (10.7)
	Average	44 (31.4)
	Satisfaction	81 (57.9)
Satisfaction with clinical practice	Dissatisfaction	21 (15.0)
	Average	48 (34.3)
	Satisfaction	71 (50.7)
Relationship with peers	Average	19 (13.6)
Relationship with peers	Good	121 (86.4)
A difficult relationship in practice	Head nurse or general nurse	93 (66.4)
	Someone else (medicine, exam room, etc.)	11 (7.9)
	Patients and carers	25 (17.9)
	Practical colleague	11 (7.9)
Affiliated hospital	Yes	50 (35.7)
Affiliated hospital	No	90 (64.3)

M±SD=mean±standard deviation.

Table 2

Degree of Incivility, Resilience, Social Support, Burnout of Clinical Practice in Nursing College Students (N=140)

Variables	M±SD	Range (min–max)
Resilience	3.73±0.43	2.29–5.00
Incivility	0.54±0.56	0.00–2.75
Social support	3.25±0.84	1.22–5.00
Burnout	2.81±0.51	1.60–4.20

M±SD=mean±standard deviation.

Table 3

Differences in Burnout of Clinical Practice in Nursing College Students (N=140)

Variables	Categories	M±SD	t/F (p)	Scheffé test
Sex	Male	2.97±0.37	0.92 (.356)
Sex	Female	2.80±0.51	0.92 (.356)
Age (year)	≤21	2.77±0.46	0.34 (.715)
	22–23	2.84±0.52
	≥24	2.83±0.59
Grade	Junior	2.69±0.49	−3.41 (.001)
Grade	Senior	2.98±0.49	−3.41 (.001)
Religion	Yes	2.80±0.52	−0.13 (.893)
Religion	No	2.81±0.50	−0.13 (.893)
Residence	With parents	2.80±0.54	0.68 (.563)
	With single parent	2.62±0.50
	With grandparents or relatives	3.13±0.77
	Self-catering	2.82±0.41
Academic achievement	≤3.0	3.02±0.52	3.03 (.051)
	3.01–4.0	2.78±0.51
	≥4.01	2.63±0.32
Motivation for admission	High school record	2.79±0.44	1.24 (.299)
	Recommendation of others	2.78±0.57
	Volunteer spirit	2.78±0.43
	Employment rate	2.89±0.51
	Nurse's good image	2.57±0.47
Satisfaction with major	Dissatisfaction^a	3.38±0.43	25.36 (<.001)	a>b>c
	Average^b	2.98±0.47
	Satisfaction^c	2.60±0.42
Satisfaction with clinical practice	Dissatisfaction^a	3.28±0.47	31.24 (<.001)	a>b>c
	Average^b	2.99±0.37
	Satisfaction^c	2.54±0.44
Relationship with peers	Average	3.20±0.54	3.83 (<.001)
Relationship with peers	Good	2.74±0.47	3.83 (<.001)
A difficult relationship in practice	Head nurse or general nurse^a	2.83±0.50	3.43 (.019)	d>b
	Someone else (medicine, exam room, etc.)^b	2.42±0.58
	Patients and carers^c	2.77±0.42
	Practical colleague^d	3.08±0.51
Affiliated hospital	Yes	2.87±0.47	1.20 (.231)
Affiliated hospital	No	2.77±0.52	1.20 (.231)

M±SD=mean±standard deviation.

Table 4

Correlation among Incivility, Resilience, Social Support, Burnout of Clinical Practice in Nursing College Students

Variables	r (p)
Variables	Resilience	Incivility	Social support	Burnout
Resilience	1
Incivility	−.09 (.309)	1
Social support	.29 (<.001)	−.36 (<.001)	1
Burnout	−.36 (<.001)	.23 (.008)	−.36 (<.001)	1

Table 5

Factors Influencing on Burnout of Clinical Practice in Nursing College Students (N=140)

Variables		B	SE	β	t	p	Adj. R²	F	p
Constant		2.41	0.282		8.56	<.001		19.94	<.001
Satisfaction with major^†
	Dissatisfaction	0.61	0.114	.37	5.35	<.001	.15
	Average	0.36	0.074	.33	4.79	<.001	.26
Social support		−0.16	0.040	−.26	−3.96	<.001	.34
Grade		0.21	0.070	.20	2.95	.004	.38
Relationship with peers		0.24	0.099	.17	2.45	.016	.41

SE=standard error; Adj. R²=adjusted coefficient of determination R².

^†Dummy variable: reference=satisfaction, Durbin-Watson: 1.871, Variance Inflation Factor: 1.14–1.07.

Notes

^{Conflict of Interest} The authors declared no conflict of interest.

^{Author Contributions}

Conceptualization: Lee EJ, Sung MH, Ahn HK, Kim YA.
Data curation: Lee EJ, Ahn HK.
Formal analysis: Lee EJ, Ahn HK.
Investigation: Lee EJ, Ahn HK.
Methodology: Lee EJ, Sung MH, Ahn HK, Kim YA, Ahn HK.
Supervision: Sung MH.
Writing - original draft: Lee EJ.
Writing - review & editing: Sung MH.

Summary Statement

• What is already known about this topic?

Burnout of nursing students is higher than that of other university students.
• What this paper adds?

This paper revealed that burnout were satisfaction with major-dissatisfaction, satisfaction with major-average, social support, grade, and relationship with peers.
• Implications for practice, education and/or policy

There is a need to develop and implement programs that can reduce dissatisfaction with major and increase social support and relationship with peers in order to lower burnout level of nursing students.

References

1. Casey T, Wilson-Evered E. Predicting uptake of technology innovations in online family dispute resolution services: an application and extension of the UTAUT. Computers in Human Behavior. 2012; 28(6):2034–2045.

2. Kang YH, Hong MJ. Influencing factors of learning style, critical thinking disposition on clinical performance competency of nursing students. Journal of the Korean Data Analysis Society. 2014; 16(5):2841–2853.

3. Lim YJ. The impact of nursing students' emotional labor and clinical practice stress on burnout. Journal of Learner-Centered Curriculum and Instruction. 2017; 17(6):461–474.

4. Fang DZ, Young CB, Golshan S, Moutier C, Zisook S. Burnout in premedical undergraduate students. Academic Psychiatry. 2012; 36(1):11–16.

5. Cho HH, Kang JM. Factors influencing clinical practice burnout in student nurses. Child Health Nursing Research. 2017; 23(2):199–206.

6. Cho HH, Kang JM. Effect of resilience, coping, and mental health on burnout of student nurses. Child Health Nursing Research. 2018; 24(2):199–207.

7. Anderson LM, Pearson CM. Tit for tat? The spiraling effect of incivility in the workplace. Academy of Management Review. 1999; 24(3):452–471.

8. Kim SL, Lee JE. Relationship among stress, coping strategies, and self-esteem in nursing students taking clinical experience. Journal of Korean Academic Society of Nursing Education. 2005; 11(1):98–106.

9. Hong Y, Kim Y, Son H. Effect of nurses' incivility experienced by nursing student, coping on burnout in clinical practice. Journal of Korean Academy of Nursing Administration. 2016; 29(4):323–331.

10. Por J, Barriball L, Fitzpatrick J, Roberts J. Emotional intelligence: its relationship to stress, coping, well-being and professional performance in nursing students. Nurse Education Today. 2011; 31(8):855–860.

11. Seo JH. Effects of nursing image, satisfaction in major, ego-resilience on nursing professionalism of nursing students [master's thesis]. Chungnam: Kongju National University;2018. 49.

12. Hong HH, Kong JH, Kang HS, Jeong HS, Yang SK. The study on the professional self -concept, ego-resilience, clinical competence of nursing students. Journal of Korean Clinical Health Science. 2014; 2(2):98–106.

13. Cohen S, Hoberman HM. Positive events and social supports as buffers of life change stress. Journal of Applied Social Psychology. 1983; 13(2):99–125.

14. Kim BK. Factors related to interpersonal relationship stress in clinical practice among nursing students [master's thesis]. Seoul: Yonsei University;2017. 87.

15. Kang SY. Impact of nursing students' emotional labor on burnout during nursing practice in a hospital: moderating effect of emotional intelligence. Journal of Korean Academy of Nursing Administration. 2015; 21(1):77–87.

16. Anthony M, Yastik J, MacDonald DA, Marshall KA. Development and validation of a tool to measure incivility in clinical nursing education. Journal of Professional Nursing. 2014; 30(1):48–55.

17. Yang YH, Kim EM, Yu M, Park SM, Lee HY. Development of the resilience scale for korean nursing college students. Korean Journal of Adult Nursing. 2015; 27(3):337–346.

18. Park JW. A study to development a scale of social support [dissertation]. Seoul: Yonsei University;1985. 127.

19. Woo JA. Emotional responses, coping and social support for verbal abuse, sexual harassment, physical threats experienced by nursing students in clinical training [dissertation]. Pusan: Pusan National University; 2017;2017. 153.

20. Schaufeli WB, Martinez IM, Pinto AM, Salanova M, Bakker AB. Burnout and engagement in university students: a cross-national study. Journal of Cross-Cultural Psychology. 2002; 33(5):464–481.

21. Lee J, Puig A, Kim YB, Shin HJ, Lee JH, Lee SM. Academic burnout profiles in Korean adolescents. Stress and Health. 2010; 26(5):404–416.

22. Kim JG, Yoo JH, Cheon EY. Realtionship among incivility, burnout, coping and satisfaction to clinical practice experienced by nursing college students in clinical practice. Journal of the Korea Academia-Industrial Cooperation Society. 2017; 18(1):316–324.

23. Park JW, Ha NS. Nursing student's clinical experience. Journal of Korean Academy of Psychiatric and Mental Health Nursing. 2003; 12(1):27–35.

24. Lee YE, Jang YN. Effects of exposure to violence during clinical practicum, self-esteem and resilience on depression among nursing students. Journal of the Korea Contents Association. 2018; 18(8):646–657.

25. Lee YE, Kim EY, Park SY. Effect of self-esteem, emotional intelligence and psychological well-being on resilience in nursing students. Child Health Nursing Research. 2017; 23(3):385–393.

26. Korean Accreditation Board of Nursing Education. A report on evaluation of nursing school, 2016. Seoul: Korean Accreditation Board of Nursing Education;2017.

27. Löfmark A, Wikblad K. Facilitating and obstructing factors for development of learning in clinical practice: a student perspective. Journal of Advanced Nursing. 2001; 34(1):43–50.

28. Jeon SY. The relationship between social support, health status, college adjustment and academic achievement in college students. Journal of Korean Society for School & Community Health Education. 2010; 11(1):99–115.

29. Noh YG. Influence of social support on the relationship between practice stress, emotional labor and burnout among nursing students. Journal of Korean Academy of Nursing Administration. 2017; 23(5):461–470.

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ORCID iDs

Eun Jung Lee
https://orcid.org/0000-0002-7294-1219

Mi-Hae Sung
https://orcid.org/0000-0002-5769-5857

Hye-Kyong Ahn
https://orcid.org/0000-0002-4214-9300

Yun Ah Kim
https://orcid.org/0000-0003-0295-0627

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