Conditional Effect of Years Employed in Self-efficacy and Stress among Studying Clinical Nurses: An Exploratory Mixed Method Study

Soo-Young Yu; Eunyoung E. Suh

doi:10.7475/kjan.2019.31.3.303

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Yu and Suh: Conditional Effect of Years Employed in Self-efficacy and Stress among Studying Clinical Nurses: An Exploratory Mixed Method Study

Original Article

Korean J Adult Nurs 2019;31(3):303-314.

Published online: 21 June 2019

DOI: https://doi.org/10.7475/kjan.2019.31.3.303

Conditional Effect of Years Employed in Self-efficacy and Stress among Studying Clinical Nurses: An Exploratory Mixed Method Study

Soo-Young Yu¹, Eunyoung E. Suh^2,

¹Doctoral Student, College of Nursing, Seoul National University, Seoul, Korea

²Professor, 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

Received 26 February 20197 May 2019 Accepted 21 May 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.

Keywords: Nurses, Stress, psychological, Self efficacy, Epidemiologic effect modifier, Focus groups

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Table 1.

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.

Table 2.

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

Characteristics	Categories	n (%)	Perceived stress			Self-efficacy
Characteristics	Categories	n (%)	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.

Table 3.

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

Variables	Model I			Model II			Model III
Variables	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.

Table 4.

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.

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