Effects of Emotional Regulation, Resilience, and Distress Disclosure on Post-Traumatic Growth in Nursing Students
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Participants
2.2. Research Instruments
2.2.1. Post Traumatic Growth Inventory-X (PTGI-X)
2.2.2. Emotional Regulation Questionnaire (ERQ)
2.2.3. Resilience
2.2.4. Distress Disclosure Index (DDI)
2.3. Data Collection and Ethical Consideration
2.4. Data Analysis
3. Results
3.1. Respondents’ General Characteristics
3.2. PTG, Emotional Regulation, Resilience, and Distress Disclosure Levels
3.3. Correlations among PTG, Emotional Regulation, Resilience, and Distress Disclosure
3.4. Determinants of PTG
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Seo, H.W. Change and Adaptation of Post-COVID-19. BRIC View 2021-T08. 2021. Available online: https://www.ibric.org/myboard/read.php?Board=report&id=3718 (accessed on 18 April 2022).
- Healthchosun. Coexisting with COVID-19, How to Relieve ‘Posttraumatic Stress’. Available online: https://health.chosun.com/site/data/html_dir/2021/10/18/2021101801373.html (accessed on 21 December 2022).
- Shim, M.Y. Psychological effects of the coronavirus disease 2019 pandemic. Korean J. Med. 2020, 95, 360–363. [Google Scholar] [CrossRef]
- Rossi, R.; Socci, V.; Talevi, D.; Mensi, S.; Niolu, C.; Pacitti, F.; Di Marco, A.; Rossi, A.; Siracusano, A.; Di Lorenzo, G. COVID-19 pandemic and lockdown measures impact on mental health among the general population in Italy. Front. Psychiatry 2020, 11, 790. [Google Scholar] [CrossRef] [PubMed]
- Tedeschi, R.G.; Calhoun, L.G. Posttraumatic growth: Conceptual foundations and empirical evidence. Psychol. Inq. 2009, 15, 1–18. [Google Scholar] [CrossRef]
- Maercker, A.; Zoellner, T. The janus face of self-perceived growth: Toward a two-component model of posttraumatic growth. Psychol. Inq. 2004, 15, 41–48. [Google Scholar]
- Jang, H.; Kim, J.S. A meta-analysis on relationship between post-traumatic growth and related variables. Korean J. Couns. 2017, 18, 85–105. [Google Scholar] [CrossRef]
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders; American Psychiatric Association: Washington, DC, USA, 1980; Volume 3, pp. 399–406. [Google Scholar]
- Korean Law Information Center. Framework Act on the Management of Disasters and Safety. Available online: https://www.law.go.kr/%EB%B2%95%EB%A0%B9/%EC%9E%AC%EB%82%9C%EB%B0%8F%EC%95%88%EC%A0%84%EA%B4%80%EB%A6%AC%EA%B8%B0%EB%B3%B8%EB%B2%95 (accessed on 21 December 2022).
- Morris, B.A.; Shakespeare-Finch, J.; Rieck, M.; Newbery, J. Multidimensional nature of posttraumatic growth in an Australian population. J. Trauma Stress 2005, 18, 575–585. [Google Scholar] [CrossRef] [PubMed]
- Calhoun, L.G.; Tedeschi, R.G. The foundation of posttraumatic growth: New Considerations. Psychol. Inq. 2004, 15, 93–102. [Google Scholar] [CrossRef]
- Seo, Y.S.; Cho, H.J.; An, H.Y.; Lee, J.S. Traumatic events experienced by South Koreans: Types and prevalence. Korean J. Couns. Psychother. 2012, 24, 671–701. [Google Scholar]
- Sung, K.M.; Park, S.A.; Oh, E.J.; Lee, S.M.; Lee, S.Y. Traumatic experiences and posttraumatic growth of nursing students who were in the clinical training. J. Digit. Converg. 2018, 16, 489–503. [Google Scholar] [CrossRef]
- Boyarsky, K. What Is Hybrid Learning? Here’s Everything You Need to Know. Available online: https://resources.owllabs.com/blog/hybrid-learning (accessed on 29 January 2023).
- Lee, C.K.; Ahn, J.H. College nursing students’ experiences of COVID-19 pandemic. J. Korea Acad. -Ind. Coop. Soc. JKIAS 2020, 21, 142–152. [Google Scholar] [CrossRef]
- Finstad, G.L.; Giorgi, G.; Lulli, L.G.; Pandolfi, C.; Foti, G.; León-Perez, J.M.; Cantero-Sánchez, F.J.; Mucci, N. Resilience, coping strategies and posttraumatic growth in the workplace following COVID-19: A narrative review on the positive aspects of trauma. Int. J. Environ. Res. Public Health 2021, 18, 9453. [Google Scholar] [CrossRef] [PubMed]
- Han, S.H.; Tu, H.S. College women’s self-leadership, stress of clinical practice and self-disclosure in an Area. J. Korean Acad. Soc. Nurs. Educ. 2012, 18, 131–140. [Google Scholar] [CrossRef]
- Compas, B.E.; Connor-Smith, J.K.; Saltzman, H.; Thomsen, A.H.; Wadsworth, M.E. Coping with stress during childhood and adolescence: Problem, progress, and potential in theory and research. Psychol. Bull. 2001, 127, 87–127. [Google Scholar] [CrossRef] [PubMed]
- Bowes, L.; Carnegie, R.; Pearson, R.; Mars, B.; Biddle, L.; Maughan, B.; Lewis, G.; Fernyhough, C.; Heron, J. Risk of depression and self-harm in teenagers identifying with goth subculture: A longitudinal cohort study. Lancet Psychiatry 2015, 2, 793–800. [Google Scholar] [CrossRef] [PubMed]
- Jang, I.S. The effects of emotional regulation between clinical practice stress and nursing professionalism in nursing students. J. Korean Data Inf. Sci. Sociaty JKDIS 2016, 27, 749–761. [Google Scholar] [CrossRef]
- Kwon, J.H.; Park, J.I.; Sakong, J.K.; Yang, J.C. Characteristics of the perception of the somatic symptoms and the cognitive emotional regulation strategies in patients with posttraumatic stress disorder. Korean J. Psychosom. Med. 2021, 29, 102–110. [Google Scholar] [CrossRef]
- Ji, E.H.; Cho, Y.R. The influences of trauma-related negative cognitions and difficulties in emotional regulation on posttraumatic stress symptoms in a sample of traumatized university students. Cogn. Behav. Ther. Korea CBTK 2015, 15, 195–212. [Google Scholar]
- Werner, E.E. Journeys from childhood to midlife: Risk, resilience, and recovery. Pediatrics 2004, 114, 492. [Google Scholar] [CrossRef] [PubMed]
- Hong, H.S.; Kim, H.Y. Effect of academic stress, clinical practice stress, resilience on nursing student’s adjustment to college life. Asia-Pac. J. Multimed. Serv. Converg. Art Humanit. Sociol. AJMAHS 2016, 6, 221–234. [Google Scholar] [CrossRef]
- Baek, H.S.; Lee, K.U.; Joo, E.J.; Lee, M.Y.; Choi, K.S. Reliability and validity of the Korean version of the Connor-Davidson resilience scale. Psychiatry Investig. 2010, 7, 109–115. [Google Scholar] [CrossRef] [PubMed]
- Kahn, J.H.; Hucke, B.E.; Bradley, A.M.; Glinski, A.J.; Malak, B.L. The distress disclosure index: A research review and multitrait-multimethod examination. J. Couns. Psychol. 2012, 59, 134–149. [Google Scholar] [CrossRef] [PubMed]
- Kennedy-Moore, E.; Watson, J.C. How and when does emotional expression help? Rev. Gen. Psychol. 2001, 5, 187–212. [Google Scholar] [CrossRef]
- Park, J.W. Experiences of posttraumatic growth by undergraduate. Korean J. Stres Res. 2016, 24, 285–295. [Google Scholar] [CrossRef] [Green Version]
- Shin, S.Y.; Chung, N.W. The effect of meaning in life and social support on posttraumatic growth: Rumination as a mediating variable. J. Hum. Underst. Couns. 2012, 33, 217–235. [Google Scholar]
- Hwang, C.U. The influence of unconditional self-acceptance and distress disclosure on post-traumatic growth of firefighters. Fire Sci. Eng. 2020, 34, 126–133. [Google Scholar] [CrossRef]
- Han, H.J.; Kim, M.; Nam, S.I. The effects of intentional rumination, self-disclosure and cherishing activities of university students involved in cherishing the memory of SEWOL ferry disaster on their indirect posttraumatic growth. Korean J. Youth Stud. 2017, 24, 179–204. [Google Scholar] [CrossRef]
- Cozolino, L. The Neuroscience of Psychotherapy: Healing the Social Brain (Norton Series on Interpersonal Neurobiology), 2nd ed.; WW Norton & Company: New York, NY, USA, 2017. [Google Scholar]
- Tedeschi, R.G.; Cann, A.; Taku, K.; Senol-Durak, E.; Calhoun, L.G. The posttraumatic growth inventory: A revision integrating existential and spiritual change. J. Trauma Stress 2017, 30, 11–18. [Google Scholar] [CrossRef] [PubMed]
- Kim, S.Y.; Lim, S.J.; Shin, J.Y.; Lee, D.H.; Lee, D.H. Validation of the Korean version of the posttraumatic growth inventory expanded. Korean Psychol. J. Cult. Soc. Issues 2020, 26, 195–220. [Google Scholar] [CrossRef]
- Gross, J.J.; John, O.P. Individual differences in two emotional regulation processes: Implications for affect, relationships, and well-being. J. Pers. Soc. Psychol. 2003, 85, 348–362. [Google Scholar] [CrossRef]
- Shon, J.M. Individual Differences in Two Regulation Strategies: Cognitive Reappraiser vs. Emotion Suppressor. Master’s Thesis, Seoul National University, Seoul, Republic of Korea, 2005. [Google Scholar]
- Cho, S.H.; Lee, K.N. Effects of maternal parenting, self-esteem and emotional regulation strategy on emotional regulation of children. Fam. Environ. Res. 2010, 48, 61–72. [Google Scholar]
- Yang, Y.H.; Kim, E.M.; Yu, M.; Park, S.M.; Lee, H.Y. Development of the resilience scale for Korean nursing college students. Korean J. Adult Nurs. 2015, 27, 337–346. [Google Scholar] [CrossRef]
- Kahn, J.H.; Hessling, R.M. Measuring the tendency to conceal versus disclose psychological distress. J. Soc. Clin. Psychol. 2001, 20, 41–65. [Google Scholar] [CrossRef]
- Shin, Y.H.; Ahn, H.U. The relative importance of approach factors and avoidance factors in predicting professional help seeking behavior. Korean J. Couns. Psychother. 2005, 14, 177–195. [Google Scholar]
- Kim, M.J. Effects of emotional intelligence, resilience, and post-traumatic growth on communication skills of nursing students. J. Ind. Converg. JIC 2018, 16, 23–32. [Google Scholar] [CrossRef]
- Kim, K.H.; Hwang, E.H. Transfer-students’ lived experience of the first semester in the baccalaureate nursing program: University life adjustment and crisis overcome. Crisisonomy 2012, 8, 123–142. [Google Scholar]
- Mclntyre, J.; Cheal, K.; Bartels, S.; Durai, U.N.; Herr, B.M.; Quijano, L.; Llorente, M.; Ware, J.J.; Costantino, G.; Miller, C.; et al. Anxiety and depressive disorders in older primary care patients: Defining a clinical severity gradient corresponding to differences in health status. Ageing Int. 2008, 32, 93–107. [Google Scholar] [CrossRef]
- Park, H.J.; Oh, J.W. The relationships of the clinical practice stress and the major satisfaction with the nursing professionalism of nursing college students. J. Digit. Converg. 2014, 12, 417–426. [Google Scholar] [CrossRef] [Green Version]
- Kim, K.N.; Kim, J.Y.; Kim, H.J.; Kim, H.J.; Moon, Y.; Moon, H.J.; Park, E.S. Factors influencing nursing students’ adjustment to college life. J. Korean Clin. Health Sci. 2020, 8, 1417–1425. [Google Scholar] [CrossRef]
- Nummenmaa, M.; Nummenmaa, L. University students’ emotions, interest and activities in a web-based learning environment. Br. J. Educ. Psychol. 2008, 78, 163–178. [Google Scholar] [CrossRef] [PubMed]
- Lee, I.S. Influence of experienced emotion and emotional regulation to learning activity and learning achievement in synchronous participative environment: Focusing on Facebook environment. J. Educ. Technol. JET 2014, 30, 413–442. [Google Scholar] [CrossRef]
- Jun, W.H.; Yun, S.H. Factors affecting spirituality in nursing students. J. Korean Acad. Soc. Home Care Nurs. 2019, 26, 64–71. [Google Scholar] [CrossRef]
- Kim, J.O.; Yoon, J.H. Effects of social support perceived by youth on post-traumatic growth: Mediating effects of hope and deliberate rumination. Korean J. Youth Stud. 2017, 24, 229–252. [Google Scholar] [CrossRef]
- Lee, S.Y.; Jeon, S.Y.; Kim, Y.Y. Mediation effect of a positive stress coping strategy in the relationship between clinical practice stress and clinical practice satisfaction. Korean J. Health Serv. Manag. KJOHSM 2016, 10, 193–204. [Google Scholar] [CrossRef]
- Hwang, H.M.; Kim, J.O. Influence of job stress, coping strategies on life satisfaction in long-term care workers –focused in Gyeonggi-do. J. Korea Acad. Ind. Coop. Soc. 2015, 16, 6152–6159. [Google Scholar] [CrossRef]
- Kim, S.Y. The influence of self-control and resilience on college life adjustment in nursing students. J. KOEN 2018, 12, 253–262. [Google Scholar]
- Xu, X.; Chen, L.; Yuan, Y.; Xu, M.; Tian, X.; Lu, F.; Wang, Z. Perceived stress and life satisfaction among Chinese clinical nursing teachers: A moderated mediation model of burnout and emotional regulation. Front. Psychiatry 2021, 12, 548339. [Google Scholar] [CrossRef] [PubMed]
- Gullone, E.; Taffe, J. The emotional regulation questionnaire for children and adolescents (ERQ-CA): A psychometric evaluation. Psychol. Assess. 2012, 24, 409–417. [Google Scholar] [CrossRef] [PubMed]
- Klunk, E.R. Distress Disclosure and Personaity in College Students. Honors Theses. 2014, p. 283. Available online: https://digitalcommons.bucknell.edu/honors_theses/283/ (accessed on 26 December 2022).
- Kno, K.; Kwon, H.J.; Kwon, H.I. Reducing non-suicidal self-injury craving by emotional regulation strategies. Cogn. Behav. Ther. Korea CBTK 2021, 21, 689–708. [Google Scholar] [CrossRef]
- Sull, K.H.; Kim, M.H. Relationship between suppression strategy of emotional expression and posttraumatic growth: Serial multiple mediating effects of self-disclosure on Traumatic event and social support. J. Korea Contents Assoc. 2021, 21, 392–403. [Google Scholar] [CrossRef]
- Dillon, D.G.; Ritchey, M.; Johnson, B.D.; LaBar, K.S. Dissociable effects of conscious emotional regulation strategies on explicit and implicit memory. Emotion 2007, 7, 354–365. [Google Scholar] [CrossRef]
- Gross, J.J. Emotional regulation: Affective, cognitive, and social consequences. Psychophysiology 2002, 39, 281–291. [Google Scholar] [CrossRef] [PubMed]
- Hayes, J.P.; Morey, R.A.; Petty, C.M.; Seth, S.; Smoski, M.J.; McCarthy, G.; LaBar, K.S. Staying cool when things get hot: Emotional regulation modulates neural mechanisms of memory encoding. Front. Hum. Neurosci. 2010, 4, 230. [Google Scholar] [CrossRef] [PubMed]
- Kim, H.; Kim, E.; Yu, Y. Traumatic events and factors affecting post-traumatic growth of nurses in general hospitals. J. Korean Acad. Nurs. Adm. 2020, 26, 218–229. [Google Scholar] [CrossRef]
- Jung, K.I.; Jeon, H.S. Analysis of structural relationships among perceived spouse support, post traumatic growth, resilience and cognitive emotional regulation strategies in middle-aged adults with trauma experiences. Fam. Fam. Ther. 2020, 28, 427–450. [Google Scholar]
- Kim, H.J.; Nam, C.W.; Lee, S.K. The impact of social support on the psychological well-being of returnee college students and ordinary college students: Mediating Effects of Resilience. Korea J. Couns. 2015, 16, 433–449. [Google Scholar] [CrossRef]
- Kim, S.Y.; Ahn, G.Y.R. The effect of trauma-experienced college students’ emotional regulation style and emotional distress disclosure on Post Traumatic Growth. Korean J. Youth Stud. 2021, 28, 145–174. [Google Scholar] [CrossRef]
- Lee, D.H.; Kim, S.H.; Lee, S.Y.; Choi, S.J. The effects of perceived social support and self-disclosure on posttraumatic growth: The mediating effects of stress coping strategy. Korean J. Couns. Psychother. 2018, 30, 371–395. [Google Scholar] [CrossRef]
- Emmons, R.A.; Colby, P.M. Emotional conflict and well-being: Relation to perceived availability, daily utilization, and observer reports of social support. J. Pers. Soc. Psychol. 1995, 68, 947–959. [Google Scholar] [CrossRef]
- Song, H.; Lee, Y.S. A analysis of posttraumatic growth processes structural relationship. Korean J. Rehabil. Psychol. KJRP 2017, 24, 573–591. [Google Scholar]
- Lee, H.S.; Sin, H.J. Effects of parameters of distress disclosure and social support in Relation to emotional cognitive clarity and post-traumatic growth. J. Wellness KSW 2021, 16, 257–265. [Google Scholar] [CrossRef]
Characteristics | Categories | n (%) | Mean ± SD | t/Z/F | p Scheffé |
---|---|---|---|---|---|
Grade | Junior | 115 (49.8) | 3.94 ± 0.89 | 0.63 | 0.530 |
Senior | 116 (50.2) | 3.86 ± 0.93 | |||
Gender | Male | 35 (15.2) | 3.81 ± 1.05 | −0.66 | 0.511 |
Female | 196 (84.8) | 3.92 ± 0.88 | |||
Transfer student | Yes | 13 (5.6) | 4.43 ± 0.80 | −2.14 | 0.032 † |
No | 218 (94.4) | 3.87 ± 0.91 | |||
Housing type | Home | 151(65.4) | 3.86 ± 0.91 | −0.97 | 0.333 |
Independent residence | 80 (34.6) | 3.98 ± 0.90 | |||
Religion | No | 157 (68.0) | 3.85 ± 0.91 | −1.13 | 0.258 |
Yes | 74 (32.0) | 4.00 ± 0.91 | |||
Economic status | High | 54 (23.4) | 4.02 ± 0.88 | 1.65 | 0.194 |
Middle | 123 (53.2) | 3.93 ± 0.80 | |||
Low | 54 (23.4) | 3.90 ± 0.91 | |||
Subjective health status | Healthy a | 106 (45.9) | 3.99 ± 0.95 | 3.37 | 0.036 a > c |
Average b | 107 (46.3) | 3.90 ± 0.85 | |||
Bad c | 18 (7.8) | 3.40 ± 0.88 | |||
Satisfaction with major | Satisfied a | 108 (46.8) | 4.11 ± 0.92 | 8.28 | <0.001 a, b > c |
Neutral b | 104 (45.0) | 3.80 ± 0.80 | |||
Dissatisfied c | 19 (8.2) | 3.30 ± 1.07 | |||
Satisfaction with academic achievement | Satisfied | 27 (11.7) | 4.16 ± 0.92 | 2.50 | 0.085 |
Neutral | 108 (46.8) | 3.96 ± 0.82 | |||
Dissatisfied | 96 (41.6) | 3.76 ± 0.99 | |||
Satisfaction with hybrid-learning class | Satisfied a | 87 (37.7) | 4.06 ± 0.98 | 4.13 | 0.017 a > c |
Neutral b | 109 (47.2) | 3.90 ± 0.83 | |||
Dissatisfied c | 35 (15.2) | 3.54 ± 0.89 | |||
Satisfaction with interpersonal relationship | Satisfied a | 85 (36.8) | 4.20 ± 0.86 | 12.70 | <0.001 a, b > c |
Neutral b | 122 (52.8) | 3.83 ± 0.81 | |||
Dissatisfiedc | 24 (10.4) | 3.23 ± 1.15 | |||
Satisfaction with clinical practice | Satisfied a | 63 (27.3) | 4.27 ± 0.86 | 12.63 | <0.001 a > b > c |
Neutral b | 130 (56.3) | 3.86 ± 0.86 | |||
Dissatisfied c | 38 (16.5) | 3.38 ± 0.90 |
Variables | Min | Max | Mean ± SD |
---|---|---|---|
Post-traumatic growth | 1.40 | 6.00 | 3.90 ± 0.91 |
Emotional regulation-Suppression | 1.00 | 5.00 | 2.61 ± 0.92 |
Emotional regulation- Reappraisal | 1.00 | 5.00 | 3.32 ± 0.87 |
Resilience | 1.96 | 4.90 | 3.70 ± 0.54 |
Distress disclosure | 1.25 | 5.00 | 3.25 ± 0.81 |
Variables | Post-Traumatic Growth | Emotion Regulation | Resilience | Distress Disclosure | |
---|---|---|---|---|---|
Suppression | Reappraisal | ||||
Post-Traumatic Growth | 1 | ||||
Emotional Regulation -Suppression | 0.03 (0.684) | 1 | |||
Emotional Regulation -Reappraisal | 0.56 (<0.001) | 0.23 (<0.001) | 1 | ||
Resilience | 0.59 (<0.001) | 0.03 (0.681) | 0.62 (<0.001) | 1 | |
Distress Disclosure | 0.18 (0.005) | −0.62 (<0.001) | 0.11 (0.094) | 0.32 (<0.001) | 1 |
Variables | B | SE | β | t | p |
---|---|---|---|---|---|
(constant) | 0.43 | 0.32 | 1.36 | 0.174 | |
Resilience | 0.62 | 0.11 | 0.37 | 5.71 | <0.001 |
Emotional regulation -Reappraisal | 0.33 | 0.07 | 0.31 | 5.00 | <0.001 |
Satisfaction with clinical practice = satisfied * | 0.29 | 0.10 | 0.14 | 2.85 | 0.005 |
Transfer student = yes * | 0.50 | 0.20 | 0.13 | 2.54 | 0.012 |
Tolerance = 0.60–0.99, VIF = 1.01–1.66, Durbin-Watson = 1.97 | |||||
Adjusted R² = 0.44, R² = 0.45, F = 45.24, p < 0.001 |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Kim, K.; Lee, J.; Yoon, J. Effects of Emotional Regulation, Resilience, and Distress Disclosure on Post-Traumatic Growth in Nursing Students. Int. J. Environ. Res. Public Health 2023, 20, 2782. https://doi.org/10.3390/ijerph20042782
Kim K, Lee J, Yoon J. Effects of Emotional Regulation, Resilience, and Distress Disclosure on Post-Traumatic Growth in Nursing Students. International Journal of Environmental Research and Public Health. 2023; 20(4):2782. https://doi.org/10.3390/ijerph20042782
Chicago/Turabian StyleKim, Kyungmi, Jongeun Lee, and Jaeyeon Yoon. 2023. "Effects of Emotional Regulation, Resilience, and Distress Disclosure on Post-Traumatic Growth in Nursing Students" International Journal of Environmental Research and Public Health 20, no. 4: 2782. https://doi.org/10.3390/ijerph20042782