Self-Perception and Value System as Possible Predictors of Stress
Nursing Ethics. 1998 Mar; 5(2): 103-121.
This study was directed towards personality-related, value system and sociodemographic variables of nursing students in a situation of change, using a longitudinal perspective to measure their improvement in principle-based moral judgement (Kohlberg; Rest) as possible predictors of stress. Three subgroups of students were included from the commencement of the first three-year academic nursing programme in 1993. The students came from the colleges of health at Jonkoping, Vaxjo and Kristianstad in the south of Sweden. A principal component factor analysis (varimax) was performed using data obtained from the students in the spring of 1994 (n = 122) and in the spring of 1996 (n = 112). There were 23 variables, of which two were sociodemographic, eight represented self-image, six were self-values, six were interpersonal values, and one was principle-based moral judgement. The analysis of data from students in the first year of a three-year programme demonstrated eight factors that explained 68.8% of the variance. The most important factors were: (1) ascendant decisive disorderly sociability and nonpractical mindedness (18.1% of the variance); (2) original vigour person-related trust (13.3%) of the variance); (3) orderly nonvigour achievement (8.9% of the variance) and (4) independent leadership (7.9% of the variance). (The term 'ascendancy' refers to self-confidence, and 'vigour' denotes responding well to challenges and coping with stress.) The analysis in 1996 demonstrated nine factors, of which the most important were: (1) ascendant original sociability with decisive nonconformist leadership (18.2% of the variance); (2) cautious person-related responsibility (12.6% of the variance); (3) orderly nonvariety achievement (8.4% of the variance); and (4) nonsupportive benevolent conformity (7.2% of the variance). A comparison of the two most prominent factors in 1994 and 1996 showed the process of change to be stronger for 18.2% and weaker for 30% of the variance. Principle-based moral judgement was measured in March 1994 and in May 1996, using the Swedish version of the Defining Issues Test and Index P. The result was that Index P for the students at Jonkoping changed significantly (paired samples t-test) between 1994 and 1996 (p = 0.028), but that for the Vaxjo and Kristianstad students did not. The mean of Index P was 44.3% at Vaxjo, which was greater than the international average for college students (42.3%) it differed significantly in the spring of 1996 (independent samples t-test), but not in 1994, from the students at Jonkoping (p = 0.032) and Kristianstad (p = 0.025). Index P was very heterogeneous for the group of students at Vaxjo, with the result that the paired samples t-test reached a value close to significance only. The conclusion of this study was that, if self-perception and value system are predictors of stress, only one-third of the students had improved their ability to cope with stress at the end of the programme. This article contains the author's application to the teaching process of reflecting on the structure of expectations in professional ethical relationships.
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