The authors have declared that no competing interests exist.
To examine the relationships between Australian nursing students’ anxiety, depression, personality and family interaction with psychological well-being and suicidal ideation.
A sample of 201 nursing students completed a series of structured questionnaires in an Australian University.
A cross-sectional descriptive research design was used. After explanation of this study, 201 nursing students voluntarily participated. Six reliable and structured questionnaires were used to do data collection. SPSS was used for data analysis including descriptive data, Pearson Correlation, and Stepwise Multiple Regression.
Anxiety and depression were positively associated with suicidal ideation and had negative relationships with psychological well-being. Positive personality and family interaction were positively associated with psychological well-being and negatively with suicidal ideation. Parents’ harsh discipline had a negative relationship with the nursing students’ psychological well-being.
Depression, personality, and positive family interaction were significant predictors of Australian nursing students’ psychological well-being. Anxiety, depression, and harsh discipline were significant predictors of suicidal ideation
It is globally recognized that nursing is a stressful occupation
Research indicates that some students experience feelings of anxiety, hopelessness and depression
Mental illness is a central topic in Australia
There are 1.2 million students with higher education in Australia; three out of five (61%) are aged 15-24 years
Is there any relationship between personality and psychological well-being? Personality is developed by biological temper, family interaction and cognitive learning
How an individual deals with the stress caused by exposure to harsh parenting or with the significant stressors that are intrinsic to the role of nursing is mediated by personality. Personality and emotional stability were associated with nursing students’ psychological well-being
Positive family interaction also provides a stable framework within which the individual is safe to make important decisions, debrief and feel supported. Individuals who had positive family interactions (eg., communication and involvement) reported lower rates of suicidal behaviours
The convenience sample consisted of 201 Bachelor of Nursing (BN) students inclusive of 20 (10%) males and 181 (90%) females. The mean age was 25.80 yrs (
and and the criteria of Alpha at 0.05 and power (1- Beta) at 0.80”
Data were collected using six instruments, all of which were selected for their reliability and validity. All of the instruments had good internal consistency. Their Cronbach’s Alpha values were greater than 0.7 (
Variables | Instruments | Items | Cronbach's Alpha | Range of Scores |
Anxiety | Hamilton Anxiety Scale (Hamilton, 1969) | 42 | 0.95 | 0-168 |
Depression | Zung Depression Scale (Zung, 1976) | 20 | 0.8 | 20-80 |
Personality | Personality scale (Goldberg, 1999) | 50 | 0.88 | 50-250 |
Family Interaction | Iowa Family Interaction Rating Scales (Melby et al., in 1998) | 29 | Positive: 0.94 Negative: 0.83 | 29-145 |
Psychological Well-Being | Psychological Well-Being Scale (Ryff, 1989) | 18 | 0.81 | 18-108 |
Suicidal Ideation | Brief Screen for Adolesent Depression | 7 | 0.73 | 0-7 |
Participants’ psychological well-being was measured using the 18-item PWBS
The Brief Screen for Adolescent Depression Scale (BSADS) was developed by the Signs of Suicide Project
Anxiety was measured by the Hamilton Anxiety Scale (HAS)
Depressionwas measured using the Zung Depression Scale (ZDS)
Personality characteristicswere measured using the Big FivePersonality Test developed by Goldberg
Family Interactionwas measured using the Iowa Family Interaction Rating Scales (IFIRS)
Data analyses were conducted using the Statistic Package for Social Sciences (SPSS) PC + Version 20.0. Descriptive statistics (mean, SD, range, and percentages) were used to describe the study sample and the main variables. The Cronbach’s alpha of the instruments was examined in this study. Pearson’s Correlation was used to examine the relationships between variables. Stepwise Multiple Regression was used to examine the significant predictors of psychological well-being and suicidal ideation.
Most participants were female (
Variables | n | % | M | SD |
Gender | ||||
Male | 20 | 10 | ||
Female | 181 | 90 | ||
Age (18-61 years) | 25.80 | 8.43 | ||
Anxiety (0-140) | 35.61 | 21.93 | ||
Depression | 10 | 5 | 38.48 | 8.09 |
(22-69) | ||||
Race: Australian | 157 | 78.1 | ||
Asian | 18 | 9 | ||
African | 7 | 3.5 | ||
Other | 13 | 6.5 | ||
Marriage | ||||
Single | 130 | 64.7 | ||
Married | 38 | 18.9 | ||
de facto | 20 | 10 | ||
divorced | 10 | 5 | ||
Religion | ||||
Christian | 96 | 47.8 | ||
Not Religious | 81 | 40.3 | ||
Income per month | ||||
Below $1000 | 85 | 42.3 | ||
1000-1999 | 65 | 32.3 | ||
2000-2999 | 28 | 13.9 | ||
3000-3999 | 14 | 7 |
Overall, participants expressed low levels of anxiety (
Main Variables | M | SD | Minimum | Maximum |
Anxiety | 35.61 | 21.93 | 0 | 140 |
Depression | 38.48 | 8.09 | 22 | 69 |
Personality | 171.8 | 18.43 | 120 | 233 |
Positive Family Interaction | 74.2 | 16.18 | 21 | 105 |
Harsh Discipline | 8.22 | 3.39 | 4 | 20 |
Psychological Well-being | 82.06 | 11.01 | 45 | 107 |
Suicidal Ideation | 1.98 | 1.79 | 0 | 7 |
According to Pearson’s correlation, Australian nursing students’ psychological well-being was significantly associated with anxiety (
When the participants’ scores of anxiety and depression decreased, their scores of psychological well-being increased and their scores of suicidal ideation decreased. When the participants’ scores regarding positive personality and positive family interaction increased, their scores of psychological well-being increased and their scores of suicidal ideation decreased. Results indicated that students exposed to harsh discipline had a decreased level of psychological well-being.
Stepwise multiple regression analysis was used to examine the degree to which psychological well-being was predicted by the five independent variables. As shown in
Psychological Well-being | Suicidal Ideation | |||
Variables | Beta | t | Beta | t |
Anxiety | 0.215 | 3.00 |
||
Depression | -0.427 | -8.05 |
0.532 | 7.45 |
Personality | 0.395 | 7.23 |
||
Positive family interaction | 0.127 | 2.58 |
||
R |
R |
|||
F(df= 3, 197)= 89.298 |
F(df= 2, 198)= 95.478 |
p< 0.05,
p < 0.01,
p < 0.001 (2 tailed).
Stepwise multiple regression analysis also examined the degree to which suicidal ideation was predicted by the five independent variables.
Overall, participants expressed low levels of anxiety, medium levels of depression, and medium-high levels of positive personality. They perceived medium-high levels of positive family interaction and medium-low levels of harsh discipline. Therefore, participants expressed medium high levels of psychological well-being and low levels of suicidal ideation. These results are unique and different from previous studies. Other studies indicate Australian younger adults have higher levels of depressive and anxiety symptoms compared to older age groups of Australians
Other unique findings are the predictors of psychological well-being and suicidal ideation. They will be discussed as follows.
There was a significantly negative relationship between participants’ depression and psychological well-being. Personality and family interaction were positively associated with participants’ psychological well-being.
Previous studies showed significant correlations between psychological distress, depression, and anxiety with psychological well-being
In this study, participants had medium-high levels of positive personality, which were positively associated with psychological well-being. Family interaction influences the development of personality
Participants perceived medium-high levels of positive family interaction and medium-low levels of harsh discipline. The family interaction was positively associated with participants’ psychological well-being. This result is consistent with previous studies in which positive family interaction helped people feel safe and supported, so they have higher psychological well-being than people who perceived negative family interaction such as harsh parenting
There were two significant predictors of suicidal ideation for nursing students in this study: depression and anxiety. The results are consistent with previous studies
Interestingly, our results display a divergence from the contemporary understandings of the significant number of University students who are highly distressed and are experiencing high levels of anxiety and depression
This study has three main limitations. First, the cross-sectional design does not provide insights on the nursing students’ psychological distress over time. Second, the sample was recruited from an Australian University, so the generalizability of this study is limited. Third, the participants in this study were voluntary and thus the results only refer to those who are willing to share their experiences.
Nursing students require positive psychological well-being to cope with their work. Psychological well-being enhances sound clinical decision making and the development of mature, sensitive and therapeutic nurse-patient relationships. It also enhances the nurse’s ability to successfully communicate with patients, their families, and members of the multidisciplinary team. Given that nursing students are expected to be able to work within rapidly changing and stressful environments, caring for their psychological well-being is important. Identifying factors that influence psychological well-being and suicidal ideation means that strategies can be developed to enhance positive mental health.