الفهرس 
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Abstract
The term ego resilience has gained great popularity during the last decade. It serves as a stress resistance variable because it promotes successful adaptation when one is faced with various stressors. The ability to recover from negative emotional experiences and to flexibly adapt to stressful events is essential to individual’s well-being and life satisfaction. It was found that having high level of ego resilience and managing perceived stress are very important to enhance life satisfaction for every individual and more especially nursing students as they are exposed to different stressors during their clinical experience.
The current study aimed to assess levels of ego resilience, perceived stress, and degree of life satisfaction among Faculty Nursing Students, Damanhour University. In addition, it aims to determine the relationship between levels of ego resilience, perceived stress, and degree of life satisfaction among these students.
This study followed a descriptive correlational research design. It was conducted at the Faculty of Nursing, Damanhour University.
Study subjects composed of 50% of the registered students enrolled at the faculty during the academic year 2014-2015. These students were randomly selected using a systematic random sampling method and amounted to 520 students.
The data for this study were obtained using the following tools:
Tool 1: A Socio-demographic and Academic Data Questionnaire: It was developed by the researcher after reviewing the related literature to elicit data about the socio- demographic as well as the academic characteristics of the studied subjects.
Tool 2: Connor-Davidson Resilience Scale (CD-RISC): It was originally developed in 2003, translated into Arabic language by Tomah et al. (2013) (166). The scale comprises 25 self-report statements used to measure the level of resilience, which are rated on a five-point likert scale. The total score of CD-RISC is ranging from 0 to 100. A score from 0-19 is considered as having very low level of resilience, score ranging from 20-40 low level of resilience, score from 41-62 means undetermined trait, score from 63-83, high level of resilience, and score from 84-100 reflect very high level of resilience.
Tool 3: Perceived Stress Scale (PSS): It was developed by Cohen et al. (1983). The 10 items version modified by Cohen & Williamson (1988) to assess level of perceived stress was used. It is rated on a five-point likert scale. Total score ranging from 0 to 40. Respondents with a total score ranging from 0-7 are considered as having very low level of perceived stress, score from 8-11 low level of perceived stress, score from 12-15 average level of perceived stress, score from 16-20 indicating high level of perceived stress, and score from 21 and over will reflects very high level of perceived stress.
Tool 4: Satisfaction With Life Scale (SWLS): It was developed by Diener et al. (1985) (26). It is a 5-items scale designed to measure global cognitive judgments of one’s life satisfaction. Subjects were asked to respond to the 5 items on a seven-point Likert scale. The total score is ranging from 5 to 35, with a score ranging from 5-9 is considered as being extremely dissatisfied with life, score from 10-14 denotes being dissatisfied, score from 15-19 reflects being slightly dissatisfied, score 20 is neutral. Students with a score from 21-25 are considered slightly satisfied, score from 26-30 are considered satisfied, and score from 31-35 is extreme satisfaction with life.
After developing tool 1, and translating tool 3 and 4 into Arabic language, the three tools (2, 3, and 4) were tested for content validity by a group of seven experts in psychiatric nursing field.
Reliability of tools 2, 3, and 4 was tested using Cronbach’s Alpha and Test, Re-test reliability on 20 students. Tools proved to be reliable, tool 2 (α= 0.885), and a coefficient correlation (0.833), tool 3 (α= 0.806), and a coefficient correlation (0.812), and tool 4 (α= 0.871), and a coefficient correlation (0.860).
A pilot study was carried out on 52 students. It revealed that tools were clear, understood and applicable.
The researcher started the actual data collection by meeting the randomly selected students on a group basis in their classroom lectures, and clinical areas in order to answer study tools. The time required to complete the study tools was between 20 to 25 minutes.
The data were collected over a period of about three months, from November 2014 and ending January 2015.
Data were coded, computerized, and then analyzed using SPSS version 20 program to achieve the results.
The followings are the main results obtained by the present study:
Socio-demographic characteristics of the studied students:
- More than two third (70.8%) of the studied students were females, with a mean age 20.02 ± 1.351 years, nearly three quarter of them (70.4%) were living in rural areas, and 89.2% were living with their families or relatives. As regards marital status, the majority of the studied students (95.19%) were single. 88.7% of them had adequate family income.
- Concerning social support received, the majority of the studied students (97.7%) reported that they received social support. More than three quarter of them mentioned emotional, esteem, and interaction support (89.4%, 81.7%, and 78.5% respectively), and 88.5% of them were satisfied with the social support provided to them. The majority (85.4%) of the studied students received the social support from parents, and nearly half of them (47.3%) received the social support from friends.
- As regards exposure to traumatic events, more than two third of the studied students (67.5%) reported exposure to traumatic events. 22% reported exposure to death of sibling, second degree relative or a friend, 13.5% reported a traumatic events of having parents or sibling with physical or psychiatric illness, and 12.5% considered being admitted to the faculty of nursing as a traumatic experience.
Academic characteristics of the studied students:
- As regards year of enrollment, more than one third of the studied students (34.6%) were registered in the third year, and more than one quarter (25.6%) in the first year. While the rest of the studied students were registered in the second and fourth year (22.9% and 16.9% respectively).
- Nearly half of the studied students (45.7%) obtained very good grade, and more than one quarter of them (29.7%) obtained excellent grade in the previous academic year.
- As regard participation in academic/social activities, almost half of the studied students (48.5%) participated in sports, and more than one third of them (33.5%) participated in music, art, drawing, and histrionics activities.
Healthy behaviors practiced by the studied students:
- The majority of the studied students mentioned that they are not using substance and don’t smoke cigarettes (97.7% and 96%, respectively). More than two third of the sample have time to relax between 20-30 minutes/day and sleep between 7-8 hours/ day (69.2 and 65%, respectively). More than half of the sample (59.2%) mentioned that they don’t eat breakfast each day, and 64.6 do not practice exercises at least 3 times per week.
Levels of ego resilience, perceived stress, and degree of life satisfaction of the studied students:
- More than half of the studied students (51.7%) had high level of ego resilience with a mean score of 65.75 ±14.15. As regards the factors of ego resilience it was observed that ”spiritual influences” and ”positive acceptance of change, and security in interpersonal relationship” had the highest mean score (6.68± 1.34 and 13.74 ±3.31, respectively).
- More than half of the studied students (56.0%) had very high level of perceived stress with a mean score of 21.11 ± 5.23.
- As regard satisfaction with life nearly two third of the studied students their score ranged from slightly satisfied to extremely-satisfied with their lives.
Relationship between ego resilience, perceived stress, and life satisfaction among studied students:
- A negative significant correlation was found between ego resilience and perceived stress (r=- 0.51) and a positive significant correlation between ego resilience and life satisfaction (r = 0.39).
- There was a negative significant correlation between perceived stress and satisfaction with life (r = - 0.47).
Relationship between ego resilience, perceived stress, satisfaction with life and socio demographic characteristics of the studied students:
- A statistically significant difference was found between both sexes regarding the perceived stress score (t= 4.6, p= 0.001), female students obtained a mean score of 21.8 ± 5.2 compared to a mean score of 19.5± 5.0 for male students.
- No statistically significant difference was found between the age groups on their mean scores of ego resilience, perceived stress, and satisfaction with life (F= 0.22, P= 0.801, F= 1.8, P= 0.164 and F= 0.68, P= 0.508, respectively).
- There was a statistically significant difference between students who lived with their families or relatives and those who lived in university students’ hostel, supervised students’ houses or alone concerning their mean score on perceived stress scale (t=0 .22, p= 0.031). The same was also true in relation to satisfaction with life, students who lived in university students’ hostel, supervised students’ houses or alone obtained a mean score of 24.2± 5.0 compared to a mean score of 21.9± 5.5 for those students who lived with their families or relatives with a statistically significant difference (t= 3.0. p= .002). As regards, ego resilience mean score no statistically significant difference was observed (t= 1.0, p= 0.303).
- No statistically significant difference observed between students’ family income in relation to their mean score of ego resilience and perceived stress. While in relation to satisfaction with life, students who had adequate family income obtained a mean score of 22.4±5.4 compared to a mean score of 19.9 ± 5.4 for students who had inadequate family income with a statistically significant difference (t=3.1, p=0.001).
- A statistically significant difference was found between the studied students in relation to their mean scores of ego resilience, perceived stress, and satisfaction with life and the number of social support received (F= 6.9, P=0.001& F=2.4, P=0.041, and F=7.6, P= 0.001, respectively). This means that as number of social support increase, ego resilience and life satisfaction increase, and perceived stress decrease.
- Insignificant relation was found between students’ exposure to traumatic events and their mean score on ego resilience scale (t=1.3, P=0.194), perceived stress mean score (t=1.1, P=0.261), and satisfaction with life mean score (t=0.31, P=0.750). However, students who reported exposure to traumatic events obtained a mean score of 66.3± 14.4 for ego resilience compared to a mean score of 64.6± 13.6 for those who reported not exposed to traumatic events.
Relationship between ego resilience, perceived stress, life satisfaction and academic characteristics:
- No statistically significant relation was observed between ego resilience, perceived stress, satisfaction with life mean scores, and students’ grade in previous academic year (F= 1.9, P= 0. 709, F= 0.23, P= 0.949, and F= 1.0, P= 0.408, respectively).
- A borderline significant difference was noticed between the year of enrollment and students’ scores in relation to ego resilience, perceived stress and satisfaction with life (F= 2.3, P= 0.078, F= 2.1, P=0.099 and F= 0.31, P= 0.081, respectively).
- A statistically significant difference was observed between students who participated in academic/social activities, and those who did not participate concerning their mean score on ego resilience (t=3.7, P=0.001), and perceived stress mean score (t=4.3, P=0.001). However a borderline significant relation was noticed regarding satisfaction with life mean score (t=1.7, P= 0.085).
Relationship between ego resilience, perceived stress, life satisfaction and healthy behaviors practiced by the studied students
- A statistically significant relation was observed between students’ number of practiced healthy behaviors and their mean scores of ego resilience, perceived stress, and satisfaction with life (F= 3.4, P= 0.005, F=9.5, P=0.001 and F= 5.5, P= 0.001, respectively). This means that as healthy behaviors increase, ego resilience and life satisfaction increase, and perceived stress decrease.
Conclusion and Recommendations:
It can be concluded that more than half of the studied students have high level of ego resilience, very high level of perceived stress, and two third are satisfied with their life. Ego resilience is negatively correlated with perceived stress and positively correlated with life satisfaction. However, a negative correlation is reported between perceived stress and life satisfaction among studied students.
Participation in academic/social activities, receiving several types of social support, and practicing healthy behaviors are the most predicting factors of high level of ego resilience among students. Moreover, living with families, not participating in academic/social activities, and not practicing healthy behaviors are the most predicting factors of high level of perceived stress among students. In addition, living in university hostels or alone, having adequate family income, practicing healthy behaviors, and receiving several types of social support are the most predicting factors of life satisfaction among students.
The followings are the main recommendations yielded by this study:
8. Nursing educators should be aware of the importance of developing and enhancing the students’ level of ego resilience to produce graduate professional nurses who are not only academically and clinically competent, but also to be able to adapt to workplace adversities.
9. Students’ resilience could be promoted through giving continuous encouragement, enhancement of their self-esteem and self-confidence as well as promoting their independence.
10. Monitoring students’ stress level on a regular base could help implementing appropriate interventions to students in order to cope better with stress. This can be achieved by planning suitable activities program such as stress management programs, confidence building programs, problem solving skills, and encourage supervised self-help group.
11. Further research is required to study the effect of implementing intervention programs to enhance resilience and decrease stress among nursing students.