Exploring the relationship between first‐year nursing student self‐esteem and dropout: A cohort study

Abstract

Aim To describe nursing student self‐esteem prior to the influence of nursing education and to explore the relationship between self‐esteem and dropout. Design Cohort study. Methods At the beginning of their first year of study, in October 2017, 464 nursing students completed a questionnaire that assessed their self‐esteem level via Tafarodi & Swann Scale and self‐esteem profile following Mruk's model, along with sociodemographic information, state anxiety, self‐efficacy, intention to continue and social support. One year later, data on grades and re‐enrolment were collected. Multivariate analyses explored the factors influencing self‐esteem level (multiple regression), self‐esteem profile (multinomial logistic regression) and dropout (binary logistic regression). Results/Findings The mean level of self‐esteem was 50.8 (9.0), scale of 16 to 80. Forty‐nine per cent of self‐esteem profiles were classified as ‘high’, 20.1% as ‘defensive acceptance based’, 11.2% as ‘defensive achievement based’ and 19.6% as ‘low’. State anxiety (p < 0.0001), self‐efficacy about completion of the nursing programme (p < 0.0001) and self‐efficacy about internship (p < 0.0001) were associated with self‐esteem. The dropout rate was 21.5%. Self‐esteem level (p = 0.039) and academic performance (p < 0.0001) were associated with dropout. Conclusion While nursing student self‐esteem is often described as low, we know little about its baseline before entering the nursing programme and the factors that influence it. The dropout rate among first‐year nursing students is high, but self‐esteem is rarely explored as a possible explanation. We found that students had medium, and potentially fragile, self‐esteem when starting their nursing education, and that self‐esteem was associated with dropout. Impact Given that association and the impact of self‐esteem on well‐being and professional behaviour, educational institutions should foster self‐esteem both generally and in students with anxiety or low self‐efficacy. Future research should explore nursing student self‐esteem using a longitudinal mixed methods approach. Society should value nurses and nursing students.

The Role of Self-Esteem in the Academic Performance of Rural Students in China

“…Earlier studies investigated that self-esteem is positive prospective related to success and schooling [ 12 ]. Substantial studies also indicate that, in general, children and adolescents with low self-esteem are more likely to achieve poor schooling, as they have relatively less motivation to learn [ 13 ], poorer logical ability [ 14 ], more distraction [ 15 ], higher school dropout rate [ 16 ], and lower learning efficiency [ 17 ].…”

Self‐esteem and learning dynamics in nursing students: An existential‐phenomenological study

“…This paper reports one part of a larger longitudinal mixed methods study that follows nursing students from their first to the fourth year of study to understand how their self‐esteem changes over time and the relationship between self‐esteem and clinical competence development. Four out of the 16 vocational colleges offering a Bachelor's degree in nursing in French‐speaking Belgium were invited to participate in the study, which used purposive sampling based on geographical, network, size and institutional criteria yielding maximum diversity (Dancot et al, 2021). A cohort of 815 first‐ and second‐year students was assembled in October 2017 using accidental sampling (attending class) and followed annually with quantitative and qualitative data collection.…”

“…Inefficient learning behaviours can be a way to protect low or defensive self‐esteem (Covington, 2000; Mruk, 2013), and external feedback may be sought to confirm good or bad self‐views, rather than to improve (Bosson & Swann, 1999). Although the relationship between self‐esteem and achievement, when present, is weak (Baumeister et al, 2003), self‐esteem can indirectly affect achievement through the intermediary of learning approaches – that is, deep/surface processing and effort – in university students (Román et al, 2008), and could influence initiative‐taking and persistence after failure (Baumeister et al, 2003; Dancot et al, 2021). In nursing students, self‐esteem is related to critical thinking (Suliman & Halabi, 2007), which is an important educational outcome and a prerequisite for the expression of competence (Lechasseur et al, 2011).…”

Reinforcement during the COVID-19 pandemic: Perception of nursing students and impact on intention to drop-out of nursing education

“…Further factors include a poor understanding of the outset of what the nursing profession factually entails [ 22 ], a poor understanding of the nurse's role in contemporary society [ 15 , 23 ], a mismatch between student expectations of their future profession and the reality of professional activity [ 22 ]. Individual factors related to the physical or mental characteristics of the students have also been shown to have an impact on the pursuit of nursing studies, such as the ability to manage stress or stressors related to the mode of learning [ 24 , 25 ], self-esteem [ 26 ], a propensity towards pessimism [ 27 ], work conditions that are too physically or mentally demanding [ 26 ], burnout [ 28 ] and personal health problems [ 9 , 29 ]. Other factors, related to the educational institution and the delivery of the nursing education have also been implicated in dropouts, such as the feeling of not being valued, communication and operational factors [ 30 ], satisfaction with the teaching, interest in the course [ 31 ], frequent exposure to violence [ 32 ], and working conditions that the students find difficult [ 33 ].…”