Keywords
well-being - resilience - undergraduate students
Introduction
The students face many issues or challenges while moving from school to college, particularly
medical and paramedical students. The reasons for these difficulties could be being
away from home to a hostel, absence of parental and social support, parental influences,
time management, or exposure to unexpected situations. A student's coping skills are
also an enormous part of his or her life to overcome challenges or stress. These are
cognitive and behavioral effects for dealing with day-to-day life stressors. It aids
a person's psychological adaptation to tense situations.[1]
Several research studies have been done on the concept of resilience to study how
individuals cope with their difficulties to become stronger. Resilience is defined
as the ability and dynamic process of adapting to stress and adversity while maintaining
normal psychological and physical functioning. An individual might get support from
family, friends, or others. A report released by the Organization for Economic Co-operation
and Development (OECD) publicized that Asian students are among the most academically
resilient in the world.[2] In India, 75,000 students committed suicide between the years 2007 and 2016. In
2019, a minimum of one student died by suicide each hour in India.[3]
Research studies show that university students who have good psychological well-being
handle their issues and traumatic events, instead of avoiding or escaping from them.
Psychological well-being is correlated with resilience positively. It additionally
encompasses a vital relationship between psychological well-being, internal locus
of control, positive functioning, and high levels of self-esteem. Graduate students
suffer from psychological distress, which detrimentally affect their physical, mental,
and psychological well-being. They may not share their problems with their friends,
parents, or teachers, and it may cause the development of mental health issues. If
they do not get any support, they keep on with their mental health problems with less
severity at the beginning. Gradually, it affects academic performance, and if no one
notices, that will result in major mental illness. A student with high resilience
can overcome any situation and be free from mental stress and illness.[4]
Previous literature revealed that 60 to 70% of medical and dental students have psychological
issues like depression, anxiety, and stress. Some studies showed negative correlation
between resilience and well-being among nursing undergraduate students.[5]
Educators have an enormous role in developing resilience and well-being among students.
They ought to have the capacity to spot every student's resilience level and well-being.
If they flourish in identifying it, they will take a step to assist students who have
a low level of resilience and mental well-being.[6] The researcher felt that there is a necessity to look at the relation between the
level of resilience and well-being among healthcare professional students because
it permits in early identification of mental health problems among them. Hence, the
researcher initiated this research work. The objectives of the study were to assess
the levels of well-being, resilience, its correlation, and to find the association
with selected demographic variables.
Materials and Methods
A quantitative research approach with descriptive correlational research design was
adopted to assess the levels of well-being, resilience, and its relationship among
undergraduate students. A total of 135 students studying in a selected university
using disproportionate stratified probability sampling technique were selected. Undergraduate
students studying in all levels of Bachelor of Science in Nursing (BSc Nursing), Bachelor
of Medicine and Bachelor of Surgery (MBBS), Bachelor of Dental Surgery (BDS), Physiotherapy,
Bachelor of Pharmacy (B.Pharm) courses, and available at the time of data collection
were included in this study. The tools used for data collection were baseline proforma,
positive emotion, engagement, relationships, meaning, and accomplishment (PERMA) scale,
and Connor-Davidson Resilience scale. The baseline proforma included age in years,
gender, education, level of study, marital status, religion, do you believe in spirituality,
socioeconomic status, type of family, residence, do you have any major illness affecting
your daily life, and presence of support system. Connor-Davidson Resilience Scale
had 25 items with the maximum score of 5 and the minimum score of 1. The reliability
estimated by Cronbach's alpha was 0.927. PERMA profiler scale consisted of 23 items
and total score was 230. The reliability estimated by Cronbach's alpha was 0.917.
The data collection was done from 15-11-2020 to 20-12-2020 at Yenepoya University,
Mangaluru, Karnataka. Approval from the Scientific Review Board and Institutional
Ethical Clearance was obtained and formal written permission received from Principals
of respective colleges. Informed consent was obtained from the respondents who were
willing to participate after explanation about purpose, benefits of the study, and
assurance was given about the confidentiality of their responses. The tools were administered
to all participants.
Statistical Analysis
The data were analyzed by descriptive and inferential statistics using SPSS version
20.0. Karl Pearson correlation coefficient was used to assess the correlation between
well-being and resilience. Chi-square test was adopted to assess the association between
well-being scores and the selected demographic variables of undergraduates.
Ethical Considerations
Scientific Review Board and Institutional Ethical Clearance were obtained and formal
written permission was received from the principals of respective colleges. The researcher
personally approached each participant to explain the study and requested his or her
participation. All participants were informed that participation in the study was
voluntary and they were free to withdraw. Participants had the opportunity to ask
questions regarding their participation and had additional opportunities to ask questions
during the time of filling form.
Results
Baseline Characteristics of Undergraduates
Majority of the participants (60.7%) belonged to the age group of 21 to 25 years.
Majority of them (83%) were females and 17% were males. Most of them (94.8%) belonged
to nuclear family, while 5.2% belonged to joint family. Most of the participants (87.4%)
were hostellers and (12.6%) were day scholars. Majority (97%) of participants believed
in spirituality and 94.1% belonged to above poverty line (APL) in their socioeconomic
status. Nearly half of the participants (47.4%) considered their parents are the supporting
system, while 42.2% considered their friends as the supporting system.
Level of Well-Being among Undergraduate Students
Majority of participants (49.7%) had normal level of well-being, just above 20% of
the participants, that is, 21.5% of participants had high level and 20.7% participants
had suboptimal level of well-being, while 8.1% of participants were identified of
having languishing level of well-being and none of the participants had above high-level
of well-being ([Table 1]).
Table 1
Level of well-being of undergraduate students, n = 135
|
Level of well-being
|
Grading
|
Frequency (f)
|
Percentage (%)
|
|
Above high functioning
|
196–230
|
0
|
0
|
|
High functioning
|
184–195
|
29
|
21.5
|
|
Normal functioning
|
149–183
|
67
|
49.7
|
|
Sub optimal functioning
|
115–148
|
28
|
20.7
|
|
Languishing
|
Below 115
|
11
|
8.1
|
Level of Resilience among Undergraduate Students
The study results revealed that highest number of participants (77%) had greater level
of resilience, while the lowest (23%) had average level of resilience and none of
the participants had lesser resilience ([Table 2]).
Table 2
Level of resilience among undergraduate students, n = 135
|
Level of resilience
|
Grading
|
Frequency (f)
|
Percentage (%)
|
|
Lesser resilience
|
0–33
|
0
|
0
|
|
Average resilience
|
34–66
|
31
|
23
|
|
Greater resilience
|
67–100
|
104
|
77
|
Correlation between Resilience and Well-Being
The study result showed that there was a significant correlation between well-being
and resilience among undergraduate students (r = 0.237, p = 0.006; [Table 3]).
Table 3
Correlation between resilience and well-being, n = 135
|
Variables
|
Mean ± SD
|
r-Value
|
p-Value
|
|
Wellbeing
|
160.34 ± 26.15
|
|
|
|
Resilience
|
73.67 ± 10.28
|
0.237
|
0.006[a]
|
Abbreviation: r, Karl Pearson correlation coefficient; SD, standard deviation.
a
p < 0.05 statistically significant.
Association between Levels of Well-Being and Selected Demographic Variables
The study result showed that there was significant association between level of well-being
and selected demographic variables like age (p = 0.009), education (p = 0.0001), level of study (p = 0.04), religion (p = 0.0001), and residence (p = 0.022) at p-value less than 0.05 ([Table 4]).
Table 4
Association between level of well-being and selected demographic variables
|
Sl no.
|
Demographic characteristics
|
χ2-Value
|
p-Value
|
|
1
|
Age in years
a) ≤20
b) 21–25
c) 26–30
|
11.564
|
0.009a
|
|
2
|
Education
a) MBBS
b) BDS
c) Physiotherapy
d) B.Sc Nursing
e) B.Pharm
|
82.744
|
0.0001a
|
|
3
|
Level of study
a) First year
b) Second year
c) Third year
d) Fourth year
e) Fifth year
|
22.195
|
0.035a
|
|
4
|
Religion
a) Hindu
b) Muslim
c) Christian
|
29.472
|
0.0001a
|
|
5
|
Residence
a) Hosteller
b) Day-scholar
|
9.610
|
0.022a
|
|
6.
|
Type of family
a) Nuclear
b) Joint
|
3.11
|
0.38
|
|
7.
|
Socioeconomic status
a) APL (above poverty line)
b) BPL (below poverty line)
|
5.67
|
0.17
|
χ2—chi-square, a
p < 0.05 statistically significant.
Association between the Level of Resilience Score and Selected Demographic Variables
This study showed that there was significant association between level of resilience
and selected demographic variables like types of education (p = 0.0001), religion (p = 0.006), and socioeconomic status (p = 0.0001) at p-value < 0.05)[Table 5]).
Table 5
Association between level of resilience and selected demographic variables, n = 135
|
Sl. no
|
Demographic characteristics
|
χ2-Value
|
p-Value
|
|
1.
|
Age in years
a) ≤20
b) 21–25
c) 26–30
|
0.005
|
0.94
|
|
2.
|
Education
a) MBBS
b) BDS
c) Physiotherapy
d) B.Sc.Nursing
e) B.Pharm
|
29.48
|
0.0001a
|
|
3.
|
Level of study
a) First year
b) Second year
c) Third year
d) Fourth year
e) Fifth year
|
8.58
|
0.072
|
|
4.
|
Religion
a) Hindu
b) Muslim
c) Christian
|
10.20
|
0.006a
|
|
5.
|
Residence
a) Hosteller
b) Day-scholar
|
0.46
|
0.50
|
|
6.
|
Type of family
a) Nuclear
b) Joint
|
0.31
|
0.58
|
|
7.
|
Socioeconomic status
a) APL (above poverty line)
b) BPL (below poverty line)
|
13.02
|
0.0001a
|
χ2—chi square, a
p < 0.05 statistically significant.
Discussion
Baseline Characteristics
Majority of the participants (60.7%) belonged to the age group of 21 to 25 years.
Majority of them (83%) were females and 17% were males. Most of them (94.8%) belonged
to nuclear family, while 5.2% of participants belonged to joint family. Most of the
participants (87.4%) were hostellers and 12.6% were day scholars. Majority (97%) of
the participants believed in spirituality and 94.1% belonged to APL in their socioeconomic
status. Nearly half of the participants (47.4%) considered their parents are the supporting
system, while 42.2% considered their friends as the supporting system.
These findings were consistent with the study findings of Udhayakumar and Illango
that were conducted to assess the psychological well-being among college students.
In this study, majority (82%) of the participants belonged to the age group of 21
to 22 years.[1] The findings of the study were consistent with the findings of Bute et al, which
was conducted in Madhya Pradesh to assess the mental well-being among undergraduate
students in a medical college, in central India. About three-fourths (74.4%) of participants
were living in nuclear families and only one-fourth (25.6%) in joint families. Majority
of the participants (55.8%) were hostellers and 44.2% were day scholars.[7]
Correlation between Well-Being and Resilience
This study showed that there was a significant correlation between well-being scores
and resilience scores (r = 0.237, p < 0.05) among undergraduate students. The result of the study is consistent with
the findings of another study conducted in Nigeria to assess the well-being elements
leading to resilience among undergraduate nursing students. There was a significant
difference between high and low resilience characteristics of participants on two
of the five components of the well-being measures: positive emotion (F (1.65) = 8.96, p = 0.004) and engagement (F (1.65) = 9.73, p = 0.003).[8]
Association between the Level of Well-Being and Selected Demographic Variables
This study showed that there was significant association between level of well-being
and selected demographic variables like age (p = 0.009), education (p = 0.0001), level of study (p = 0.04), religion (p = 0.0001), and residence (p = 0.022) at p-value less than 0.05. The findings of the study were consistent with another study
on its effects on psychological well-being of undergraduate nursing students in selected
nursing colleges of Assam. There was significant association between age (p < 0.01), religion (p < 0.05), and psychological well-being.[9]
Association between the Level Resilience Score and Selected Demographic Variables
This study showed that there was significant association between resilience scores
and selected demographic variables between level of resilience and selected demographic
variables like types of education (p = 0.0001), religion (p = 0.006), and socioeconomic status (p = 0.0001) at p-value less than 0.05. The findings of the study were consistent with findings of
the study conducted in Malaysia on associations between demographic characteristics
and resilience factors. There was significant association between education (p < 0.05) and resilience.[10]
Limitations
This study was confined to specific geographical area that is a limitation for generalization
of the study findings. Participants of the study were representative of health-related
courses only, so understanding the resilience and well-being among undergraduate students
is constricted. The limited sample size further restricts the understanding of the
study variables.
Conclusion
The study concluded that there was a significant correlation between levels of well-being
and resilience. From the study findings, it is evident that along with empowering
students with knowledge and skills, there is a need to strengthen their resilience
by focusing on different approaches fostering their personal qualities in order to
improve their level of well-being. Educational strategies and supportive learning
environment can be created to foster resilience among students. Mentorship programs
will help the students to prepare for facing the challenges and to provide an extra
support.
