Mediating effect of resilience on association among stress, depression, and anxiety in Indonesian nursing students

Background: Studies on beneficial effects of resilience among nursing students are scarce, particularly in the context of Indonesian cultural characteristics and family socioeconomic status. Consequently, whether resilience affects the associations between clinical practice-related stress and mental health problems remains unknown.

Purpose: We aimed to reveal whether resilience mediates the associations among stress, depression, and anxiety.

Methods: In this study, 336 nursing students were recruited and completed the Connor-Davidson Resilience Scale and the Depression, Anxiety, and Stress questionnaires. Students' economic status was assessed using the Self-Reported Questionnaire Family Socioeconomic Status. Data were collected in mid-2016 and analyzed using Pearson's correlation, independent t-test, one-way ANOVA, and simple linear regression with a mediation test.

Results: Results demonstrated that resilience had a partial mediating effect on depression (B = 0.044) and anxiety (B = 0.017) after controlling for student age, living situation, and living allowance. These results indicated that resilience affects stress, depression, and anxiety.

Conclusion: Resilience is thus a crucial mediator of the relationship of clinical practice-related stress with depression and anxiety in nursing students. A well-balanced relationship between academic demands, private life, and financial support can counteract the influence of depression and anxiety in this population.