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

Abstract

AIM\nTo describe nursing student self-esteem prior to the influence of nursing education and to explore the relationship between self-esteem and dropout.\n\n\nDESIGN\nCohort study.\n\n\nMETHODS\nAt 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).\n\n\nRESULTS/FINDINGS\nThe 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\xa0<\xa00.0001), self-efficacy about completion of the nursing programme (p\xa0<\xa00.0001) and self-efficacy about internship (p\xa0<\xa00.0001) were associated with self-esteem. The dropout rate was 21.5%. Self-esteem level (p\xa0=\xa00.039) and academic performance (p\xa0<\xa00.0001) were associated with dropout.\n\n\nCONCLUSION\nWhile 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.\n\n\nIMPACT\nGiven 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.