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. 2025 Apr 11;24(1):409.
doi: 10.1186/s12912-025-03066-0.

A mixed methods study of wellbeing and resilience of undergraduate nursing students: implications for the post-pandemic era

Kim Foster  1 , Louise Alexander  2   3 , Michael Steele  4 , Tyneille Hale  5 , Larissa Hutchison  5 , Ronald Trejo  5 , Johanna Boardman  5
Affiliations

A mixed methods study of wellbeing and resilience of undergraduate nursing students: implications for the post-pandemic era

Kim Foster et al. BMC Nurs. .

Abstract

Background: The COVID-19 pandemic and rapid shift to online learning have had ongoing impacts on nursing students' wellbeing and resilience. We are yet to fully understand the implications for this emerging workforce in the post-pandemic era. The aims of this mixed methods study were to investigate wellbeing, coping and resilience of undergraduate nursing students in the pandemic; explore relationships between these variables and investigate predictors of wellbeing and coping, including differences between domestic and international students; explore how students experienced and managed adversity; understand how their mental distress and wellbeing were influenced by resilience resources used to deal with adversity, and identify implications for nurse wellbeing as they enter the workforce in the post-pandemic era.

Methods: A convergent mixed methods design was used. An online survey investigated wellbeing (COMPAS-W), psychological distress (DASS-21), coping (Brief COPE) and resilience (ARM-R) was completed by n = 175 undergraduate nursing students. Semi-structured interviews with n = 18 students explored how they navigated challenges. Descriptive, correlational, and regression analyses, and thematic analysis, were conducted. Mixed methods analysis was used to integrate both sets of findings.

Results: Students reported high levels of mental distress, yet also moderate levels of wellbeing and resilience. Key findings included domestic students reporting significantly greater stress than international students, and wellbeing being predicted by lower mental distress and increased problem-focused coping. Students coped with challenges by being proactive, drawing on a range of coping strategies, and seeking technical and emotional support. From a social-ecological resilience perspective, access to and engagement with a range of personal, environmental and relational resources served as protective factors for their wellbeing.

Conclusions: This study provides valuable new insights into protective factors for nurses during a period of extraordinary challenge. In the post-pandemic era, there is a need to strengthen the wellbeing and retention of new graduates now entering the workforce from university. Implementation of targeted strategies to strengthen graduates' peer relationships and sense of belonging at work, and wellbeing and resilience education, are needed. Longitudinal follow-up of graduates' wellbeing is recommended.

Keywords: Coping; Mixed methods; Post-pandemic era; Resilience; Undergraduate nursing students; Wellbeing.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: In accordance with the Australian Code for the Responsible Conduct of Research (2018), and the Declaration of Helsinki, ethical approval for the study was granted from Australian Catholic University Human Research Ethics Committee (approval number 2021-311E). An information sheet was provided at the start of the online survey, outlining the study purpose and procedures. Participation was voluntary and all participants gave written informed consent to take part by selecting “Yes, I agree to participate”, at the beginning of the survey. For the interview phase of the study, audio-recorded verbal assent was obtained from participants prior to commencing the interview. Consent for publication: Not applicable. Clinical trial number: Not applicable. Competing interests: The authors declare no competing interests.

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