Journal of Psychology in Africa

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Social support and work readiness of Chinese

final-year nursing students: The moderating role
of psychological resilience

Huan Ma, Chang-Ping Huang, Jin-Mei Zou & Ying Zhong

To cite this article: Huan Ma, Chang-Ping Huang, Jin-Mei Zou & Ying Zhong (2024) Social
support and work readiness of Chinese final-year nursing students: The moderating
role of psychological resilience, Journal of Psychology in Africa, 34:1, 88-94, DOI:
10.1080/14330237.2023.2291231

To link to this article: https://doi.org/10.1080/14330237.2023.2291231

Published online: 06 Mar 2024.

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Journal of Psychology in Africa, 2024
Vol. 34, No. 1, 88–94, https://doi.org/10.1080/14330237.2023.2291231
© 2024 Africa Scholarship Development Enterprize

Social support and work readiness of Chinese final-year nursing students: The moderating role
of psychological resilience
Huan Ma1, Chang-Ping Huang1, Jin-Mei Zou1*, and Ying Zhong2
1
School of Nursing, Sichuan Vocational College of Health and Rehabilitation, Zigong, China
2
Nursing Department, Zigong First People’s Hospital,Zigong, China
* Correspondence: cszoujinmei@163 .com

We explored the relationships among perceived social support, psychological resilience, and work readiness of final-year
nursing students . Participants included 376 Chinese final-year nursing students (female = 83 .8%; mean age = 20 .24 years,
SD = 1 .37 years) . They completed the Multidimensional Perceived Social Support Scale, the Connor–Davidson Resilience
Scale, and the Work Readiness Scale for graduate nurses . Hierarchical regression analysis results showed that social support
was significantly associated with higher work readiness . Further, social support was associated with higher psychological
resilience . Psychological resilience partially mediated the relationship between social support and work readiness to be
higher . These study findings suggest a need for targeted student social support programs to increase their psychological
resilience, which is important for increasing their work readiness .

Keywords: China, nursing student, psychological resilience, social support, work readiness

Introduction
Nursing is a practice-based profession and clinical practice workplace, handle interpersonal conflict, seek help,
requiring a high level of work readiness training and pre- develop teamwork, and collaborate . The work competence
paration (Jamieson et al ., 2019) . Work readiness refers to dimension includes clinical skills, clinical experience,
“the degree to which graduates possess the characteristics critical thinking, and problem-solving ability . Personal work
and attributes that prepare them for success in the characteristics include adaptability, responsibility, flexibility,
workplace” (Walker et al ., 2015, p . 632) . To be work ready self-awareness, self-direction, and stress management .
includes having psychological resilience and the ability to Studies have shown that nursing students with higher work
overcome adversity (Li et al ., 2020b) . Both work readiness readiness will have a higher level of self-efficacy, work
and psychological resilience require social support both at engagement, and job satisfaction, and a lower level of
work and in one’s personal life (Järvinen et al ., 2018) . Good turnover intention (Li et al ., 2022; Woo & Newman, 2020;
social support can help individuals to make the right choice Lee et al ., 2021) .
when exploring their careers (Jiang, 2017) . Nursing is a
stressful profession because of factors including shift work, Social support
concerns about patient safety, fear of making a mistake, the Social support is an important factor that influences work
physical and emotional demands of practice, and dealing readiness . Social support involves the care and support that
with relationships with patients, mentors, supervisors, and people perceive as being provided by others (Hong et al .,
other health care professionals (Kaur et al ., 2020; Patterson 2021; Xiao et al ., 2020) . Social support covers a series of
et al ., 2017) . We explored the relationships among the material, emotional, and information resources (Patel et al .,
perceived social support, psychological resilience, and work 2008) . These resources are mainly provided from family,
readiness of final-year Chinese nursing students. friends and other important people . A previous study found
that, without sufficient social support, students lack work
Work readiness readiness . Therefore, to achieve maximum work readiness,
Work readiness is considered to be a key factor in nurs- they require social support (Tentama & Riskiyana, 2020) .
ing students’ professional development potential, job Owing to the complexity of the clinical environment,
performance, and career success, as well as helping final- final-year nursing students experience a high level of stress
year nursing students have a smooth and successful and anxiety, which can impair their health and performance
transition to practice (Güner, 2015; Tarhan et al ., 2022; (Calma et al ., 2021; Mendes et al ., 2020; Onu et al ., 2022;
van Rooyen et al ., 2019; Caballero & Walker, 2010) . It Sun et al ., 2021; Rayan, 2019) . As a potential resource,
consists of four dimensions including social competence, social support can help nursing students to get career-
organisational acumen, work competitiveness, and personal specific advice and information and meet the changing
characteristics (Masole et al ., 2016) . The organisational demands of nursing work (Karaca et al ., 2019) . Meanwhile,
acumen subdomain comprises hospital policies, ward it is well documented that social support relieves stress,
knowledge, professional development, and career maturity . changes perspectives of stressful events, increases personal
The social intelligence dimension focuses on the ability strength in challenging situations, and promotes coping
to communicate with different people in the complex abilities (Kılınç et al., 2021).

Journal of Psychology in Africa is co-published by NISC (Pty) Ltd and Informa UK Limited (trading as Taylor & Francis Group)
 SOCIAL SUPPORT AND WORK READINESS 89

Psychological resilience practice undertaken continuously; and (iii) those who gave
Psychological resilience plays an important role in signed consent to participate .
improving one’s ability to cope with stressful situations,
establish effective coping strategies, and adapt to changing Measures
conditions (Öksüz et al ., 2019) . Psychological resilience Participants self-reported their socio-demographic informa-
is also considered a critical factor allowing nursing tion including age, sex, census area, being a student leader,
students to successfully to deal with many difficulties and and number of children in the family . They completed the
challenges during their clinical practice (Dong et al ., 2020) . Multidimensional Perceived Social Support Scale (Zimet
Additionally, psychological resilience is positively related et al ., 1988; Jiang, 1999), the Connor–Davidson Resilience
to work readiness and individuals with high psychological Scale (Connor & Davidson, 2003), and the Work-readiness
resilience have good work readiness skills (Lau et al ., 2020) . Scale for graduate nurses (Walker et al ., 2015; Li et al .,
With advances in health care and medical technology, the 2020) .
clinical setting has become more complicated and stressful
(Alharbi et al ., 2020) . Therefore, for a student nurse with Social support
low psychological resilience, entering and adjusting to the The Multidimensional Scale of Perceived Social Support
clinical workplace can be a challenge . (MSPSS) is a 12-item measure of social support from
Clinical practice can help final-year nursing students to family, friends, and other individuals (4 items each) . The
develop professional skills and take on professional roles . In scale items are rated on a seven-point scale ranging from
China, all nursing students are required to complete at least 1 = very strongly disagree, to 7 = very strongly agree .
32 weeks (1 280 hours) of clinical practice continuously Sample items include: “My family really tries to help me”;
in their final year before graduation; it is a mandatory “I have a special person who is a real source of comfort
requirement of preregistration nursing programs (Hamadi to me”; and “I have friends with whom I can share my
et al ., 2021; Hughes et al ., 2023; Jack et al ., 2021) . To joys and sorrows” . The total scores range from 12 to 84,
handle these stressful situations, final-year nursing students with a higher total score indicating a higher degree of
perceived social support . In the present study, scores from
must adapt to the existing circumstances, maintain their
the MSPSS achieved a Cronbach’s alpha of 0 .975 .
mental health, obtain sufficient social support, and build
psychological resilience, to complete their nursing practice
Psychological resilience
successfully .
The Connor–Davidson Resilience Scale (CD-RISC)
Although numerous studies have been conducted
comprises 25 items on three subscales: tenacity (13 items),
on aspects of work readiness in new graduate nurses
strength (8 items), and optimism (4 items) . The items
(Almotairy et al ., 2022; Lee et al ., 2021; Li et al ., 2020a;
are scored on a 5-point Likert-type scale ranging from
Ma et al ., 2023; Walker et al ., 2015), only a few focused
0 = not true at all, to 4 = true all the time . Sample items
on the social support, psychological resilience, and level of
include: “I can deal with whatever comes my way”; “I like
work readiness of final-year nursing students. Therefore,
challenges”; and “You can achieve your goals” . The total
we put forward a mediating model in which psychological
score ranges from 0 to 100, with a higher score indicating
resilience mediates the relationship between social support higher resilience . In the current study, the Cronbach’s
and work readiness . In this model, we expect that enhancing alpha for scores from the CD-RISC was 0 .983 .
psychological resilience will help final-year nursing
students to seek more social support and further increase Work readiness
work readiness . The Work-Readiness Scale for graduate nurses (WRS-GN)
consists of 37 items in five subscales: work competence (8
Goal of the study items), social intelligence (9 items), organisation hierarchy
We aimed to examine the moderating role of psychological (9 items), organisational acumen (7 items), and personal
resilience on social support and work readiness . Our work characteristics (4 items) . The items are rated on a
hypotheses were: 10-point response scale ranging from 1 = completely
H1: Social support and psychological resilience are disagree, to 10 = completely agree . Sample items include:
associated with higher work readiness levels . “One of my strengths is that I have an eye for detail”;
H2: Psychological resilience mediates the relationship “I am confident about my learnt knowledge and could
between social support and work readiness, strength- readily answer clinical questions about my field”; and “I
ening the relationship . find I am good at reading other people’s body language”.
Higher scores represent greater levels of perceived work
readiness . In the present study, the Cronbach’s alpha value
Methods for WRS-GN scores was 0 .966 .
Participants and setting
The participants were 372 final-year nursing students Procedure
(83 .8% = female; age range 18 to 25 years old) . About 42% The survey was completed in paper form. Specifically,
were student leaders and 23 .7% were from a single-child two trained research assistants distributed the paper
family. The inclusion criteria were as follows: (i) final-year questionnaires in a classroom to those nursing students
nursing students who were experiencing clinical practice; who signed the consent form . All questionnaires
(ii) those who had had more than 3 months of clinical used in this study were in Chinese and each student
90 Ma, Huang, Zou and Zhong

Table 1: Demographic characteristics of nursing students (n = 376)

Work readiness
Variables n (%) t-value p-value
Mean (SD)
Sex
Male 61 (16 .2) 294 .96 (40 .40) 3 .378 0 .001
Female 315 (83 .8) 273 .02 (47 .51)
Census area
Rural area 274 (72 .9) 274 .18 (46 .41) −1.624 0 .106
Urban area 102 (27 .1) 283 .01 (48 .48)
Be a student leader
Yes 158 (42) 285 .18 (44 .05) 3 .049 0 .002
No 218 (58) 270 .34 (48 .31)
From single-child family
Yes 89 (23 .7) 279 .88 (45 .43) 0 .758 0 .449
No 287 (76 .3) 275 .55 (47 .61)

Table 2. Work readiness, social support, psychological readiness . A p value of <0 .05 was considered statistically
resilience levels of nursing students (n = 376) significant (two-tailed).

Variable Mean SD Ethical considerations

Work readiness 276 .58 47 .08 This study was approved by the Ethics Committee
Work competence 59 .99 13 .62 of Zigong First People’s Hospital (Approval number
Social intelligence 68 .76 15 .83 20220415) . Participating nursing students consented
to participate in the study . We informed them that their
Organisation hierarchy 72 .74 14 .39
participation was voluntary, and they could withdraw at
Organisational acumen 59 .39 10 .61 any time if they did not wish to participate in the study .
Personal work characteristics 15 .68 9 .24 We also assured them of the anonymity and confidentiality
Perceived social support 68 .46 13 .14 of their data . The nursing students completed the survey
Support by family 22 .75 4 .72 forms during normal school hours .
Support by friends 22 .97 4 .45
Results
Support by significant other 22 .74 4 .47
Descriptive statistics
Psychological resilience 100 .07 17 .73
Table 1 presents the differences in work readiness scores
Tenacity 51 .74 9 .53 according to the characteristics of the nursing college
Strength 32 .70 5 .54 students. There were significant differences in work
Optimism 15 .65 3 .14 readiness scores based on sex (p < 0 .01) and being a
student leader (p < 0 .01) . Table 2 presents the mean
total scores for perceived social support, psychological
spent approximately 15–20 minutes completing the resilience, and work readiness; they were 68 .46 (SD =
questionnaire . The data were collected for three months, 13 .14), 100 .07 (SD = 17 .73), and 276 .58 (SD = 47 .08),
from September to November 2022 . A total of 400 nursing respectively .
students from three different schools were surveyed in this
Correlation analysis
study, and 376 valid questionnaires were returned, with a
Table 3 summarises the relationships among perceived
valid return rate of 94 % .
social support, psychological resilience, and work
readiness . Work readiness was positively associated
Data analysis
with perceived social support (r = 0 .690, p < 0 .01) and
All statistical analyses were conducted using SPSS
psychological resilience (r = 0 .731, p < 0 .01) . Perceived
(version 23 .0) and AMOS (version 23 .0) . Hierarchical social support was positively and significantly associated
multiple regression analysis was used to examine the with psychological resilience (r = 0 .703, p < 0 .01) .
mediating role of psychological resilience (Baron &
Kenny, 1986) . Final-year nursing students’ scores Test of the hypothesised model
for work readiness were considered as the dependent The results of the hierarchical multiple regression
variable . Demographic characteristics and perceived analysis of psychological resilience and work readiness
social support served as the independent variables . are presented in Table 4 . To predict work readiness from
Psychological resilience was entered as a mediating social support, the following steps were taken: In Step 1 of
variable . Furthermore, the bias-corrected bootstrapping the hierarchical linear regression analyses, sex and being
multiple mediation method with an SPSS Macro was a student leader (yes/no) were entered into the regression
used to analyse indirect effects (Preacher & Hayes, 2008). model as control variables . In step 2, perceived social
Student’s t-test was used to analyse differences in work support was added to the model and was found to be
 SOCIAL SUPPORT AND WORK READINESS 91

Table 3: Correlation analysis of work readiness, perceived social support and psychological resilience (n = 376)

1 2 3 4 5 6 7 8 9
1 . Work readiness 1
2 . Perceived social support 0 .690** 1
3 . Support by family 0 .625** 0 .961** 1
4 . Support by friends 0 .655** 0 .960** 0 .874** 1
5 . Support by significant other 0 .713** 0 .968** 0 .896** 0 .901** 1
6 . Psychological resilience 0 .731** 0 .703** 0 .670** 0 .680** 0 .681** 1
7 . Tenacity 0 .698** 0 .675** 0 .645** 0 .650** 0 .654** 0 .988** 1
8 . Strength 0 .747** 0 .698** 0 .663** 0 .677** 0 .676** 0 .974** 0 .939** 1
9 . Optimism 0 .688** 0 .689** 0 .654** 0 .669** 0 .667** 0 .927** 0 .882** 0 .880** 1
Note. **p < 0 .01

Table 4. Hierarchical regression analysis exploring the mediating at the 5% level, accounting for 47.73 % of the total effect.
role of psychological resilience (n = 376) These findings are in support of Hypothesis 2.
Variables Work readiness Discussion
Step 1 (β) Step 2 (β) Step 3 (β)
In the current study, we found that perceived social support
Block 1
Sex 15 .795*** 7 .072*** 7 .004 was positively related to psychological resilience, which
Be a student leader 3 .131 0 .890 2 .025 was in line with the result of a previous study (Lök et al .,
Block 2 2021) . Individuals with high levels of perceived social
Perceived social support can receive help from different sources when
0 .932*** 1 .267***
support they face all kinds of difficulties, and their psychological
Block 3 resilience may be enhanced (Eskandari et al ., 2019;
Resilience 1 .243*** Yıldırım & Tanrıverdi, 2020). In addition, psychological
R2 0 .493 0 .518 0 .599 resilience and perceived social support were positively
ΔR2 0 .489 0 .514 0 .595 associated with work readiness, indicating that final-year
F 120 .694*** 133 .252*** 138 .510***
nursing students with higher levels of psychological
Note. β = standardised regression coefficient resilience and social support have higher work readiness .
ΔR2 = variance explained in each step of the regression analysis For example, Dudley and colleagues (2020) also found
***p < 0 .001; **p < 0 .01; *p < 0 .05 that graduate nurses have good psychological personality
characteristics, including psychological resilience, and
perceived social support which can contribute to high
positively related to work readiness (β = 0 .932, p < 0 .001) .
levels of work readiness .
These findings are in support of Hypothesis 1.
In the present study, among social characteristics
In step 3, psychological resilience was added to the
associated with higher levels of work readiness, being a
model, and was found to be positively related to work student leader was significant (see also Li et al., 2020a).
readiness (β = 1 .243, p < 0 .001) . Psychological resilience A possible explanation for this finding is that final-year
partially mediated the relationship between perceived nursing students who have served as student leaders
social support and work readiness, with psychological may possess stronger organisation, coordination, and
resilience increasing the main effect of perceived social communication skills (Fuster Linares et al ., 2020) .
support on work readiness when it was added to the model Psychological resilience played a partially mediating role
(from β = 0 .932 to β = 1 .267, p < 0 .001) . between perceived social support and work readiness .
The specific indirect effect of psychological resilience Final-year nursing students with higher levels of social
was further tested . The estimated beta values are presented support may have higher psychological resilience, thereby
in Table 5, which reveals that the mediating effect of developing good work readiness . Hence, to enhance
psychological resilience was 1.158, which was significant nursing students’ psychological resilience, more social

Table 5. Estimated effects and bootstrap confidence intervals

Bootstrap
Estimated Boot
Model pathways confidence interval Effect ratio
effect SE
(BootLLCI–BootULCI)
Total effects
PSS→WR 2 .426 0 .134 2 .163–2 .689 –
Direct effects
PSS→WR 1 .267 0 .167 0 .939–1 .596 0 .522
Indirect effects
PSS→(res)→WR 1 .158 0 .149 0 .861–1 .447 0 .478
Note. res = resilience; PSS = perceived social support; WR = work readiness
92 Ma, Huang, Zou and Zhong

support should be provided for them . Work readiness is Measures that focus on enhancing psychological resilience
an important factor in job satisfaction, work engagement, and providing more social support for final-year nursing
and career turnover intentions for newly qualified nurses students will be effective in raising work readiness.
in their first year of practice (Walker & Campbell, 2013).
Final-year nursing students who are undertaking clinical Authors’ notes
practice are at a critical stage in their development because Conflict of interests: None declared .
they have not yet reached a professional level, and lack Funding: This research study was funded by Sichuan
autonomy, knowledge, and skills (Bryan et al ., 2022; Vocational College of Health and Rehabilitation
Cleary et al ., 2018; Leufer et al ., 2020) . Therefore, these (Grant Number: CWKY-2022Y-11) .
findings will help nursing educators become aware that Data availability statement: Data are available upon
high levels of social support and psychological resilience reasonable request .
are positive resources that improve the work readiness of
final-year nursing students. Acknowledgments
We wish to offer our sincere thanks to all final-year
Implications for research and practice nursing students for their unbiased participation in our
Our findings confirmed our hypothesis that psychological study .
resilience mediates the relationship between social
support and work readiness . In other words, strengthening References
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