The association of psychosocial distress with amotivation, self-efficacy and academic performance in nursing students: A path analysis

Background: Nursing students often experience psychosocial disturbance which affect their academic performance. This study examines the underlying mechanisms by how psychosocial disturbances predict academic amotivation and self-efficacy and influence academic performance.
Methods: This is a cross-sectional study involved 164 undergraduate nursing students, using convenience sampling at the university in Hong Kong, SAR. To evaluate psychosocial disturbances, academic amotivation, self-efficacy and academic performance, Patient Health Questionnaire-9 (PHQ), General Anxiety Disorder-7 (GAD), Perceived Stress Scale-10 (PSS), Work and Social Adjustment Scale (WSAS), Academic Motivation Scale (AMS), and Student Self-Efficacy Scale (SSE) were administered, respectively. A self-developed rating scale was used to rate the satisfaction of the students towards the nursing curriculum. Cumulative Grade Point Average (cGPA) was adopted to evaluate academic performance. Structural equation modelling was conducted to quantify the pathways of the scores of PHQ, GAD, PSS, WASA, amotivation, program satisfaction, self-efficacy, academic amotivation and academic performance.
Results: Significant indirect effects were observed from PHQ score (B = -0.004, p = .043) and GAD score (B = 0.004, p = .039) to academic performance via amotivation. Additionally, significant indirect effects from PSS to academic performance (B = -0.008, p = .009), WSAS to academic performance (B = 0.002, p = .027), and satisfaction with the program to academic performance (B = 0.01, p = .022) were observed via SSE. This indicates that amotivation and self-efficacy significantly mediate the path from the psychosocial disturbance, particularly depression, anxiety, stress, social adjustment and program satisfaction, to academic performance.
Conclusions: The study findings indicate that nursing educators may identify students with psychological disturbances by observing their amotivation, low self-efficacy, and declining academic performance. They should develop and implement appropriate measures to detect these disturbances and support academic performance, with particular emphasis on amotivation and students perceived self-efficacy.