Academic performance and subtypes of psychological traits in undergraduate nursing students: A latent class analysis

Abstract Background: Undergraduate nursing students often encounter emotional problems due to academic stress. However, researchers have primarily focused on the impact of stressors, rather than understanding the subtypes of psychological state among students.Objectives: To identify subgroups of psychological traits among undergraduate nursing students using latent class analysis (LCA), and to examine the relationship between subgroups and exam failure risk.Design and Methods: A cross-sectional study was performed from May to July 2019. The Ruminative Responses Scale, Learning Burnout Questionnaire and Psychological Capital Scale were used to evaluate students’ psychological traits. Subjects were categorized into subgroups by latent class analysis. Cross-sectional comparisons and longitudinal regression analyses were subsequently performed.Settings and Participants: A total of 379 undergraduate nursing students from three medical colleges in Shanghai were investigated by cluster sampling method.Results: A total of four latent classes were identified based on the mean scores of rumination, learning burnout and psychological capital: Class 1 – General group (N=181, 47.76%); Class 2 – Negative psychologically dominated group (N=54, 14.25%); Class 3 – Positive psychologically dominated group (N=65, 17.15%); and Class 4 – Ambivalence psychological group (N=79, 20.84%). Students belonging into Class 1 and 2 displayed a higher rate of exam failure compared with those in Class 3 and 4 (p<0.05). Regression analysis showed that Class 1 (OR=2.108, 95%CI 1.240-4.118, p=0.006) and Class 2 (OR=2.694, 95%CI 1.229-6.293, p=0.016) independently predicted exam failure among undergraduate nursing students after adjusting for age, gender, grade and other academic related factors.Conclusions: Our findings provide practical implications for effective interventions that target each specific subgroup. Undergraduate nursing students with “Negative psychologically dominated group” were at a higher risk of exam failure. Urgent attention should be paid to address issues associated with psychological coping in students and their effect on learning outcomes.