Implications of coping strategies and community cohesion for mental health in Colombia

In the face of mass human rights violations and constant threats to security, there is growing recognition of the resilience of people and communities. This paper builds on such work by investigating the effects of individual coping strategies, perceived community cohesion, and their interaction on mental health symptoms in Colombia. The study was conducted five years after the mass demobilisation of the former paramilitaries and takes an exploratory quantitative approach to identify two distinct forms of coping approaches among participants living in the Caribbean coast of Colombia. A constructive coping approach included active engagement, planning behaviours, emotional support, acceptance and positive reframing of daily stressors. A destructive coping approach in this study entailed denial of problems, substance use and behavioural disengagement from day-to-day stress. In addition, the strength of perceived community cohesion, or how close-knit and effective the individuals feel about the community in which they live, was examined. Structural equation modelling revealed that a constructive coping approach was significantly related to lower depression, while a destructive coping approach predicted more symptoms of depression. Although there was not a significant direct effect of perceived community cohesion on mental health outcomes, it did enhance the effect of constructive coping strategies at the trend level. That is, individuals who used constructive coping strategies and perceived their communities to be more cohesive, reported fewer depression symptoms than those who lived in less cohesive settings. Implications for promoting constructive coping strategies, as well as fostering cohesion in the community, are discussed.

Testing the psychometric properties of two self-report clinical competence scales for nursing students.

Background: It is important to assess the clinical competence of nursing students to gauge their educational needs. Competence can be measured by self-assessment tools; however, Anema and McCoy (2010) contend that currently available measures should be further psychometrically tested.
Aim: To test the psychometric properties of Nursing Competencies Questionnaire (NCQ) and Self-Efficacy in Clinical Performance (SECP) clinical competence scales.
Method: A non-randomly selected sample of n=248 2nd year nursing students completed NCQ, SECP and demographic questionnaires (June and September 2013). Mokken Scaling Analysis (MSA) was used to investigate structural validity and scale properties; convergent and discriminant validity and reliability were also tested for each scale.
Results: MSA analysis identified that the NCQ is a unidimensional scale with strong scale scalability coefficients Hs =0.581; but limited item rankability HT =0.367. The SECP scale MSA suggested that the scale could be potentially split into two unidimensional scales (SECP28 and SECP7), each with good/reasonable scalablity psychometric properties as summed scales but negligible/very limited scale rankability (SECP28: Hs = 0.55, HT=0.211; SECP7: Hs = 0.61, HT=0.049). Analysis of between cohort differences and NCQ/SECP scores produced evidence of discriminant and convergent validity; good internal reliability was also found: NCQ α = 0.93, SECP28 α = 0.96 and SECP7 α=0.89.

Discussion: In line with previous research further evidence of the NCQ’s reliability and validity was demonstrated. However, as the SECP findings are new and the sample small with reference to Straat and colleagues (2014), the SECP results should be interpreted with caution and verified on a second sample.
Conclusions: Measurement of perceived self-competence could start early in a nursing programme to support students’ development of clinical competence. Further testing of the SECP scale with larger nursing student samples from different programme years is indicated.

References:
Anema, M., G and McCoy, JK. (2010) Competency-Based Nursing Education: Guide to Achieving Outstanding Learner Outcomes. New York: Springer.
Straat, JH., van der Ark, LA and Sijtsma, K. (2014) Minimum Sample Size Requirements for Mokken Scale Analysis Educational and Psychological Measurement 74 (5), 809-822.