الفهرس 
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Abstract
Academic burnout is a common problem among nursing students around the world. Students experience feelings of inferiority and mental fatigue as a result of chronic stress caused by a lack of resources to complete their tasks and duties. In addition, academic burnout leads to poor performance, academic failure, and decreased life satisfaction. Given these consequences, dealing with the problem is highly important. Resilience is one of the mechanisms for combating academic burnout. Resilience is essential for nursing students, who face multiple risk factors on a daily basis while providing standard care to patients. Nursing students with increased resilience can cope with adverse conditions. Resilience is considered an important mediator between academic burnout and psychological well‐being. Psychological well-being has a significant impact on nursing students’ decisions to enter and remain in the nursing field, as well as their ability to successfully adapt to college and university life. Therefore, an emphasis on nursing students’ resilience and psychological well-being will be influence on their confidence and maturity for think analytically and handle effectively the stressors in their academic learning. The present study aimed to explore the relations between academic burnout, resilience and psychological wellbeing of baccalaureate nursing students. The study followed a descriptive correlation research design and it was conducted at the Faculty of Nursing at Tanta University. The study subjects were all nursing students in the third and fourth academic year (2022-2023). They were (1066) students in third year and (555) students in fourth year, but in actual study the participants were (1487) students involved (997) students in third academic year and (490) students in fourth academic year. The researcher selected students in third and fourth academic years for this reason: The students in this final year (third and fourth) having additional stress and burnout due to multiple assignments during clinical practice, heavy theoretical courses and lessons and their working beside the academic study. In addition, the duties that placed on them from the personal and social life events. -These students in the last years close to graduation from the faculty and they have more expectation about life after graduation. Suppose to be more qualified and highly professional to identify how they deal with and interact with patients and how to cope with the stressful work events perfectly. The study data was collected at first semester of academic year (2022-2023), by utilizing the following 3 tools: - Tool I: Nursing students’ academic burnout questionnaire: This tool consisted of two parts: Part 1: Personal data of nursing students: It was developed by the researcher to elicit data such as: age, sex, academic year, marital status, residence and parents’ education level, parents’ occupation and family income. Part 2: Maslach Burnout Inventory: The original tool was Maslach Burnout Inventory (MBI) which was adapted by Maslach C & Jackson E. (1996), and validated by Shi Y et al. (2019) to be used for medical students. The researcher used the validated MBI to measure academic burnout in nursing students. The tool consists of 15 items rated on 7- point likert scale, ranged from (1) never to (7) every day with 6 items with reverse score. The tool consisted of three domains: Emotional exhaustion, cynicism, and low personal efficacy with reverse score items. Tool II: Connor-Davidson Resilience Scale (CD-RISC): This tool was developed by Connor K & Davidson J. (2003) and was adapted by the researcher. This tool was used to measure resilience among nursing students. It was consisting of 25 items, the items were rated on 5-point Likert scale, ranging from (0) = not true at all to (4) = true nearly all the time. This scale consisted of five subscales were explained as a following: Personal competence, trusting student’s instincts, tolerance to negative affect, student’s positive attitude to change, perceived control, and spirituality. Tool III: Ryff’s Psychological Wellbeing Scale: - It was developed by Ryff Carol D & Keyes C (1995) and was adapted by the researcher. This tool was used to measure positive aspects of psychological functioning among nursing students. This scale consisted of a 42-item, on a 6-point Likert scale ranged from (1) = strongly disagree, to (6) = strongly agree. 22 item of this scale had reverse score. The scale divided on to six subscales: autonomy, positive relation with others, environment mastery, personal growth, purposes of life, and self- acceptance. - Method: 1. An official letter clarifying the purpose of the study was addressed to the Dean of Faculty of Nursing to obtain permission for data collection. 2. Ethical considerations: - The permission to conducted to the study was obtained from the scientific research ethical committee in Faculty of Nursing at Tanta university and informed consent was obtained from students after explaining to them in details what kind of the study was it. The participants was reassured about confidentiality of their information. Anonymity was used instead of person’s name on questionnaire sheets. Respecting the right of the participants to withdraw at any time during the data collection period. The study caused no harm for nursing students. 3. The study tools were translated into Arabic by the researcher and tested for internal validity by a jury composed of five experts in psychiatric nursing to ascertain the appropriateness of items for measuring what they were supposed to measure. The required corrections were carried out accordingly. 4. A pilot study was carried out on 10% of the study subjects to ascertain the clarity and applicability of the study tools and to identify obstacles that might be faced during data collection. The total number of students are (1621) and the pilot study from third academic year was (107) students and from fourth academic year was (55) students. Those subjects was selected randomly, the simple modification was done accordingly and those subjects were not excluded from study sample. During actual study: The researcher collected the data at first semester of academic year (2022-2023). The study sample was already divided in small groups during days of practical training. The average number of students group in third academic year range from 40-50 and in fourth academic year range from 30-40. The researcher met of the students during break or after end of clinical day in their classroom, during meeting the researcher initially explain the purpose of the actual study and take consent from students. Then distributed the study tools on participants and explained any confusion or misunderstand during data collection. The duration of group interview ranged from 20-30 minute. The researcher was collected study data four days per weeks. The duration of data collected was three months (from first October 2022 to end December 2022. The following were the main results of the study: - - More than one third of nursing students 40.2% aged 22 to less than 23 years old, while the minority of them (1.7%) aged 23 years old. In relation to sex; 64.4% of nursing students are female and 35.6% are male. In addition to marital status; around two third (67.9%) of the nursing students are single, and 32.1% of them are married. - Around half of the nursing students (51.7%) have high level of academic burnout, and near to one third of students (31.4%) have low level of academic burnout and 16.9% of students have moderate level of academic burnout. - More than half (55.3%) of the nursing students in fourth year have high level of academic burnout, and about to one third (32.4%) of other students have low level of academic burnout, while only 12.2% of other students have moderate level of academic burnout. On the other hand, nearly to half of the nursing students (49.9%) in third year have high level of academic burnout, and near to one third (30.9%) of other students have low level of academic burnout, while 19.2 of other students have moderate level of academic burnout. - The result appeared that domains of academic burnout were firstly with higher level was emotional exhaustion, it presents among 51.8% of students, and among 35.6% of students with lower level. The second domain was low personal efficacy, the around half of students (51.0%) had higher level, and 30.0% of other students had lower level. The third domain was cynicism. It represent 48.0% of students that complained from higher level, and 26.0% of students expressed moderate level, and the same level among other students had lower level of cynicism. - It’s obvious that, low Personal efficacy domain has the highest mean score followed by emotional exhaustion and Cynicism. There is no statistically significant difference between mean score of academic burnout and its’ domain among students in third and fourth academic years. - More than half (55.5%) of the nursing students have low level of resilience, and near to one quarter (23.3%) of students have moderate level of resilience, while 21.2% of students have high level of resilience. - It obvious that, more than half (61.0%) of the nursing students in fourth academic year have low level of resilience, and less than one quarter (20.4%) of other students have moderate level of resilience, while 18.6% of other students have high level of resilience. On the other hand, more than half (52.9%) of the nursing students in third academic year have low level of resilience, and about one quarter (24.7%) of other students have moderate level of resilience, while 22.5% of other students have high level of resilience. - Regarding to the domains of resilience, The first domain was students’ positive attitude to change, more than half (54.5%) of nursing students have low level and more than quarter (26.1%) of other students have moderate level. The second domain was trusting student’s desires, tolerance to negative affect 53.9% of nursing students have low level and 26.3% of other students have moderate level. The third domain was personal competence, more than half (53.7%) of nursing students have low level and around one quarter (25.4%) of students have moderate level of personal competence. The fourth domain was students’ perceived control, it was found that 52.3% of nursing students have low level and 29.6% of other students have moderate level. The fifth domain was spirituality, near to half (47.7%) of nursing students have low level and 29.7% of other students have moderate level, and less than It’s obvious that, personal competence domain has the highest mean score followed by trusting student’s desires, tolerance to negative affect, students’ positive attitude to change, perceived control and spirituality. There is not statistically significant difference between students in third and fourth academic years regarding to mean score of their resilience and its’ domain. - Regarding to psychological wellbeing among study sample, more than half (62.7%) of the nursing students have low level of psychological well-being, and 16.1% of students have moderate level of psychological well-being. While less than one quarter (21.2%) of students have high level of psychological well-being. - It appears that, around two thirds (67.3%) of the nursing students in fourth year have low level of psychological well-being, and less than one quarter 18.6% of other students have high level of psychological well-being, while 14.1% of other students have moderate level of psychological well-being. On the other hand, more than half 60.4% of the nursing students in third year have low level of psychological well-being, and 22.5% of other students have high level of psychological well-being, and only 17.2% of other students have moderate level of psychological well-being. - The result explored that domains of psychological wellbeing among study sample were firstly; autonomy, more than two third (71.4%) of nursing students have low level. The second domain was personal growth, while two thirds (63.4%) of nursing students have low level. The third domain was purpose in life, which 61.8% of nursing students have low level. The fourth domain was environmental mastery, that near to two thirds (61.1%) of nursing students have low level. The fifth domain was a positive relation with others, which 61.0% of nursing students have low level. The sixth domain was self-acceptance, which 59.6% of nursing students have low level. It also shows mean score of total psychological well-being 126.80 with standard deviation 59.036 and with range 65-230. - It’s observed that, a similarity in mean score between students in third and fourth academic years regarding total psychological wellbeing and its’ domain and there is not any statistically significant difference between them. - It’s show that, there is highly negative statistical significant correlation between academic burnout and psychological well-being (r= -0.976, p-value = 0.000). Also, there is highly positive statistical significant correlation between resilience and psychological well-being (r= 0.972, p-value = 0.000). - It’s show that, there is highly negative statistical significant correlation between resilience and academic burnout (r= -0.947, p-value = 0.000). - There is a statistical significant relation students’ age, sex, marital status, residence, family income and their academic burnout (P= 0.000). - There is a statistical significant relation between age of students, sex, marital status, residence, family income and their total resilience (P= 0.000). - There is a statistical significant relation between age of students, sex, marital status, residence, family income and their total psychological wellbeing (P= 0.000). Recommendations According to this results of the current study, this following recommendations were suggested: - 1) Recommendations for the students: - 1- Conducting a series of workshops, seminars and training programs about techniques that used to overcome on academic burnout for nursing students. 2- Conducting resilience training program that help students to understand causes of stress and how to develop their resilience. 3- Establishing training program to help students how to enhance their psychological wellbeing and identify issues which affect on their psychological wellbeing. 2) Recommendations for the student’s families: - 1- Directing student’s families to increase their awareness about causes of academic burnout of their students through performing workshops training about how they deal with these problems. 2- Performing regular counseling session for the student’s families which help the families to identify all aspects of psychological health to promote resilience and psychological wellbeing of their students. 3)Recommendations for the staff members: - 1- Establishing a collaborative efforts and responsibility by academic nursing staff members for early detection of academic problems. 2- Building training program about resilience to increase experience of staff members about strategies to increase resilience. 3- Enhancing psychological wellbeing of students through lectures that involved as in educational course while the staff teach to them. 4)Recommendations for the future research: - 1- Implementation of research project for nursing students on resilience training skill program to reduce and adapt with academic burnout which faced in academic life and enhance their psychological wellbeing.