Nursing students' sexual harassment experience in clinical practicum and its association with nursing professionalism and post-traumatic stress

Nursing students have been reported to be a vulnerable group to sexual harrassment in prior studies. However, only direct experiences have been assessed and there is a lack of research looking into how such experiences are associated with nursing professionalism. The purpose of this study was to examine the level of sexual harassment perception, sexual harassment experiences during clinical practicum(both direct and indirect), nursing professionalism, and post-traumatic stress of nursing students, and to identify their association. Fourth-year nursing students were invited to voluntarily participate in an online/mobile survey, with advertising flyers distributed in nursing schools in Seoul, Daejeon, Wonju, and Daegu. A total of 190 responses were analyzed using IBM SPSS statistics 25.0 statistics program. The main findings are as follows. 1. Most of the respondents were female students (93.7%) and the average age was 22.29 (±1.69). More than half of the respondents answered that they were satisfied (61.6%) with the nursing major, but the students were less satisfied (41.0% satisfied, 31.6% moderate) with clinical practicum. 60.5% of the respondents received sexual harassment-related education in schools prior to clinical practicum, but 51.6% reported such education was not sufficient. Both perception of sexual harassment (mean 138.83±13.73 out of a possible score of 33-165 points), and nursing professionalism (mean 61.23±9.09 out of a possible score of 17-85), showed moderate-to-high levels. During clinical practicum 65.3% (n=124) had experienced sexual harassment directly or indirectly, including 46.3% with direct experiences (n=88). A large proportion of students (108 out of 124) did not report the incidence to school authorities. Although post-traumatic stress level was very low at an average of 6.08 (±9.99) out of a possible 88 points, 7.26% were identified as partial PTSD (scores of 18-24; 1.61%) or PTSD (>25; 5.65%). 2. Perception of sexual harassment and nursing professionalism showed a statistically significant positive weak correlation (r=0.300, p=.000). Nursing professionalism and post-traumatic stress showed statistically significant weak levels of negative correlation (r=-0.225; p=.012) when only the data of the 124 with sexual harassment experience were analyzed. 3. There was no statistically significant difference between nursing professionalism and post-traumatic stress depending on the participant's experience with sexual harassment. However, perception of sexual harassment of those who experienced 'other types' of sexual harassment directly (126.20±48.43) was lower(p=.034) than the ones who had no experience of it (142.00±11.31). 4. Factors identified to affect nursing professionalism were perception of sexual harassment (β=0.340, p=.000), satisfaction with nursing major (β=0.165, p=0.025), and satisfaction with clinical practicum (β=0.283, p=.000), which explained 26.3% of the variance in nursing professionalism. 5. Factors identified to affect post-traumatic stress were satisfaction with clinical practicum (β=-0.318, p=.003) and having experienced sexual harassment before clinical practicum (β=-0.193, p=.031), which explained 17.6% of the variance. This study found that nursing professionalism and post-traumatic stress were related to satisfaction with nursing major or clinical practicum, rather than sexual harassment experience itself. Also, a negative correlation between nursing professionalism and post-traumatic stress was identified. These findings suggest that measures to enhance nursing professionalism by improving satisfaction with nursing major and clinical practicum would be beneficial, as well as plans to prevent sexual harassment in practicum itself.open석