Type D Personality, Self-Resilience, and Health-

Promoting Behaviors in Nursing Students

Eun Ju Lim RN PhD1, Jun Hee Noh RN PhD

2, Yong Sun Jeong RN PhD

3

1Assistant Professor, Red Cross College of Nursing, Chung-ang University, Seoul, Korea,

2Assistant Professor, Department of Nursing, Woosuk University, Wanju-gun, Jeollabuk-

do, Korea 3Assistant Professor, Department of Nursing, Dongshin University, Naju-si

Jeollanam-do, Korea

Abstract. The purpose of this study was to examine the relationships among

type D personality, self-resilience, and health promoting behaviors in nursing

students. Grade, self-esteem, Type D personality, and self-resilience were

significant predictors of health promoting behaviors, accounting for 34.8% of

its variance (F = 25.714, P < 0.001). Of these four variables, self-resilience was

the most significant contributor to health promoting behaviors in nursing

students. Health promotion programs for nursing students should be designed

and developed with consideration of interventions for psychological variables

such as Type D personality and self-resilience.

Keywords: Health promotion, nursing students, personality, resilience

1. Introduction

As future professional nurses who will assume the role of a healthcare provider in the

community, college nursing students should prepare themselves to exhibit exemplary

health promoting behaviors in their daily lives [1][2]. Thus, it is worthwhile to

measure their level of health promoting behaviors and to identify the factors affecting

it. The purposes of this study were to examine comprehensively the relationship

among nursing students’ Type D personality, self-resilience, and health promoting

behaviors, and ultimately to provide some basic knowledge about materials for the

physical and psychological healthcare of nursing students, who will play key roles as

healthcare providers in the future.

2 Corresponding author: Jun Hee Noh, RN, Ph.D.

Department of Nursing, Woosuk University, Wanju-gun, Jeollabuk-do, Korea

E-mail: snow-1004@daum.net

Advanced Science and Technology Letters Vol.116 (Healthcare and Nursing 2015), pp.184-188

http://dx.doi.org/10.14257/astl.2015.116.37

ISSN: 2287-1233 ASTL Copyright © 2015 SERSC

2. Methods

2.1 Data collection and participants

To ensure the reliability of this study, data were collected across the country with

consideration of regional similarities and differences. The selected regions ranged

from metropolitan areas to small and medium-sized cities. Nursing students from

universities of three different cities were randomly selected to participate in the

survey. The data were collected from March to June 2013, and 538 nursing students

participated in this study. After excluding 21 incomplete questionnaires (valid

response rate: 96.1%), data from 517 nursing students were analyzed.

2.2 Measurements

Type D personality. Type D personality was measured using the questionnaire

developed by Denollet [3]; the Korean version was translated by Lim et al. [4]. We

used this questionnaire with the Korean version and the original author’s permission.

This questionnaire consists of 14 items: 7 items on the domain of negative affectivity,

indicating the tendency to experience negative affect, depending on the time and

situation; and 7 items on the domain of social inhibition, indicating the tendency to

inhibit the expression of emotion or behavior in social interactions in order to avoid

rebuke. Each question was answered on a 5-point Likert scale ranging from 0 (No) to

4 (Yes); if the score of each domain was 10 or higher, the respondent was classified as

having Type D personality. The Cronbach’s for this tool was .88 for negative

affectivity and .86 for social inhibition during its development, and it was .82 and .85,

respectively, for the present study.

Self-resilience. Self-resilience refers to a tendency to respond flexibly to situational

demands or stressful situations [5]. In this study, self-resilience was measured using

the questionnaire developed by Wagnild and Young [5], for which we paid a

copyright royalty to use; the Korean version was translated by Shin [6]. This

questionnaire consists of 25 items: 17 items on personal self-resilience and 8 on the

respondent’s acceptance of his/her own life. Each item was answered on a 7-point

Likert scale ranging from 1 (Not at all) to 7 (Absolutely yes) and the total score

ranged from 25 to 175. A high score indicates a high level of self-resilience. The

Cronbach’s for this tool was .91 during its development and .88 in this study.

Health promoting behaviors. Health promoting behaviors was measured using the

Health Promotion Lifestyle Profile (HPLP) developed by Walker, Sechrist, and

Pender [7] and translated into Korean and revised by Seo [8] with the original author’s

permission. This questionnaire consists of 47 items in 6 domains, including 11 items

on spiritual growth, 10 on health responsibility, 5 on physical activity, 7 on nutrition,

7 on interpersonal relations, and 7 on stress management. Each item is answered on a

4-point scale, and the total score ranges from 47 to 188. A high score indicates a high

level of health promoting behaviors. The Cronbach’s of this tool was .90 in Seo’s

Advanced Science and Technology Letters Vol.116 (Healthcare and Nursing 2015)

Copyright © 2015 SERSC 185

[8] study and .90 in this study.

2.3. Data analysis

Data analysis was conducted using SPSS for Windows version 18.0 (SPSS Inc.,

Chicago, IL, USA). Multiple regression analysis by the concurrent input method was

used to derive factors affecting health promoting behaviors.

3. Results

3.1 The relationships among Type D Personality, Self-Resilience, and Health-

Promoting Behaviors

There were statistically significant negative correlations between type D personality

and resilience (r=-0.410, p<.001), health promoting behavior (r=-0.377, p<.001). There was

statistically significant positive correlations between resilience and health promoting

behavior (r=0.536, p<.001)..

3.2 Factors Affecting Health Promoting Behaviors

Grade (β = 0.103, t = 2.307, P = 0.021), self-esteem (β = 0.115, t = 2.519, P = 0.012),

Type D personality (β = -0.128, t = -2.932, P = 0.004), and self-resilience (β = 0.393,

t = 8.617, P < 0.001) significantly accounted for 34.8% of the variance in health

promoting behaviors (F = 25.714, P < 0.001) (Table 1). Of these four variables, self-

resilience was the most significant contributor to health promoting behaviors in

nursing students.

4. Limitations

A limitation of this study is the inability to generalize the results to all nursing

students. This is because the participants of this study do not reflect the diversity of

school systems and all of them were students at 4-year colleges. Furthermore, given its

cross-sectional design, this study could not examine changes in the observations that

might have occurred over the students’ 4-year course of education. Finally, we cannot

exclude the possibility that psychological variables such as depression might affect

Type D personality and the health-related behaviors that were observed.

Advanced Science and Technology Letters Vol.116 (Healthcare and Nursing 2015)

186 Copyright © 2015 SERSC

Table 1. Factors Affecting Health Promoting Behaviors (N = 517)

Predictors

Health promoting behaviors

Unstandardized

coefficient

Standardized

coefficient

t p

B Standard

error

β

Constant 59.632 9.124 6.536 <.001

Age -0.015 0.253 -0.003 -0.057 0.954

Gender 2.318 2.016 0.045 1.150 0.251

Grade 1.451 0.629 0.103 2.307 0.021

Economic level 1.812 1.530 0.046 1.184 0.237

Social support 1.062 1.178 0.038 0.902 0.368

Student satisfactionlevels

with their courses

1.196 1.092

0.045 1.095 0.274

Subjective health status 1.026 0.836 0.047 1.227 0.220

Self-esteem 2.351 0.933 0.115 2.519 0.012

Type D personality -0.248 0.085 -0.128 -2.932 0.004

Self-resilience 0.386 0.045 0.393 8.617 <.001

F (p) = 25.714 (<.001) R2 = .348, adj. R2 = .334

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