Date of Award


Degree Type


Degree Name

Doctor of Philosophy



Major Professor

Mary E. Gunther

Committee Members

Kenneth D. Phillips, Marian W. Roman, John G. Orme


Nursing students not only face the same developmental challenges as other college students, but also experience unique stressors that contribute to increased risk for negative outcomes. The intimate nature of patient care, the exposure to workplace adversity, death and dying, and the chaotic nature of healthcare can have cumulative negative effects on students’ health and well-being. Increased resilience could prove useful in helping students confidently face challenges and successfully move forward. The lack of empirical evidence regarding resilience-enhancing interventions with nursing students supports the need for examining the effectiveness of an educational intervention to increase resilience in adolescent baccalaureate nursing students. The purpose of this study was to: (1) determine the effectiveness of an educational intervention delivered via Twitter to increase resilience and sense of support, as well as decrease perceived stress, in a sample of adolescent baccalaureate nursing students, and (2) to describe the personal characteristics of this sample of nursing students. Ahern’s model of adolescent resilience, as adapted from Rew and Horner’s youth resilience framework, was the guiding theoretical model for the study. The study was a multisite experimental repeated measures design with a follow-up email survey. Participants were a sample of 70 randomly assigned junior-level baccalaureate nursing students, ages 19-23, at two state-supported universities in the southeastern United States. Both groups completed three instruments, the Perceived Stress Scale (PSS), Sense of Support Scale (SSS), and Connor-Davidson Resilience Scale (CD-RISC) at three times of measurement. Multilevel modeling was used to examine growth trajectories over time. Both groups showed a decline in perceived stress, but the control group demonstrated a greater decrease in scores at follow-up. No statistically significant difference was detected between groups in terms of sense of support. The experimental group demonstrated an increase in resilience from pretest to posttest, but declined at follow-up. Despite these unexpected findings, results of the email survey indicate the intervention was beneficial to some students. Strengths of the study include the innovative intervention using Twitter, the use of repeated measures, the use of multilevel modeling to analyze longitudinal data, and the first known use of Ahern’s model as a guiding framework.

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