Exploring nursing student self-esteem change and its predictors: Cohort study and its methodological challenges.

Objective: Considering methodological difficulties and inconsistent results of previous studies on it, the objective was to describe the change in nursing student self-esteem over time and its predictors, using a sound theoretical framework and relevant tools to measure and analyse the data.

Method: Cohort study. Self-esteem and related factors were assessed in nursing students in a 4-year bachelor's program at the beginning of each academic year from 2017 to 2019 and at the end of the academic year in May 2020, using he revised version of Self-liking/Self-competence scale of Tafarodi and Swann. Univariate and multivariate analyses were performed via generalized linear mixed modelling.

Results: Self-esteem was moderate at the beginning of the program: 50.40 (9.10). It increased slightly over time: 51.15 (9.11) at T1; 51.64 (0.49) at T2; and 51.39 (10.79) at T3 (P = .002). Baseline variables that predicted self-esteem change were gender, secondary school graduation level, state anxiety, intent to continue, and self-efficacy. Assessing and improving those last variables via a strong career plan could boost student achievement and increase retention during and after training.

Conclusion: Nursing student self-esteem can be assessed using a bidimensional model, with a two-factor scale like Tafarodi & Swann's self-liking/self-competence scale. Generalized linear mixed model is a useful way to correlate large sets of longitudinal data.