Qom University of Medical Sciences Journal

Introduction
The novel coronavirus (COVID-19) was first reported in China in late 2019 and then spread all over the world in 2020. Many studies investigated the prevalence of psychological disorders during the COVID-19 pandemic, and their results indicated the negative effects of this disease on the mental health of the general population, including students. Stress is the psychological and physiological response of the body to any perceived change or threat. Medical students had more stress and anxiety about infection or transmitting the disease to their families due to being in medical centers and contact with the infected patients. Studies have shown that the use of coping strategies, such as psychological capital, is effective in managing stressful events. This study aims to determine the relationship between perceived stress and the psychological capital components (hope, optimism, resilience, self-efficacy) in nursing students during the COVID-19 pandemic.
Methods
This is a descriptive-correlational study that was conducted on 178 third- and fourth-year undergraduate students in nursing and Midwifery from Ahvaz Jundishapur University of Medical Sciences (AJUMS) in Iran, who were selected using a census method. The data were collected from May to July 2022 online using a demographic checklist, Cohen’s Perceived Stress Scale (PSS), and Luthans’s Psychological Capital Questionnaire (PCQ). Demographic checklist surveyed age, sex, marital status, history of COVID-19 infection, family history of COVID-19 infection, history of death due to COVID-19 in the family, and history of visiting a psychologist due to having stress, depression, and anxiety. The PSS has 14 items scored on a 5-point Likert scale. The total score ranges from 0 to 56, where higher scores indicate higher levels of stress. Items 4, 5, 6, 7, 8, 9, 10, and 13 have reversed scoring. In this study, a score of 0-17.99 indicates a low level of stress; a score of 18-35.99 shows a moderate level of stress; and a score >36 indicates a high level of stress. The Persian version of PSS was validated in Iran by Maroufizadeh et al., who reported a Cronbach’s alpha coefficient of 0.9. The PCQ has 24 items and four subscales of hope, optimism, resilience, and self-efficacy. Each subscale contains six items rated on a six-point Likert scale from 1 (completely disagree) to 6 (completely agree). In this study, a score of 24-39.99 indicates a low and unfavorable level; a score of 40-79.99 shows a moderate level; and a score ≥80 indicates a high and favorable level of psychological capital. The validity and reliability of the PCQ were confirmed in the study by Shokri et al. For the reliability, they reported Cronbach’s alpha values of 0.87, 0.83, 0.86, and 0.70 for the subscales of self-efficacy, hope, resilience, and optimism, respectively. Data were analyzed using an independent t-test, one-way ANOVA, Pearson’s correlation test, and multiple linear regression analysis in SPSS software, version 22.
Results
The mean total score of PCQ in students was 110.2±16, which shows a good and high level. The highest score was related to the self-efficacy dimension and the lowest score was related to the resilience dimension. The majority of students (97.2%) showed a high psychological capital. The mean total score of PSS was 24.4±10.3, which shows a moderate level. The majority of students (61.8%) reported moderate level of stress.
A significant and negative correlation was found between perceived stress and psychological capital components (r=-0.5, P<0.001). Regression models showed that optimism (β=-0.36, P<0.001), self-efficacy (β=-0.30, P=0.001), visiting a psychologist (β=-0.17, P=0.005), and resilience (β=0.16, P=0.043) were the predictors of perceived stress in nursing students. These factors together were able to predict 32% of the changes in the perceived stress variable.
Conclusion
The results of the present study showed that the majority of nursing students in AJUMS had high psychological capital. However, those who had a history of visiting a psychologist due to mental problems during the pandemic significantly reported lower scores in all dimensions of psychological capital. The majority of students reported moderate perceived stress. The results of the present study showed a negative and significant correlation between perceived stress and all components of psychological capital. Therefore, the increase in self-efficacy, hope, resilience, and optimism of students can reduce their stress. This shows the need to pay attention to the psychological aspects of nursing students. It is recommended to manage psychological problems of nursing students and improve their self-efficacy, hope, optimism, and resilience so that they can take advantage of psychological capital as much as possible and can control their perceived stress.

Ethical Considerations
Compliance with ethical guidelines
This study was approved by the ethics committee of Ahvaz Jundishapur University of Medical Sciences (ethics code: IR.AJUMS.REC.1400.633).
Funding
This article was extracted from a research proposal and funded by Jundishapur University of Medical Sciences.
Authors contributions
Design, data analysis, supervision: Mehrnaz Ahmadi; Data collection: Shaghayegh Salehi and Negar Leylatan; Writing: All authors.
Conflicts of interest
The authors declared no conflicts of interest.
Acknowledgements
The authors would like to thank the Vice-Chancellor for Research and Technology and the Student Research Committee of Ahvaz Jundishapur University of Medical Sciences, and all the nursing students who participated in this study for their support and cooperation.