Abstract
BACKGROUND:
The role of spirituality in people’s lives, particularly the lives of health professionals, as well as its impact on mental health issues like anger and aggressiveness and resilience, are particularly significant. Therefore, the purpose of this study was to examine the link between the propensity for violence and personal resilience in dental students by taking into account the function of spirituality as a mediator.
MATERIALS AND METHODS:
In this cross-sectional questionnaire survey, 211 volunteer dentistry students participated from a government institute in Jammu and Kashmir, India using a stratified sample procedure. The Spiritual Orientation Scale, Buss and Perry Aggression Questionnaire, and Connor-Davidson Resilience Scale were used to gather the data. SPSS version 20.0 was used for conducting a bivariate analysis to ascertain the directionality connection between the research variables. In addition; structural equation modelling analysis was conducted by Smart PLS.
RESULTS:
According to the findings, resilience and spirituality have a substantial and positive link (r = 0.468 r = 0.023). Aggressiveness and resilience revealed a statistically significant inverse link (r = 0.325, P = 0.04), but aggression and spirituality had no significant correlation. Spirituality played a substantial mediation influence in the indirect pathway of violence on resilience (P = 0.001).
CONCLUSION:
According to the study’s findings, spirituality can help pupils become more resilient as individuals and can act as a helpful intermediary between aggressiveness and resilience.
Keywords: Aggression, resilience, spirituality, structural equation model
Introduction
Spirituality includes the search for purpose in life and is characterised by a feeling of connectedness to a higher power.[1,2] It assists in realising one’s full potential, purpose in life, and internal fulfilment. Through self-evolution, self-actualisation, and transcendence, one can achieve this condition of existence.[3] People who are in a condition of spiritual health are able to live their everyday lives in a way that helps them realise their full potential, the meaning of life, and their inner contentment.[3] According to the World Health Organisation, spiritual health is a crucial aspect and the fourth dimension of overall health. This has an impact on their physical, mental, and social health[4,5] and also on an individual’s behaviour.[6] People who are spiritual feel more connected to life and are happier.[1] Researchers have demonstrated that spirituality and associated ideas (including religion, beliefs, and religious activities) have a favourable association with human health in recent findings from meta-analysis studies. For instance, it discovered that suicide, antisocial behaviour, and low levels of sadness have all been linked to spirituality.[7,8]
Resilience is one of the aspects of spirituality that may be studied, according to a recent research.[9] The ability to adapt successfully in the face of difficulty, trauma, tragedy, danger, or severe causes of stress is known as resilience.[10] Resilience refers to a person’s capacity to bounce back from adversity or maintain their previous state.[11] Because resilience is dynamic, its level of intensity changes throughout time.[12] Recent research by clinical psychologists has examined how people cope with pain, disability, tragedy, melancholy, and antagonism. The findings of this research demonstrate the beneficial, constructive, and protective roles that resilience plays in effective coping and expanding adaption to demanding living circumstances.[13] In their research on South African families, Greeff and Loubser[14] highlight the importance of spirituality as a quality and resilience. Anger with aggression was reliable signs of mental health that are connected to spirituality.[15]Any verbal or nonverbal behaviour that is directly or indirectly meant to hurt another person’s bodily or mental well-being is aggression.[16] Aggression may also be defined as any behaviour that is meant to cause harm to others.[17] As a result, those who are more spiritual and connected to God tend to be in better mental health.[18,19]
Many studies have proven that dentists face a greater amount of stress in their profession than any other job. Just a few of the stresses that dental students typically encounter include Admission into dental school, competitive training to develop clinical skills, coping with ingrained feelings related to the doctor-patient relationship, intense work pressure, exam stress, limited free time, and stress resulting from meeting clinical requirements. These stressors might result in fatigue, health issues, and the emergence of bad behaviours. They must thus be able to manage their stress.[5,20,21] Spiritual well-being improves a person’s coping mechanisms, which can aid dentistry students in overcoming difficult circumstances as future healthcare workers.[5] Students who have high levels of resilience are happier and more content with their lives, claim Aboalshamat et al.[22]
Psychologists and other mental health specialists are paying more and more attention to people’s spirituality levels. The role of spirituality in people’s lives, particularly that of health professionals, and its effects on resiliency in facing difficulties in life, as well as various elements of mental health like rage and aggressiveness, are particularly significant. The ability to use religious resources to address difficulties in one’s life is part of one’s spirituality, which also influences how they behave in public. Therefore, purpose of this study was to examine the correlation between the propensity for violence and personal resilience in dentistry students by taking into account the function of spirituality as a mediator. This is, as far as we are aware, the first study to look at all three factors simultaneously among dentistry students.
Materials and Methods
Study design and setting
A cross-sectional research using a questionnaire and the structural equation modelling (SEM) was done from April 2022 to June 2022.
Study participants and sampling
Study participants were undergraduate and postgraduate students from various academic years at a government dental institution in India, A median sample size of about 200 cases is considered for the SEM method based on reviews of various as explained by Keline.[23] To participate in the study, 230 students in total were contacted. Stratified random sampling was used to select the participants from different academic years in the study.
Ethical consideration
The research was questionnaire study with no risk to the participants and was approved by the Institutional Ethical Committee. All research participants received signed informed permission after being informed of the study’s objectives and receiving assurances about the confidentiality of their data. It was optional to take part in the study.
Data collection tools
A pretested, predesigned, structured questionnaire was used to collect the data. The demographic information on the questionnaire, including name, age, sex, and academic year, was the first section. The next sections were as follows:
Spiritual orientation scale (SOS) was developed by Kasapoped (2016) to assess individuals’ spirituality.[24] There are 16 items on this 7-point Likert scale, with 1 being the strongest disagreement and 7 being the strongest agreement, such as “Prayer/meditation is an important aspect of my spiritual life.” The entire scale has a minimum and highest potential score of 16 and 112, respectively. The level of spiritual orientation increases with increasing score on the scale. Cronbach’s alpha for the scale in the current study was 0.92.
Buss and Perry Aggression Questionnaire (AQ)[25] is a self-reported instrument that consists of 29 phrases and 4 subscales, which include physical aggression, verbal aggression, anger, and hostility (9, 5, 7, and 8 items, respectively). On a five-point scale with 1 being the most out of character for me and 5 being the best response, participants assessed their responses to each AQ item (extremely characteristic of me). The sum of the subscales’ scores is used to get the overall score for aggressiveness. In the current study, Cronbach’s alpha for AQ was 0.90.
Connor and Davidson Resilience Scale (CD-RIS) given in 2003, which comprises 25 items, to gauge how resilient various people are. The response spectrum is a 5˚ Likert scale, with 0 being completely false and 4 being quite right. Summation of all item scores yields the CD RIS’s overall score, which ranges from 0 to 100. A higher score indicated that people were more resilient. For CD RIS, 50 is the cutoff. Scores over 50 suggest resiliency in those who have faced difficulty.[26] Cronbach’s alpha for this area was 0.94.
Statistical analysis
Bivariate analysis with SPSS version 20.0 was utilised in this study to ascertain the directionality connection between the studied variables (IBM Corp., Armonk, NY, USA). After that, the research model was subjected to a route analysis. Software called Smart PLS (GmbH Boenningstedt, Hamburg, Germany) was used for the path analysis and SEM. Several indicators that are often used in SEM analysis were employed to evaluate the model fit. Only after the model meets the advised Goodness-of-Fit (GOF) metrics was it deemed feasible for the analysis. When the model is suitable, the Chi-squared fit statistic (2/df), RMSEA, GOF index (GFI), normed fit index (NFI), and comparative fit index (CFI) should all be near to or better than the suggested levels.[27] The suggested GOF were employed in this study to compare models.
Results
A total of 211 out of 230 research participants answered, with a response rate of 91.7%. Of these, 125 women (59.24%) and 86 men (40.76%) responded [Table 1].
Table 1.
Distribution of the study subjects according to demographic variables
| Variables | Number | Percentage | |
|---|---|---|---|
| Gender | Male | 86 | 40.76 |
| Female | 125 | 59.24 | |
| Academic position | Undergraduate | 136 | 64.46 |
| Postgraduate | 75 | 35.54 | |
| Marital status | Single | 183 | 86.73 |
| Married | 28 | 13.27 | |
| Type of residence | Hosteller | 145 | 68.72 |
| Day scholar | 66 | 31.27 | |
| Total | 211 | 100 | |
The total aggression mean scores in participants was 83.16 ± 21.27. The mean spirituality level and resiliency in students were 99.84 ± 8.62 and 62.55 ± 11.73, respectively [Table 2].
Table 2.
Mean and standard deviation of aggression, spirituality, and resilient dimensions
| Variable | Mean±SD | Minimum–maximum | |
|---|---|---|---|
| Aggression | Physical aggression | 23.81±6.98 | 9-40 |
| Verbal aggression | 12.64±5.42 | 5-20 | |
| Anger | 22.27±6.08 | 7-30 | |
| Hostility | 24.44±6.35 | 8-35 | |
| Total score | 83.16±21.27 | 29-120 | |
| Spirituality | 99.84±8.62 | 74-108 | |
| Resilient | 62.55±11.73 | 1-100 | |
According to correlation analysis, spirituality and resilience among study participants were statistically significantly positively correlated (r = 0.468, P = 0.023), whereas aggression and resilience were statistically significantly negatively correlated (r = 0.325, P = 0.04), and there was no statistically significant correlation between spirituality and aggression [Table 3].
Table 3.
Pearson’s correlation between aggression, spirituality, and resilient dimensions
| Variable | Spirituality | Aggression | Resilient | |
|---|---|---|---|---|
| Spirituality | Pearson’s correlation | - | ||
| P | - | |||
| Aggression | Pearson’s correlation | 0.062 | - | |
| P | 0.841 | - | ||
| Resilient | Pearson’s correlation | 0.468 | −0.325 | - |
| P | 0.023* | 0.04* | - | |
We employed the structural equation modelling approach to explore the link between aggressiveness and resilience with the mediating effect of spirituality. Good fitness indices were found in this model’s study, all of which were either near to or better than the required fit (RMSEA = 0.067, GFI = 0.930, CFI = 0.92, NFI = 0.985, and χ2/df = 0.7).
Significant results were found for the direct effects of aggression on spirituality (standardised coefficient = −0.026, P 0.001), aggressiveness on resilience (standardised coefficient = −0.113, P 0.001), and spirituality on resilience (standardised coefficient = 0.514, P 0.001). Additionally, there was a strong indirect relationship between aggressiveness and resilience with spirituality serving as the mediating factor (standardised coefficient = −0.115, P 0.001) [Figure 1].
Figure 1.
SEM analysis with the path coefficients of aggression, and the mediating role of spirituality on resilience
Discussion
High spiritual orientation was observed amongst dental students in the present study. Similar findings were seen in studies conducted in Iran and India,[2,28] whereas medium level spirituality was found in other similar studies.[5,29]
In current study, mean resilience score of dental students was high which was in line with study conducted by Hatami S. and Shekarchizadeh H.[2] However contrasting results were seen in study conducted by Aboalshamat.[22]
According to the findings, there was a strong inverse relationship between aggressiveness and personal resilience. Similar results were seen in a research by Sadeghifard et al.[8] as well. Therefore, increasing resilience as a protective mechanism that alters a person’s behaviour in dangerous situations is one of the biggest advocates for lowering violence in people. Additionally, significant positive association between spirituality and resilience was seen in study participants who were in accord to previous study.[2] So it stands to reason that spirituality has a significant impact on how resilient a person is. Spiritual experiences influence the experiences and environment of life in the same way as they are successful in resilient growth.
In the present study, we found a direct association between aggressiveness and resilience, a direct relationship between spirituality and resilience, and an indirect relationship between aggression and resilience with a mediation role for spirituality. Other researchers have shown that students’ spiritual well-being and their ability for resilience in our study are strongly correlated.[2,29,30]
Limitations and recommendation
The generalizability of this study was first limited by the inclusion of only one dental institute, which may not be indicative of other dental institutes in India. In addition, inherent limitations of questionnaire study and self-reported data to give socially acceptable answers should also be considered while viewing the results. We utilised participants’ anonymity[31] to get around this constraint. Additionally, using three questionnaires to collect data may have reduced the students’ desire to participate. We made an effort to get around this restriction by emphasising to the students the significance of the study. A cautious and rigorous assessment of causal relationships is also warranted given the cross-sectional study methodology. Because of the aforementioned limitations, it is suggested that in future cohort studies and other longitudinal research are required including more colleges private practitioners and larger sample size to identify the causal relationships between the variables.
Conclusion
According to the study’s findings, spirituality can help pupils become more resilient as individuals and can act as a helpful intermediary between aggressiveness and resilience. Overall, the findings of the present study support the notion that spirituality and individual resilience have a negative and significant influence on the tendency for violence. In order to reduce aggressiveness, schools should thus make plans to help children develop their spirituality and personal resilience. These plans can also assist significant organisations in preventing and promptly responding to social injuries.
Ethical considerations
The participation was anonymous and voluntary, and all participants have participated after giving signed informed consent in the study.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
Acknowledgment
The authors would like to express their gratitude acknowledgments to all the participants who took part in the study as well as the reviewers as their valuable comments improved the paper.
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