What Is The Definition Of â€å“comprehensiveã¢â‚¬â Exam As It Relates To A Preventive Service?

Keywords

Students; Anxiety; Self-esteem; Gender differences; Interventions

Introduction

Theoretical background of the research

The concept of self-esteem integrates cognitive and emotional as well as interpersonal dimensions of the perception of the self. Private assessments of the self embody reflections on the individual's interactions in his/her social world [1] and emotional contents linked to these assessments (satisfaction/ pride for self, feelings of inadequacy, shame etc.) [ii-4].

There are many dissimilar approaches to cocky-esteem, with Rosenberg [v] beingness i of the first theorists to focus on the sense of personal value ("worthiness"), namely on the person's value judgments on self. Co-ordinate to Rosenberg, people with high self-esteem tend to capeesh themselves more, only at the same fourth dimension, value others. Earlier than that, in the psychoanalytical tradition, Bibring [6] had described depression equally a plummet of the ego's self-esteem, a country where the ego "feels unable to live up to its aspirations" to experience good, worthy, competent and appreciated by the others. Mruk [7] defined self-esteem as the experienced sense of the individual that he/she is capable of dealing with everyday challenges "in worthy ways". Still other authors emphasize the cultural meaning of self-esteem, supporting that the concept is typical of the Western individualistic culture and not a universal human incentive [3]. For instance, within the framework of a religious civilisation, high cocky-esteem is related to arrogance, while modesty is considered a virtue and a prerequisite for a person's development, while in other contexts every bit, for case, in the traditional Japanese culture, the imperatives of collective values are regarded every bit more important than private success, recognition and self-esteem demands [8].

Beyond whatever differences in the conceptualization of the term, nigh theorists agree that at to the lowest degree in the mod western world, self-esteem is thought to be a basic human need linked to the overall quality of life as well every bit physical and mental wellbeing [9,10]. Depression self-esteem has been associated with increased risk of depression, substance abuse, delinquency [11], feet disorders and particularly, social anxiety [12-xv].

Rosenberg [5] had already related low self-esteem with "neurotic anxiety", while on the contrary, loftier self-esteem is considered a "protective filter" against stress [iii] equally it allows individuals to apply more than efficient strategies for managing difficult life situations [xvi,17] found a significant negative correlation between self-esteem (as assessed by Rosenberg's questionnaire) and perceived stress (Perceived Stress Scale) in adolescents and argued that cocky-esteem may mediate the relationship between stress and substance corruption in adolescence.

Although people with high self-esteem seem to be more than success - oriented [18] there are several studies that practice non identify a meaning relationship between academic performance and self-esteem [19]. Some authors fence that low cocky-esteem does not necessarily indicate poor bookish performance [20] and that the positive effect of self-esteem on educational achievement is either pocket-size [21] or concerns mainly the ages betwixt 7 and 15 [22]. However, a number of other studies accept demonstrated significant positive correlations between good academic performance and high self-esteem [8,23,24] thus reinforcing the view that selfesteem is a source of academic achievement [25,26].

Although methodological differences among the above studies constrain the effort to integrate their findings, several studies support a reciprocal human relationship between self-esteem, academic performance and anxiety [27,28]. The direction of the causal link between the three variables is hard to make up one's mind, only their relationship could exist considered a twoway, equally self-esteem and anxiety may affect performance, while at the aforementioned time educational experiences can exert their ain influence on self-esteem as well as on the amount of stress experienced. For instance, the experiences of academic accomplishment may increase the students' self-esteem [29,thirty], while, on the contrary, low self-esteem and the feelings of feet accompanying it, are probable to constitute meaning obstacles to the learning process [31-33]. The same may be true for very high self-esteem, equally this may be accompanied by exaggerated expectations of self, which tin can cause frustration and negative emotions that may exist inhibitory to the educational process [34].

Report purpose and hypotheses

Based on the literature review, self-esteem and anxiety are factors associated with the general well-beingness level of people and probably to their academic functioning. The self-esteem and anxiety levels of students are a matter of particular interest for educational institutions wishing to encourage their learners' active involvement in education. In this respect, it is important to plan supportive interventions to assistance students cultivate healthy self-esteem and acquire anxiety direction techniques, not only for the purpose of learning, but besides for progressing to their psychosocial identity consolidation and acquiring skills that will aid them come across the challenges of modernistic reality.

The purpose of the present study was to investigate the selfesteem of students at the Technological Educational Establish (TEI) of Athens, the anxiety level experienced and the possible correlations of these two parameters to each other besides as to other demographic variables. More than specifically, according to the literature review, the anxiety level of students is expected to show a statistically significant negative correlation with the level of their cocky-esteem. This combination of high feet level and depression self-esteem could maybe be associated with poor academic performance, as assessed by the students' average form and the number of failed courses. However, due to the impact of socio-cultural patterns that dictate diverse roles, expectations and success/ failure criteria for each gender [ane] women are expected to present dissimilar patterns of correlation betwixt self-esteem, anxiety and academic performance.

Methodology

Study population and sample

The research data was collected during the bookish year 2015-2016 at the TEI of Athens. The sample of 763 students surveyed represent 3% of the enrolled students of all faculties and schools of the establishment and was collected during three enrollment periods and the first 2 weeks of attendance of each period. The report protocol was submitted and canonical by the Research Committee of the Institute, a few months before the sample selection. The sample option was conducted by non-proportional stratified sampling as to the School and Faculty of studies. The cocky-administered questionnaires were distributed by students who had received relevant training, following the briefing of the participants on the research purpose, the procedures, the voluntary nature of their participation, the preservation of their anonymity and confidentiality. Exact consent was obtained by each participant earlier the completion of the questionnaire (Effigy 1).

Figure i: Average form of the participating students according to the faculty of study.

Instruments and measurements

The data was collected using a questionnaire that included three parts:

(a) Rosenberg'due south Self-Esteem Calibration (RSES, Rosenberg) [v] was used to explore the perceived qualities and the self-concept of the participants. RSES includes ten questions answered on a 4- point Likert scale (from "strongly concord"=3 to "strongly disagree"=0) and refer to the qualities attributed to the self ("good", "useless", "failure"…) and the emotions on the self (pride, satisfaction, respect etc.). The Greek translation of the questionnaire has been standardized on a sample of 652 students of Greek universities [35] and the results showed loftier validity and reliability of the instrument (α=0.809).

Moreover, the questionnaire included the 5 additional subjects of Rosenberg's Stability of Self Scale, which assesses whether the self-esteem level is experienced as relatively stable or unstable (with items like, "I find that on one twenty-four hour period I have one stance of myself and on another twenty-four hour period I have a different stance", "I change from a very practiced stance of myself to a very poor opinion of myself" etc.). The Stability of Self Scale has been plant to satisfyingly reverberate the short-term fluctuations in self-esteem and not its long-term changes (e.g. over a ane year period) [36].

(b) The Land Trait Anxiety Inventory (STAI), [37,38] was used equally a measure out of the participants' anxiety levels. The questionnaire is translated in Greek and standardized for the Greek population, presenting satisfactory validity and reliability [39,xl]. STAI includes 40 subjects in full, out of which the starting time 20 assess the emotional land of the respondent at the time of filling out the questionnaire, namely the state anxiety (A-state) and the adjacent 20 anxiety as a more permanent trait of personality (A-trait). For the purposes of this written report, the 2nd subscale was selected which assesses feet as a full general trait (A-trait). The answers are given on a Likert type 4-point scale, ranging from 1 ("not at all") to four ("very much so"). The total rating on the subscale granted ranges from 20 to fourscore, while the mean rate of the healthy population is 42, 79 [41].

In the present study, Cronbach's alpha for the anxiety and self-esteem scale were 0.86 and 0.81 respectively.

(c) The last role of the questionnaire included 6 questions near the gender, the age, the semester, the kinesthesia of studies and the academic performance of the participants.

Data processing and analysis

Data assay was performed using the statistical package SPSS v. 21.0 Descriptive statistics such as frequencies, mean and standard deviations was carried out for the variables of the study. Mon parametric tests were conducted due to the non-normal distributions of the contained variables anxiety and self-esteem. Isle of man-Whitney exam, Spearman'southward rho and Kruskal Wallis were performed to verify the statistical difference between variables. The level of significance was set at p<0.05.

Results

Socio-demographic characteristics

Out of the 763 participants, 34.7% (265 individuals) were male students and 65.3% (498 individuals) were female students. The faculty with the highest number of registered students was the Faculty of Wellness and Caring Professions with 45.ix% of the enquiry participants (350 male person/female person students), followed by the Faculty of Technological Applications with 22.1% (169 male person/female students), the Faculty of Fine Arts and Design with 15.ane% (115 male/female students), the Faculty of Direction and Economics with 9.7% (74 male/female person students) and last 1 the Kinesthesia of Food Technology and Nutrition with vii.2% (55 male person/female students). The student ages ranged from 17 to 45 years, with the hateful age of the sample being twenty.six years and the mode being the 19 years.

The average form of all participating students was below 7 for 41.iii% of the sample, between 7 and viii for 38.1% of them and over viii for xx.6% of the students. Equally regards the students' failed courses, the highest mean number of failed courses was obtained by the Faculty of Food Engineering science and Nutrition (M=7.97, SD=5.7), followed by the Faculty of Technological Applications (Thousand=6.17 SD=v.05), the Faculty of Management and Economics (M=5.42, SD=v.1), the Kinesthesia of Fine Arts and Design (Thou=5.21, SD=5.24) and the kinesthesia of Health and Caring Professions (Yard=iii, SD=four.61). Female students appeared to have statistically significantly fewer failed courses than the male students of the sample (Z=-five.37, p<0.001).

Self-esteem of the sample

The mean score on the cocky-esteem scale was higher for the male participants (M=29.65, SD=four.03) than for women (Thousand=28.79, SD=4.08), a difference that was plant to be statistically significant (Z=-2.917, N1=265, N2=498, p<0.05, two-tailed test). On the contrary, the students' historic period was non found to be related to their cocky-esteem level to a statistically meaning extent.

Regarding the academic performance, the average grade was statistically significantly correlated to the students' self-esteem score (x²=16.26, df=4, p<0.05). More than specifically, students with an average grade beneath half dozen were found to have lower scores on the self-esteem calibration compared to students who have an average grade over 6. Likewise, groups of students with higher average grades, like those of 8-nine, seem to exist significantly different from the group of students with boilerplate grades of 9-10, with the latter having higher scores on the selfesteem calibration (Ζ=-2.64, Ν1= 111, Ν2=16, p<0.005, ii-sided test). Furthermore, a statistically significant negative correlation appeared between self-esteem and the number of failed (ρ=-0.08, p<0.05), i.eastward., the more courses failed, the lower the score on self-esteem scale.

Investigating the possible differentiations between faculties, the Kruskal-Wallis test showed statistically significant differences in cocky-esteem scores (x²=ten.44, df=4, p<0.05). Boosted Mann Whitney U examination performed betwixt pairs indicated that the students of Faculty of Fine Arts and Blueprint present statistically significantly lower self-esteem scores than all other faculties, i.e., the Faculty of Health and Caring Professions, the Kinesthesia of Technological Applications and the Kinesthesia of Management and Economics (Table i).

Tabular array one: Mann Whitney U results for the levels of self-esteem and anxiety with the kinesthesia of studies (n=763).

Faculty of studies	Self-esteem		Anxiety
	Z-score	Sig	Z-score	Sig
Faculty of Health and Caring Professions - Faculty of Technological Applications	-0.91	0.35	-i.81	0.07
Kinesthesia of Health and Caring Professions -Faculty of Fine Arts and Design	-2.38	0.017*	-2.24	0.020*
Kinesthesia of Wellness and Caring Professions - Faculty of Nutrient Technology and Nutrition	-i.11	0.230	-1,lx	0.10
Faculty of Health and Caring Professions- Faculty of Management and Economics	-0.61	0.54	-0,31	0.75
Faculty of Technological Applications - Kinesthesia of Direction and Economics	-0.02	0.98	-1.73	0.08
Kinesthesia of Technological Applications - Kinesthesia of Fine Arts and Design	-2.75	0.006*	-3.30	0.001*
Kinesthesia of Technological Applications - Faculty of Food Engineering science and Diet	-1.77	0,075	-ii.62	0.009*
Faculty of Management and Economics - Faculty of Fine Arts and Blueprint	-2.23	0.026*	-1.46	0.xiv
Faculty of Management and Economics - Faculty of Food Technology and Nutrition	-i.38	0.16	-ane.10	0.26
Kinesthesia of Fine Arts and Blueprint- Faculty of Food Engineering and Nutrition	-0.80	0.42	-0.003	0.99

Feet levels of the sample

The mean feet level of all students participating in the research is 44.05, which is somehow higher than the hateful level of the healthy population for the specific subscale that is 42.79 [41]. The mean level is 42.06 (SD=9.28) for the men of the sample and 45.11 (SD=10.05) for the women. Past applying the Mann Whitney U-test, it was found that the anxiety levels of the female students were significantly higher than those of the male person students (Z=-4.024, N1=265, N2=498, p<0.001, twotailed test).

The variables of the age and the number of failed courses did not present a statistically meaning correlation with the anxiety levels of the sample. However, academic performance displayed a blueprint of correlation with the level of feet similar to the one found in the example of self-esteem, with the students' average grade being statistically significantly related to their anxiety score (x²=11, df=4, p<0.05). Students who indicated an average course beneath 6 appeared to take a statistically significantly higher score on the anxiety scale compared to the rest grading groups (p<0.05 in all cases).

In respect to the faculty of studies, the faculties with the highest scores on the anxiety calibration were the Faculty of Fine Arts and Design (K=46.16, SD=9.95), the Kinesthesia of Nutrient Technology and Nutrition (Yard=46.14, SD=9.58) and the Faculty of Direction and Economics (Grand=44.22, SD=8.89), while the lowest and "healthiest" anxiety scores were obtained by the students of the Faculty of Health and Caring Professions and the Faculty of Technological Applications (Yard=43.9, SD=x.13 and M=42.18, SD=9.56, respectively).

The Kruskal-Wallis test showed that the anxiety scale results are significantly unlike in the 5 faculties (ten²=fourteen.51, df=four, p=0.006). The subsequent application of Mann Whitney tests in pairs, showed that students of the Faculty of Fine Arts and Blueprint have statistically significantly higher anxiety levels than the students of the Faculty of Health and Caring Professions and the Faculty of Technological Applications, while the Faculty of Food Technology and Nutrition students display statistically significantly higher anxiety rates than the Faculty of Health and Caring Professions students (Table one).

Investigation of correlations between anxiety and self-esteem

The Spearman's rank order test revealed pregnant negative correlation betwixt anxiety and self-esteem (ρ=-0.63, p<0.001), with students having college anxiety scores tending to present lower self-esteem scores, and vice versa. This negative correlation betwixt anxiety and self-esteem applies both to male person (ρ=-0.66, df=263, p<0.001) and female population of the sample (ρ=-0.62, df=496, p<0.001).

Concerning the stability of cocky-assessments, students who appear to maintain a stable view of their self that inappreciably changes (i.e., I feel that nothing can alter the opinion I currently hold of myself), present to a statistically significant extent lower anxiety and college self-esteem levels (Table 2).

Table 2: Mann Whitney U results for the levels of self-esteem and anxiety, with the stability of cocky (due north=763).

Stability of Self	Self-esteem		Anxiety
	Z-score	Sig	Z-score	Sig
I feel that nothing can change the opinion I currently hold of myself	-2.81	0.005*	-3.31	0.001*
I change from a very good opinion of myself to a very poor opinion of myself (reverse scored)	-10.83	0.000*	-10.48	0.000*
I observe that on one day I have one stance of myself and on another twenty-four hours I have a different opinion (reverse scored)	-ten.32	0.000*	-nine.19	0.000*

Discussion and Conclusion

Based on the above mentioned results, students' age was non found to be associated with their cocky-esteem level, probably considering the majority of the participants (95.eight%) are young people between 17 and 25 years erstwhile, going through more or less the same process of transition from dependence to autonomy (gradual preparation for the professional world) and dealing with pretty much similar challenges. Too, the existing research findings on the relation between age and self-esteem are contradictory, with some studies showing an upward tendency of cocky-esteem in the progress from adolescence to early on adulthood [42,43] and others the reverse [44]. This discrepancy is usually attributed to the interference of gender differences during puberty, with boys having college selfesteem than girls during this life stage [45].

In line with other studies conducted in adolescent and educatee populations [four,44,46], female participants were found to accept lower self-esteem levels. Remarkably, although a statistically significant negative correlation was detected between cocky-esteem and the number of failed courses, dissever data analysis for each gender showed that this outcome mainly concerned male participants. This finding might be attributed to the differential touch of various cultural factors on male and female cocky-esteem, for instance, the significant influence of concrete advent on female self-esteem, combined to the demanding social standards of attractiveness [47,48]. Indicatively, in her study of the relation between selfesteem, torso image and health related behaviors in 423 firstyear college students, Lowery [49] found that dissatisfaction with physical appearance was the primary source of depression selfesteem for women, particularly in the college environment, where physical appearance may exist an important assessment criterion amongst individuals. The combination of higher feet levels and lower self-esteem renders the women of the sample much more vulnerable than male person participants. However, a potential confounder that should be taken into account when interpreting the specific result is that women may agree a more moderate position in their self-referent answers [fifty].

As to the relation between anxiety and self-esteem, the results of this research appear to be in line with earlier studies that show a negative correlation between self-esteem and anxiety level [17], while the stable perception and assessment of self was found to be related to lower anxiety and higher cocky-esteem. Several other studies support the same idea, indicating that people who tend to have a more than unstable image of the self, which Rosenberg [51] equates with feelings of insecurity near the self, experience more dissatisfaction with their cocky [52] and that a "split" self-image is probably associated with a range of psychological difficulties [53].

As to their academic performance, students with an average grade of five-six, i.e., those who achieved the lowest passing form, were as well those with the lowest cocky-esteem and the highest anxiety level, compared to the remainder performance groups, which is a reasonable event, since it these students probably experience more than insecurity virtually their academic class and their skills. On the other paw, the negative correlation of the number of failed courses to the level of selfesteem, just non to the feet level, could mayhap imply that the difficulties and the "failures" in the academic grade are primarily related to the students' conviction in their potential and non to the degree of pressure they feel. Besides, the large number of courses not passed could be as well a sign of neglect of studies and lack of business concern about the educational futurity, which at a deeper level, yet, still impairs the students' confidence in their potential and ability to fulfill their initial targets.

Moreover, based on the results, the Faculty of Fine Arts and Design students seem to be more vulnerable to the combination of high feet and low cocky-esteem, in relation to students who attend other Faculties. In order to interpret this result, several factors should be considered, such as the curriculum of the specific kinesthesia, which is based rather on exploration of ideas and creation than on memorization, the latter existence the mutual practice during much of their schoolhouse years, as well as the particular sensitivities that students who turn to arts may have.

The nowadays report has several limitations, ane of which is the lack of information related to other variables that may have a mediating outcome on the relation of students' anxiety, performance and self-esteem, such as their family background, including the economical and educational level of their family, their interactions in peer groups and their interpersonal and social relationships in full general. The findings also indicate the need for further research on the factors that underlie gender differentiation in the patterns of correlation between functioning, anxiety and self-esteem. An boosted limitation of the report derives from the cocky-reporting nature of the enquiry questionnaire, every bit individuals may non exist fully aware of the totality of their emotions and perceptions of the self, or of the fluctuations that these perceptions may present [54,55]. Further research that would include additional measures of the students educational skills, too as a follow - up in the aforementioned sample of students would be useful, in club to obtain more objective data about the stability of their self-esteem and its relation to their academic performance and feet.

Yet, self-esteem and feet, rather than existence "objective qualities", they refer to the internal feel of individuals and in this sense, the subjective assessments of individuals on their self are important for planning supportive interventions. In the educational context where this written report took identify, interventions for anxiety management and self-esteem enhancement could begin from the groups that announced to be more vulnerable to both these parameters, namely fine arts' students and female person population. Furthermore, individuals with unstable self-esteem (and as well loftier anxiety and low selfesteem levels) would be probably more than receptive and benefited from a psycho-educational intervention targeted to cocky-esteem enhancement.

During the last decades, the experience from the awarding of similar interventions has led to several additional considerations as to the recommended methodology. On one manus, there is discrepancy in respect to the effect of selfesteem enhancement programs on the improvement of academic performance, since several studies showed positive results [56,57], while others indicated the opposite [58]. On the other hand, sure authors [3,58,59], presented evidence that questioned the effectiveness of interventions for raising self-esteem or support that such interventions are probable to have negative implications also, e.g., an increase of the participants' narcissistic tendencies, or even proneness to violence, depending on the concept of self – esteem and the methodology that is adopted. Furthermore, the cultivation of a frivolous optimism and an excessive conventionalities in the self and in what 1 tin can accomplish, might turn out to be subversive, every bit a possible failure could lead the person to frustration and resignation [60].

In the educational setting, decreased academic performance indicates that both the individual and the educational system need to make several changes in the ways they manage cognition and learning procedure. In this regard, an intervention to increase self-esteem in the educational context should include not simply psychological counseling, merely also systematic guidance of students to larn control over their educational achievements. Therefore, cooperation with teachers would be important in order to assist students learn how to gear up realistic goals, how to respond to failures and how to gain feedback from their mistakes until they reach their goals [61]. Students' familiarity with active study and selfregulated learning techniques can raise both their academic development and their self-esteem [58,62,63] and it would be meliorate to starting time early in the student life in society to62 take enough time for the relevant skills to be acquired and consolidated [64,65].

Similarly, interventions for stress management could start by focusing on the management of specific issues that cause anxiety to students (eastward.chiliad. stress of exams, performance anxiety etc.), moving gradually to other issues, not bars to the educational framework [65]. Besides, the flow of studies is for most students a transitional menstruum, where personal and social identity is restructured [66,67]. In the midst of modern socio-economic conditions, the insecurity that characterizes whatsoever transition is maybe even stronger. In this transitional period that presents diverse challenges, it is important for students to acquire skills to manage everyday stress and foster healthy self-esteem that will allow them to make the best possible choices.

Funding

This research is funded past the Special Account for Research Grants of the TEI of Athens, in the framework of the Internal Program for the support of the TEI of Athens Researchers, for 2015.

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