Resilience, perceived control, and intention to receive additional vaccines for COVID-19 among healthcare university students: Mediating role of knowledge of vaccine and infection-preventive behaviors

Abstract

Aims: Psychological resilience is defined as an individual's ability to utilize strategies to cope with and grow because of stress or adversity; it is an individual's subjective belief about the amount of control he or she has over the environment or outcome. This study aimed to investigate the association between resilience, perceived control, and intention to receive additional COVID-19 vaccines among healthcare students, using the knowledge of the COVID-19 vaccine and infection-preventive behaviors as a mediating role. Methods: We conducted a cross-sectional study through an online survey when the fourth wave of vaccinations started in Japan in 2022. The participants were nursing undergraduate and graduate students, and healthcare graduate students who had received at least one vaccine at four universities. Hayes' SPSS PROCESS and structured equation modeling were used for the analyses. Results: The data of 1139 students were used for the analyses. Direct effect from resilience to intention to receive additional COVID-19 vaccines accounted for 67.3%, indirect effect via knowledge accounted for 19.4%, and preventive behaviors accounted for 12.2% of total effects. Direct effect from perceived control accounted for 43.5%, indirect effect via knowledge accounted for 4.8%, and preventive behaviors accounted for 51.6% of the total effect. Conclusion: The resilience of healthcare students plays a significant role both directly and indirectly in increasing their intention to receive additional COVID-19 vaccines, by increasing knowledge of vaccines and increasing infection-preventive behaviors. Perceived control is also important in having higher preventive behaviors, which were associated with higher intention to receive additional COVID-19 vaccines.