The Chain Mediating Effects of External Locus of Control and Psychological Entitlement between Parental Over-Protection and Academic Entitlement among Nursing Students: A cross-sectional Study

doi:10.21203/rs.3.rs-2343227/v1

Background

Academic entitlement in nursing students has been shown to cause problems such as superficial learning, lack of theoretical knowledge, and weak practical abilities, all of which affect the overall quality of nursing talents in the future, thereby affecting the quality of nursing services and patient safet. However, few studies have focused on the academic entitlement of Chinese nursing students and its influencing mechanisms.

Purpose

To explore the influence of parental over-protection on academic entitlement of nursing students, and to examine the mediating roles of external locus of control and psychological entitlement.

Methods

This study employed a cross-sectional, descriptive correlational design. The study sampled two medical universities in Guizhou and Yunnan provinces, China. Participants were nursing students in grades one to four (N = 1,003; mean age = 19.51 years; 81.95% female). Using a structural equation model, we examined the mediating effect of external locus of control and psychological entitlement on parental over-protection and academic entitlement.

Results

Chinese nurses have been shown to have a higher level of academic entitlement than American students. There was a significant correlation between all variables, and external locus of control and psychological entitlement played a chain mediating role between parental over-protection and academic entitlement.

Conclusion

The academic entitlement of nursing students in China demands urgent attention. An over-protective parenting style, an externally controlled attribution style, and psychological entitlement are key factors which lead to nursing students’ academic entitlement. Our findings suggest that academic entitlement of nursing students can be reduced by adjusting parental rearing behaviors, reducing students’ psychological entitlement, and teaching them how to form a healthier attribution style.

Academic entitlement

Parental over-protection

External locus of control

Psychological entitlement

Nursing students

Academic entitlement is an unhealthy psychological characteristic first proposed by Dubovsky (1986) after observing medical students [1]. It can be generally defined as students’ subjective belief that they are qualified for academic success without contributing individual effort [2]. Researchers regarded academic entitlement as psychological entitlement until Morrow (1994) proposed that academic entitlement and psychological entitlement are different psychological structures [3]. Academic entitlement is a privilege consciousness that only exists in the academic environment, while psychological entitlement is a more broad feeling of holistic privilege, in that one feels they have the right to preferential treatment or exemption from subjective beliefs or social responsibility. Studies have shown that students with high academic entitlement are more likely to demonstrate behavioral problems such as class absenteeism, academic evasion, and academic misconduct (e.g., plagiarism, cheating), among other negative behaviors which impact their mental health as well as the education system [4–8]. However, particularly nursing students with high academic entitlement have been shown to have a greater negative impact overall. For example, they are prone to mental health problems such as anxiety and depression [9]. Their learning and knowledge is relatively superficial, resulting in a lack of deeper theoretical knowledge, weaker practical skills, and substandard professional abilities, all of which affect the overall quality of their nursing skills in the future, thereby affecting the quality of nursing service overall and risking patients’ safety [10].

Most existing studies have focused on the negative impact of academic entitlement on students and society, but few studies have looked at the factors affecting academic entitlement. Furthermore, most existing studies have focused on the academic entitlement of non-medical students, with few focusing on nursing students. Therefore, it is of great practical significance to explore the influencing mechanism of academic entitlement of nursing students.

Parental Over-protection And Academic Entitlement

According to Bronfenbrenner's ecological systems theory, family, as a microscopic system, has the most direct influence on an individual’s psychological development and, in this system, parenting style plays an extremely important role [11]. Parenting style refers to the synthesis of parents’ stable attitudes and beliefs related to parenting in the relatively stable cross-context of parent-child communication [12]. Children typically are closest in their relationships with their parents, and parenting style can influence children’s behavior, attitude, cognition, emotion, and more [13, 14]. According to self-determination theory, parental over-parenting can interfere with their child’s formation of autonomous learning ability. As a result, children lack motivation to learn, but have high expectations for their academic performance, leading to psychological and behavioral emergence of academic entitlement and academic dishonesty (e.g., cheating, plagiarism, etc.) [15]. One study showed that an over-protective parenting style has a positive influence on academic entitlement [16].

Although existing studies have shown empirical support for the influence of parental over-protection on academic entitlement, the internal mechanism of academic entitlement has not been explored deeply. Therefore, this study introduced two variables – external control of the locus of control and psychological entitlement – to investigate the influencing mechanism of parental over-protection on academic entitlement in nursing students.

Mediating Role Of External Control

To further Heider and Weiner’s attribution theory, Rotter (1966) introduced the theory of “source of control”. The locus of control refers one’s attribution of event or behavior results on their surrounding environment, noting two extremes as control sources: internal and external [17]. Students with high external control will attribute their academic performance to external factors such as luck, opportunity, and social environment, and believe that their own work hard will not fundamentally change their learning results. Therefore, they place strict demands on teachers and schools as being responsible for them achieving well academically. Previous studies have shown that external control significantly predicts academic entitlement [2, 18–20] The formation and development of locus of control is not greatly influenced by congenital genetics; rather, the family environment has been shown to be the main influencing factor [21]. In fact, Spokas and Heimberg (2009) found that parental over-protection had a significant effect on college students' external control [22]. The overprotective parenting style over-controls the a child’s daily behaviors and activities, restricting the children for long periods of time and conditioning them to listen to others’ opinions rather than forming their own, thus forming a high sense of external control [23, 24]. Previous studies have shown that parental over-protection is positively correlated with a child’s sense of external control [25–27], external control significantly predicts academic rights [2, 18–20], parental over-protection has a positive impact on academic entitlement [16]. Therefore, external control may play a mediating role in the impact of parental over-protection on academic entitlement.

Mediating Role Of Psychological Entitlement

Psychological entitlement refers to an individual’s sustained, stable, and subjective belief that they have the right to receive preferential treatment [28]. According to fairness sensitivity theory, welfare recipients have very high level of fairness sensitivity and do not want to suffer any loss, and therefore believe they should seek more “return” while paying as little as possible [29]. Such high demand is the embodiment of psychological entitlement. People with high psychological entitlement are more likely to exhibit negative behaviors such as academic misconduct [30]. College students regard themselves as “consumers” in the university setting due to paying college fees, and many will hold the view that they should be able to complete their studies smoothly, “with less effort and the least [amount of] unpleasant [experiences]” [1]. Students with high level of psychological entitlement, then, are more likely to also exhibit academic entitlement. However, psychological entitlement is not an innate trait, rather it is influenced by situational and individual factors [31]. Parenting style is one of the important situational factors, which plays an important role in the generation of one’s psychological entitlement. Based on the theory of basic needs and compensatory motivation theory, as a result of a negative parenting style failing to meet a child’s basic needs, while also failing to give the child adequate understanding and support, the child then grows via a series of negative experience, leading to the individual thinking that they are entitled to more than others, to make up for their lacks. Thus, a sense of psychological entitlement is generated [32, 33]. In addition, parental over-protection leads to the child developing an unrealistic self-concept, drawing excessive attention to themselves, thinking that their own needs are more important than those of others, and taking for granted what they receive as well as what others sacrifice, all of which are key indicators of psychological entitlement [34, 35]. Previous literature shows that an over-protective parenting style will enhance one’s psychological entitlement [36]. In sum, parental over-protection has a positive impact on both academic and psychological entitlement, and psychological entitlement itself has a positive impact on academic entitlement. Therefore, psychological entitlement may play a mediating role in the influence of parental over-protection on academic entitlement.

The Relationship Between External Control And Psychological Entitlement

According to the above literature review, we understand that external control and psychological entitlement play mediating roles in the relationship between parental over-protection and academic entitlement. However, in the influence of parental over-protection on academic entitlement, the relationship between external control and psychological entitlement merits further investigation. According to attribution theory [37], the sense of external control of individual locus of control is closely related to psychological entitlement. People with high external control have lower expectations, believing that they are unable to affect any reward. They also do not see the relationship between effort and reward, and instead believe that success comes from what others give. This results in them opting not to proactively strive or fight for achievements or rewards, thereby reinforcing their sense of psychological entitlement. Studies have shown that locus of control is an antecedent variable of psychological entitlement [38, 39]. Therefore, external control and psychological entitlement may play a chain mediating role in the influence of parental over-protection on academic entitlement.

The Present Study

In consideration of the existing findings, then, this study took into account the external locus of control and psychological entitlement in considering the model of the influence of an over-protective parenting style on the academic entitlement of college students, and constructed a chain mediation model to explore the influence mechanism of parental over-protection on the academic entitlement of nursing students, and proposed the following hypotheses: 1. Parental over-protection positively affects the academic entitlement of nursing students; 2. Parental over-protection positively affects the psychological entitlement of nursing students; 3. Psychological entitlement of nursing students positively affects the academic entitlement of nursing students; 4. Parental over-protection positively affects the external locus of control of nursing students; 5. The external locus of control of nursing students positively affects their academic entitlement; 6. The external locus of control of nursing students positively affects their psychological entitlement; 7. Psychological entitlement of nursing students mediates the relationship between parental over-protection and academic entitlement; 8. The external locus of control of nursing students mediates the relationship between parental over-protection and academic entitlement; 9. The external locus of control and psychological entitlement of nursing students play chain mediating roles in the influence of parental over-protection on academic entitlement (Fig. 1).

Participants

A convenience sampling method was used to select participants. The participants used in this study were recruited from two universities in Guizhou and Yunan Provinces, China. A total of 1003 nursing students were recruited to complete the questionnaires. Among them, participants were aged 17 to 25 years old (M = 19.51, SD = 1.60), 181 (18.05%) were male and 822 (81.95%) were female, 475 (47.36%) were freshman, 245 (24.43%) were sophomore, 217 (21.64%) were junior, 66 (6.58%) were senior.

Procedure

A cross-sectional descriptive study was conducted between March and June 2021 to clarify the relationships between parental over-protection, external locus of control, psychological entitlement, and academic entitlement among nursing students. Before the investigation, we consulted with the local education department and the investigating school and obtained their approval. After obtaining informed consent from the participants, the questionnaire was completed in a classroom setting. In total, 1,058 questionnaires were received, of which 1,003 questionnaires were valid, yielding an effective response rate of 94.80%. Ethical approval was obtained from the human ethics research committee of Guizhou Medical University.

Measurements

The Social-Demographic Information Questionnaire

The social-demographic information questionnaire included five items regarding nursing students’ gender, age, grade, family status (i.e., single parent household or other), and hometown.

The Short Egna Minnen Barndoms Uppfostran (S-embu)

The original S-EMBU questionnaire was revised by Jiang et al. [40] to be used in Chinese college students. The questionnaire is divided into two, one part for the father and one part for the mother. Each of the two questionnaires contains 21 identical items which cover rejection (six items), emotional warmth (seven items), and parental over-protection (eight items). Question 17 is a reverse-scored question. A high score in any of these dimensions on either the father or mother questionnaire indicates that individual’s particular style of parenting. The parenting style of each parent can be the same or different. The Cronbach’s α coefficient for each dimension of the father questionnaire was 0.78, 0.82, and 0.74, respectively, and the Cronbach’s α of each dimension of the mother questionnaire was 0.82, 0.84, and 0.78, respectively [40]. In this study, we used only the parental over-protection dimension of the questionnaire. In this study, the Cronbach’s α for the paternal and maternal over-protection questionnaires were 0.71 and 0.72, respectively.

Academic Entitlement Questionnaire (Aeq)

The academic entitlement questionnaire was compiled by Kopp and revised by Hu et al. [2, 41] for use among Chinese college students. The questionnaire consists of eight items with a single dimensional structure. The measure uses a seven-point Likert scale, from 1 (strong disagreement) to 7 (strong agreement). The higher the total score, the stronger one’s level of academic entitlement. The Cronbach’s α of the original tool was 0.76 [2]; in the current study, the Cronbach’s α of the Chinese version of the AEQ was 0.73.

Psychological Entitlement Scale (Pes)

The PES was developed by Campbell et al. [28] and revised by Bai and Wang [42] for use among Chinese college students. The scale consists of nine items with a single dimensional structure, and uses a seven-point Likert scale, from 1 (strongly disagree) to 7 (strongly agree). The higher the total score, the stronger one’s level of psychological entitlement. The Cronbach’s α of the original tool was 0.86 [42]; in this study, α = 0.89.

Locus Of Control Scale (Lcs)

The LCS was compiled by Levenson et al. [43] and revised by Xiao & Chen (1989) for use among Chinese college students [44]. The scale is composed of three parts: internal control, authority, and opportunity. Each dimension has eight items, for a measure total of 24 items. Each item is rated on a six-point Likert scale from 0 (strongly disagree) to 5 (strongly agree). The higher the total score, the higher one’s tendency towards that particular dimension. The Cronbach's α coefficient for this scale is 0.80 [44]. Only the authority and opportunity dimensions were used in the current study, and the Cronbach's α coefficients of authority and opportunity were 0.83 and 0.76, respectively.

Data Analysis Strategy

Descriptive statistics and correlation analyses of parental over-protection, academic entitlement, psychological entitlement, and external locus of control were performed using SPSS 25.0. p < 0.05 (two-tailed test) was considered to be statistically significant. Harman single factor test was used to test common method bias (CMB) [45].

To verify the mediating effects of psychological entitlement and external locus of control on the relationship between parental over-protection and nursing academic entitlement, structural equation modeling using Amos 23.0 software was used with maximum likelihood estimations. Multiple fit indices were used to evaluate the model, including the chi-square/degrees of freedom ratio (χ²/df), the standardized root mean square residual (SRMR), the root mean square error of approximation index (RMSEA), the goodness-of-fit index (GFI), the adjusted goodness- of-fit index (AGFI), the normed fit index (NFI), the comparative fit index (CFI), and the Tucker-Lewis Index (TLI). In the present study, the following criteria were used to testify whether the model was fit: χ²/df < 3.00, SRMR < 0.05, RMSEA < 0.08, GFI > 0.90, AGFI > 0.90, NFI > 0.90, CFI > 0.90, and TLI > 0.90 [46].

Common Method Bias Test (CMB)

Exploratory factor analysis resulted in 10 factors with eigenvalues greater than 1. The first factor accounted for 18.46% of total variance, which is less than 40% of the critical standard, which indicated that common method bias was not apparent.

Descriptive Statistics

Table 1 presents participants’ descriptive statistics regarding parental over-protection, academic entitlement, psychological entitlement, authority, and opportunity. The mean score of academic entitlement was 25.68 (SD = 6.87). The mean scores of paternal and maternal over-protection were 16.76 (SD = 3.50) and 17.55 (SD = 3.75), respectively. The correlations among paternal over-protection, maternal over-protection, academic entitlement, psychological entitlement, authority, and opportunity are shown in Table 1. All six variables were significantly correlated.

Table 1

Correlations of Parental Over-Protection, Academic Entitlement, Psychological Entitlement, Authority, and Opportunity (n = 1,003).
Variable	M	SD	1	2	3	4	5	6
1. Paternal over-protection	16.76	3.50	1
2. Maternal over-protection	17.55	3.75	0.76**	1
3. Psychological entitlement	32.26	8.81	0.19**	0.15**	1
4. Authority	14.85	5.91	0.22**	0.17**	0.35**	1
5. Opportunity	15.82	5.26	0.20**	0.18**	0.36**	0.76**	1
6. Academic entitlement	25.68	6.87	0.24**	0.20**	0.45**	0.29**	0.29**	1

**p < .01 (two-tails).

Test Of The Hypothesized Model

In line with prior item parceling studies [47, 48], we used the “item-to-construct balance” method to parcel items, and the SEM was used to examine the hypothesized model.

The fit level of the modeling was satisfactory with χ²/df = 2.542, SRMR = 0.024, RMSEA = 0.039, GFI = 0.982, AGFI = 0.969, NFI = 0.981, CFI = 0.988, and TLI = 0.983. Based on the overall mediating model (Fig. 2 and Table 2), parental over-protection directly affected academic entitlement (β = 0.293, p < 0.01), which supported Hypothesis 1. Parental over-protection positively affected psychological entitlement (β = 0.211, p < 0.01), which supported Hypothesis 2. Psychological entitlement positively affected academic entitlement (β = 0.452, p < 0.01), which supported Hypothesis 3. Parental over-protection positively affected the external locus of control (β = 0.247, p < 0.01), which supported Hypothesis 4. The external locus of control positively affected academic entitlement (β = 0.335, p < 0.01), which supported Hypothesis 5. The external locus of control positively affected psychological entitlement (β = 0.388, p < 0.01), which supported Hypothesis 6. External control partly mediated the effects of parental over-protection on academic entitlement (β = 0.040, p < 0.01), which supported Hypothesis 7. Psychological entitlement partly mediated the effects of parental over-protection on academic entitlement (β = 0.052, p < 0.01), which supported Hypothesis 8. Psychological entitlement and external control chain mediated the effects of parental over-protection on academic entitlement (β = 0.043, p < 0.01), supporting Hypothesis 9. The values of total, direct, and indirect effects of the model are shown in Table 2.

Table 2

Total, Direct, and Indirect Effects of Each Model Path
Estimate	B	SE	β	the size of effects	95%CI
Estimate	B	SE	β	the size of effects	Minimum	Maximum
Total effect
PO → AE	0.113	0.017	0.293		0.080	0.147
PO → PE	0.160	0.029	0.211		0.109	0.225
PE → AE	0.228	0.023	0.452		0.186	0.276
PO → ELC	0.379	0.067	0.247		0.252	0.519
ELC → AE	0.084	0.011	0.335		0.063	0.107
ELC → PE	0.193	0.021	0.388		0.151	0.233
Direct effect
PO → ELC	0.379	0.067	0.247		0.252	0.519
PO → PE	0.088	0.026	0.115		0.040	0.140
PO → AE	0.061	0.014	0.158		0.034	0.089
ELC → PE	0.193	0.021	0.388		0.151	0.233
ELC → AE	0.040	0.011	0.160		0.021	0.063
PE → AE	0.228	0.023	0.452		0.186	0.276
Indirect effect
PO → ELC → AE	0.015	0.005	0.040	13.65%	0.008	0.027
PO → PE → AE	0.020	0.006	0.052	17.75%	0.009	0.033
PO → ELC → PE → AE	0.017	0.004	0.043	14.68%	0.010	0.026

Notes. Parental over-protection = PO; Academic entitlement = AE; Extenal locus of control = ELC; Psychological entitlement = PE; B = Unstandardized coefficients; β = Standardized coefficients.

This study shows that the average academic entitlement score of Chinese nursing students (25.68 ± 6.87) is higher than that of American nursing students (20.25 ± 6.86) [10], which may be due to several reasons. First, Chinese nursing students’ learning involvement[49, 50], professional identity[51], and level of independent learning outside classes are not high [52], generally only at a medium level. Second, most Chinese universities have strict admission and discharge policies, while the graduation requirements for nursing are relatively relaxed compared to clinical medicine with a high graduation rate, which may create an environment that encourages academic entitlement. Third, the implementation of the “student evaluation system” has resulted in “collusion between teachers and students” (Teachers and students rate high scores with each other) [53], which may also create space for the development of academic entitlement. Therefore, interventions via any of these reasons should be considered to reduce the occurrence or increase of academic entitlement of Chinese nursing students.

Studies have also found that parental over-protection positively affects academic entitlement in nursing students. Hypothesis 1 was supported, indicating that an over-protective parenting style positively predicts the academic entitlement of nursing students, which is consistent with previous studies. Specifically, one previous study found that parental over-protection leads to academic entitlement and academic dishonesty in college students [15]. Based on the self-determination theory, an over-protective parenting style interferes with the establishment of independent learning skills in nursing students [15]; meanwhile, nursing students generally show a strong desire for academic achievement. Therefore, parental over-protection can thereby lead to the development of academic entitlement in nursing students. Furthermore, parental over-protection positively affects psychological entitlement in nursing students, validating Hypothesis 2. According to basic needs and compensatory motivation theory, an over-protective parenting style causes students to pay too much attention to themselves and think they deserve special treatment, thus enhancing their individual level of psychological entitlement [32, 33, 36]. The current study also found that the psychological entitlement of nursing students positively affected their academic entitlement, confirming Hypothesis 3. According to the theory of psychological entitlement, nursing students with high psychological entitlement think they deserve a pass or high score on exams simply because they pay their tuition, attend classes, and complete their assignments on time. Thus, higher psychological entitlement of nursing students promotes the emergence of academic entitlement. Therefore, it is necessary to pay attention to students who have been subject to an over-protective parenting style and who already demonstrate psychological entitlement.

The current study also confirmed that the an over-protective parenting style positively affects nursing students’ sense of external control, validating Hypothesis 4. Previous studies have shown that parental over-protection weakens the development of a child’s sense of independence and causes them to believe that they are unable to decide things by themselves, and instead are controlled by mysterious external forces or powerful people, thus causing the child to form a high sense of external control [24, 54]. This study also found that nursing students’ sense of external control positively affected their academic entitlement, confirming Hypothesis 5. This is in line with previous studies [30]. Based on attribution theory [37] and Greenberger et al. [30], when students consider their successes and failures to be outside their locus of control and instead due to external factors such as luck, teachers, and so on, they believe that their academic achievement comes from outside, rather than by their own efforts. They therefore criticize their teachers to gain better grades and academic achievement, resulting in high level of academic entitlement [30]. Therefore, it is necessary to pay attention to the students with a tendency towards externalizing their locus of control.

Our study also confirmed that nursing students’ sense of external control positively affected their psychological entitlement, meaning that Hypothesis 6 was also valid. This is in line with the findings of previous studies, such as Carnes and Knotts (2018) who found that locus of control significantly predicted psychological entitlement [39]. Nursing students with a high external locus of control are unable to see the relationship between effort and reward, and instead only believe that they should be rewarded without considering the impact of their own behavior on outcomes, believing that good outcomes are for others to provide, rather than seeing they should act to persue these good outcomes. Nursing students with a high sense of external locus of control thereby nurture the formation of psychological entitlement. Psychological entitlement was shown to play a partial mediating role between parental over-protection and academic entitlement of nursing students, meaning that Hypothesis 7 is true. Previous studies have in fact shown that an over-protective parenting style causes individuals to pay too much attention to themselves, resulting in an unrealistic self-concept and the belief that they are special and deserve more than others, thus promoting their sense of psychological entitlement [55, 56]. According to the theory of psychological entitlement, nursing students with high psychological entitlement think that being a nurse means that they are only responsible for injections, infusions, and dispensing of medicine, and that deeper learning of theoretical knowledge and operational skills are therefore useless, creating a fertile environment for academic entitlement and dishonesty [10]. The current study also found that a high perceived external locus of control has a partially mediating effect on the relationship between parental over-protection and nursing students’ academic entitlement, confirming Hypothesis 8. Based on Bronfenbrenner's ecological systems theory [11] and attribution theory [37], an over-protective parenting style causes students to develop their sense of an external locus of control, making them believe that academic success is caused by luck, opportunity, and power, rather than believing that individual effort can strongly impact academic performance [23, 24], which further intensifies the students’ academic entitlement [17]. The current study also confirmed that a sense of external locus of control and psychological entitlement have a chain mediating effect in the relationship between parental over-protection and academic entitlement (i.e., parental over-protection – external control – psychological entitlement – academic entitlement). This shows that nursing students’ sense of external control and psychological entitlement further impact the way that parental over-protection impacts nursing students’ academic entitlement. An over-protective parenting style can also indirectly affect nursing students’ academic entitlement by affecting the individual’s sense of external control and psychological entitlement. Therefore, the mediating effect of external control and psychological entitlement provides a new perspective for reducing the academic entitlement of nursing students.

To summarize, the current study supports the theoretical model that an over-protective parenting style influences nursing students’ academic entitlement through individual factors (i.e., sense of external locus of control and psychological entitlement). The results of this study therefore lead to the following suggestions: 1. Reduce the psychological entitlement of college students and guide them in learning to view their own efforts and gains rationally. For example, college students’ psychological entitlement can be reduced by enhancing egalitarian concepts, reducing self-compassion, and changing subjective cognition [31]. 2. College students should be taught how to have an objective understanding of themselves, enabling them to form a healthier sense of internal control attribution, and teaching them to believe that academic success or failure depends primarily on their own ability and effort, allowing them to be better able to face learning difficulties positively and optimistically. For example, attribution training could be carried out as group development, intensive corrections, and observational learning [57]. 3. College students need guidance in how to self-integrate at a social level. Parents should be aware of the current needs of their college-aged students, and adjust their parenting behaviors appropriately to provide their child with understanding, care, and support. This is conducive to the healthy development of college students, both physically and psychologically.

Limitations

This survey had several limitations. First, the study used the method of convenient sampling investigation into two schools, which may have caused selection bias and may have also limited the generalizability of our research findings. We caution against widespread attribution of our findings to nursing students overall. Furthermore, data were collected via self-report questionnaires, which could have led to bias in overestimated responses of the participants. Finally, this study was a cross-sectional study, not cause-and-effect. The causal relationships between the variables require further investigation and verification by combining experiments and performing follow-up studies, so as to further clarify the mechanisms between variables in action.

The results show that there is a certain degree of academic entitlement in nursing students in China. Furthermore, they verify that perceived external control and psychological entitlement mediate the relationship between parental over-protection and academic entitlement in nursing students. Parental over-protection can not only lead directly to the academic entitlement of nursing students, but it can also indirectly affect the academic entitlement of nursing students through individual factors (e.g., sense of external control and psychological entitlement). Based on these results, we suggest that educators pay attention to the academic entitlement of nursing students. An over-protective parenting style, an externally controlled attribution style, and psychological entitlement are the key factors which can lead to academic entitlement. This study provides a theoretical basis for the intervention of academic entitlement in nursing students in particular.

Acknowledgements

All the authors give sincere thanks to all the nursing students for participating in our research.

Author contributions

Biao Peng: writing – preparation of original draft, investigation, software, data curation.

Bing Pang: writing – preparation of original draft.

Mingzhi Lv: investigation, validation.

Hong Li: investigation.

Xiuhong Wang: conceptualization, methodology, writing – reviewing and editing.

Ningning Hu: supervision, writing – reviewing, resources.

Availability of data and materials

The data result are available from the corresponding author on reasonable request.

Ethics approval and consent to participate

This study was approved by the ethics committee of Guizhou Medical University. The participants were informed about the purpose of the study and, prior to the start of the study, were assured that their privacy would be protected. All methods in this study were performed in accordance with the the ethical standards of the institutional and/or national research committee and the 1964 Helsinki declaration and its later amendments.

Consent for publication

Not applicable

Competing interests

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Funding

The study was funded by the Nursing Research Program of Guizhou Medical University (YJ21078).

Author details

¹School of Marxism, Guizhou Medical University, Guiyang, China . ²School of Nursing, Guizhou Medical University, Guiyang, China. ³Yunnan Trade and Foreign Affairs Vocational College⁴. School of Nursing, Xinjiang Medical University, Urumqi, China.

Dubovsky SL. Coping with entitlement in medical education. New Engl J Med. 1986; 315(26): 1672-1674. https://doi.org/10.1056/NEJM198612253152609.
Kopp JP, Zinn TE, Finney SJ, Jurich DP. The development and evaluation of the academic entitlement questionnaire. Meas Eval Couns Dev. 2011; 44(2), 105-129. https://doi.org/10.1177/0748175611400292.
Morrow W. Entitlement and achievement in education. Stud Philos Educ. 1994; 13(1), 33-47. https://doi.org/10.1007/BF01074084.
Lippmann S, Bulanda RE, Wagenaar TC. Student entitlement: Issues and strategies for confronting entitlement in the classroom and beyond. College Teaching. 2009; 57(4), 197-204. https://doi.org/10.1080/87567550903218596.
Mellor JK. Academic entitlement and incivility: Differences in faculty and students' perceptions. The University of Arizona, 2011.
Vallade JI, Martin MM, Weber K. Academic entitlement, grade orientation, and classroom justice as predictors of instructional beliefs and learning outcomes. Commun Q. 2014; 62(5), 497-517. https://doi.org/10.1080/01463373.2014.949386.
Stiles BL, Wong NCW, LaBeff EE. College cheating thirty years later: The role of academic entitlement. Deviant Behavior. 2018; 39(7), 823-834. https://doi.org/10.1080/01639625.2017.1335520.
Curtis GJ, Correia HM, Davis MC. Entitlement mediates the relationship between dark triad traits and academic misconduct. Pers Indiv Differ. 2022; 191, 111563. https://doi.org/10.1016/j.paid.2022.111563.
Barton AL, Hirsch JK. Permissive parenting and mental health in college students: Mediating effects of academic entitlement. J AM Coll Health. 2016; 64(1), 1-8. https://doi.org/10.1080/07448481.2015.1060597.
Chapin TM. Associations between Academic Entitlement, Learning Approaches and Awareness of Future Consequences in Baccalaureate Nursing Students. Doctoral dissertation, Capella University, 2018.
Bronfenbrenner U, Morris PA. The ecology of developmental processes In Damon W & Lerner RM (Eds.), Handbook of child psychology: Theoretical models of human development (pp. 993–1028). New York: John Wiley & Sons, 1998.
Prevatt FF. The contribution of parenting practices in a risk and resiliency model of children's adjustment. Brit J Dev Psychol. 2003; 21(4), 469-480. https://doi.org/10.1348/026151003322535174.
Thimm JC. Mediation of early maladaptive schemas between perceptions of parental rearing style and personality disorder symptoms. J Behav Ther Exp Psy. 2010; 41(1), 52-59. https://doi.org/10.1016/j.jbtep.2009.10.001.
Jones MH, Audley-Piotrowski SR, Kiefer SM. Relationships among adolescents' perceptions of friends' behaviors, academic self-concept, and math performance. J Educ Psychol. 2012; 104(1), 19. https://doi.org/10.1037/a0025596.
Deci EL, Ryan RM. The" what" and" why" of goal pursuits: Human needs and the self-determination of behavior. Psychol Inq. 2000; 11(4), 227-268. https://doi.org/10.1207/S15327965PLI1104_01.
Fletcher KL, Pierson EE, Speirs Neumeister KL, Finch WH. Overparenting and perfectionistic concerns predict academic entitlement in young adults. J Child Fam Stud. 2020; 29(2), 348-357. https://doi.org/10.1007/s10826-019-01663-7.
Rotter JB. Generalized expectancies for internal versus external control of reinforcement. Psychol Monogr. 1966; 80(1), 1-28. https://doi.org/10.1037/h0092976.
Achacoso MV. “What do you mean my grade is not an A?”: An investigation of academic entitlement, causal attributions, and self-regulation in college students. Doctoral dissertation, The University of Texas at Austin, 2006.
Chowning K, Campbell NJ. Development and validation of a measure of academic entitlement: Individual differences in students’ externalized responsibility and entitled expectations. J Educ Psychol. 2009; 101(4), 982-997. https://doi.org/10.1037/a0016351.
Fromuth ME, Bass JE, Kelly DB, Davis TL, Chan KL. Academic entitlement: its relationship with academic behaviors and attitudes. Soc Psychol Educ Social. 2019; 22(5), 1153-1167. https://doi.org/10.1007/s11218-019-09517-2.
Yang ZH, Wang JP. Correlation of the Locus of Control and Parental Rearing Patterns of the Junior High School Students. Chin J Clin Psychol. 2008; 16(4), 401-412. https://doi.org/10.16128/j.cnki.1005-3611.2008.04.018.
Spokas M, Heimberg RG. Overprotective parenting, social anxiety, and external locus of control: Cross-sectional and longitudinal relationships. Cognitive Ther Res. 2009; 33(6), 543-551. https://doi.org/10.1007/s10608-008-9227-5.
Steinberg L, Elmen JD, Mounts NS. Authoritative parenting, psychosocial maturity, and academic success among adolescents. Child Dev. 1989; 60(6), 1424-1436. https://doi.org/10.2307/1130932.
Chen JJ. The influence of Parental rearing style on the Future orientation of left-behind Children: the mediating role of locus of Control. Chin J Health Psychol. 2020; 28(09): 1378-1382. https://doi.org/10.13342/j.cnki.cjhp.2020.09.023.
Youssef RM, Attia MSED, Kamel MI. Children experiencing violence I: Parental use of corporal punishment. Child Abuse Neglect. 1998; 22(10), 959-973. https://doi.org/10.1016/S0145-2134(98)00077-5.
Jankowska AM, Takagi A, Bogdanowicz M, Jonak J. Parenting style and locus of control, motivation, and school adaptation among students with borderline intellectual functioning. Curr Iss Personal Ps. 2014; 2(4), 251-266. https://doi.org/10.5114/cipp.2014.47448.
Georgiou SN, Ioannou M, Stavrinides P. Parenting styles and bullying at school: The mediating role of locus of control. Int J Sch Educ Psychol. 2017; 5(4), 226-242. https://doi.org/10.1080/21683603.2016.1225237.
Campbell WK, Bonacci AM, Shelton J, Exline JJ, Bushman BJ. Psychological entitlement: Interpersonal consequences and validation of a self-report measure. J Pers Assess. 2004; 83(1), 29-45. https://doi.org/10.1207/s15327752jpa8301_04.
King JrWC, Miles EW. The measurement of equity sensitivity. J Occup Organ Psych. 1994; 67(2), 133-142. https://doi.org/10.1111/j.2044-8325.1994.tb00556.x.
Greenberger E, Lessard J, Chen C, Farruggia SP. Self-entitled college students: Contributions of personality, parenting, and motivational factors. J Youth Adolescence. 2008; 37(10), 1193-1204. https://doi.org/10.1007/s10964-008-9284-9.
BAI B, SUN R, HU Q, ZHANG Y. Psychological entitlement: Concept, measurements and related research. Adv psychol science. 2017; 25(6), 1025-1035. https://doi.org/10.3724/SP.J.1042.2017.01025.
Sivanathan N, Pettit NC. Protecting the self through consumption: Status goods as affirmational commodities. J Exp Soc Psychol. 2010; 46(3), 564-570. https://doi.org/10.1016/j.jesp.2010.01.006.
Deci EL, Ryan RM. Motivation, personality and development within social contexts: An overview of self-determination theory. In R.M.R Yan (Ed.), The Oxford handbook of human motivation (pp.85-107). New York: Oxford University Press, 2012.
Bishop J, Lane RC. The dynamics and dangers of entitlement. Psychoanal Psychol. 2002; 19(4), 739. https://doi.org/10.1037//0736-9735.19.4.739.
Zitek EM, Jordan AH, Monin B, Leach FR. Victim entitlement to behave selfishly. J Pers Soc Psychol. 2010; 98(2), 245-255. https://doi.org/10.1037/a0017168.
Rothman AM, Steil JM. Adolescent attachment and entitlement in a world of wealth. J Infant Child Adoles Psychother. 2012; 11(1), 53-65. https://doi.org/10.1080/15289168.2012.650002.
Weiner B. An attributional theory of achievement motivation and emotion. Psychol Rev. 1985; 92(4), 548. https://doi.org/10.1037/0033-295X.92.4.548.
Harvey P, Martinko MJ. An empirical examination of the role of attributions in psychological entitlement and its outcomes. J Organ Behav. 2009; 30(4), 459-476. https://doi.org/10.1002/job.549.
Carnes AM, Knotts KG. Control and expectancy: locus of control as a predictor of psychological entitlement. Employ Respons Right J. 2018; 30(2), 81-97. https://doi.org/10.1007/s10672-017-9312-6.
Jiang J, Lu ZR, Jiang BZ, Xu Y. Revision of the short-form Egna Minnen av Barndoms Uppfostran for Chinese. Psychol. Dev. Educ. 2010; 26(1): 94-99. https://doi.org/10.16187/j.cnki.issn1001-4918.2010.01.017.
Hu NN, Lin SL, Zhao D, He Z, Xu P. The reliability and validity of the Chinese version of Academic Entitlement Questionnaire. Chin J Nurs Educ. 2021; 18(12): 1110-1113. https://doi.org/10.3761/j.issn.1672-9234.2021.12.009.
Bai Y, Wang JN. Reliability and validity of psychological entitlement scale in Chinese college students. Psychol Tech Appl. 2018; 6(12), 752-759. https://doi.org/10.16842/j.cnki.issn2095-5588.2018.12.006.
Levenson H. Differentiating among internality, powerful others, and chance. In H. M. Lefcourt (Ed.), Research with the locus of control construct (Vol. 1, pp. 15-63). New York: Academic Press, 1981.
Xiao L, Chen ZG. A preliminary Analysis of the structure of locus of Control and IPC scale of College students. Chin J Appl Psychol. 1989; (02):22-27. https://d.wanfangdata.com.cn/periodical/ChlQZXJpb2RpY2FsQ0hJTmV3UzIwMjIwNDE1EgoxMDAzMDExMTY4Ggg1MTMyYnYxeA==.
Podsakoff PM, MacKenzie SB, Lee JY, Podsakoff NP. Common method biases in behavioral research: a critical review of the literature and recommended remedies. J Appl Psychol. 2003; 88(5), 879-903. https://doi.org/10.1037/0021-9010.88.5.879.
Hu LT, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Struct Equ Modeling. 1999; 6(1), 1-55. https://doi.org/10.1080/10705519909540118.
Landis RS, Beal DJ, Tesluk PE. A comparison of approaches to forming composite measures in structural equation models. Organ Res Methods. 2000; 3(2), 186-207. https://doi.org/10.1177/109442810032003.
Little TD, Cunningham WA, Shahar G, Widaman KF. To parcel or not to parcel: Exploring the question, weighing the merits. Struct Equ Modeling. 2002; 9(2), 151-173. https://doi.org/10.1207/S15328007SEM0902_1.
Liu K, Zhang XM, Zheng SS, Zhu L, Li W. Analysis on the mediating effect of self-efficacy of undergraduate nursing students between personality traits and learning input. Chin J Mod Nurs. 2021; 27(26): 3622-3627. https://doi.org/10.3760/cma.j.cn115682-20210125-00395.
Wu H, Li FL, Liu Y, Shi TY. Analysis on the mediating effect of Professional self-concept on Learning input and Humanistic Care of undergraduate Nursing students. Chin Gen Pract Nurs. 2021; 19(22): 3033-3037. https://doi.org/10.12104/j.issn.1674-4748.2021.22.003.
Zhong WQ, Jia J, Sheng SL, Yao XY. Investigation and analysis on the status of professional identity of intern nurses in tertiary grade a hospital of Beijing. Chin Evid-based Nurs. 2020; 6(12): 1387-1393. https://doi.org/10.12102/j.issn.2095-8668.2020.12.023.
Li Y, Shi XP, Song RX. Study on the relationship among professional values, autonomous learning ability and core competence of trainee nursing students. Chin Med Educ Technol. 2021; 35(05): 564-569. https://doi.org/10.13566/j.cnki.cmet.cn61-1317/g4.202105008.
Jiang GY, Guo LJ. The collusion behavior of University Teaching Evaluation and its Governance path. Univ Educ Science. 2020; (2): 105-110. https://doi.org/10.3969/j.issn.1672-0717.2020.02.015.
Zhu ZL, Cao TT. Study on Correlation between Parental Rearing Pattern and Locus of Control among 3-6 Students in Rural Primary School. Chin J Health Psychol. 2010; 18(08): 989-991. https://doi.org/10.13342/j.cnki.cjhp.2010.08.052.
Lessard J, Greenberger E, Chen C, Farruggia S. Are youths’ feelings of entitlement always “bad”?: Evidence for a distinction between exploitive and non-exploitive dimensions of entitlement. J Adolescence. 2011; 34(3), 521-529. https://doi.org/10.1016/j.adolescence.2010.05.014.
Givertz M, Segrin C. The association between overinvolved parenting and young adults’ self-efficacy, psychological entitlement, and family communication. Commun Res. 2014; 41(8), 1111-1136. https://doi.org/10.1177/0093650212456392.
Buddelmeyer H, Powdthavee N. Can having internal locus of control insure against negative shocks? Psychological evidence from panel data. J Econ Behav Organ. 2016; 122, 88-109. https://doi.org/10.1016/j.jebo.2015.11.014.

No competing interests reported.

The Chain Mediating Effects of External Locus of Control and Psychological Entitlement between Parental Over-Protection and Academic Entitlement among Nursing Students: A cross-sectional Study

Status:

Version 1

Abstract

Background

Purpose

Methods

Results

Conclusion

Figures

Introduction

Parental Over-protection And Academic Entitlement

Mediating Role Of External Control

Mediating Role Of Psychological Entitlement

The Relationship Between External Control And Psychological Entitlement

The Present Study

Materials And Methods

Participants

Procedure

Measurements

The Social-Demographic Information Questionnaire

The Short Egna Minnen Barndoms Uppfostran (S-embu)

Academic Entitlement Questionnaire (Aeq)

Psychological Entitlement Scale (Pes)

Locus Of Control Scale (Lcs)

Data Analysis Strategy

Results

Common Method Bias Test (CMB)

Descriptive Statistics

Test Of The Hypothesized Model

Discussion

Limitations

Conclusion

Declarations

References

Additional Declarations

Status:

Version 1