Psychological resilience mediates links between nursing career attitude and negative emotions among eastern China nursing students in multicentre cross‑sectional research

To assess psychological resilience and negative emotional states in nursing students in Eastern China, and to test whether resilience mediates their association with attitude toward the nursing profession. A multicentre cross-sectional survey of 500 nursing students (450 women; mean age 19.57 ± 1.08 years) at three institutions in Eastern China, recruited by cluster sampling of intact classes in April 2024. Resilience was measured with the CD-RISC and negative emotional states with the DASS-21.

Analyses (SPSS 26.0) comprised t tests, one-way ANOVA, Spearman correlations, dummy-coded regression and PROCESS Model 4 mediation with 5000 bootstrap samples. Mean resilience was 59.76 ± 16.33 and mean DASS-21 total 29.32 ± 25.50; 48.8% of students scored above the normal range for depression and 53.8% for anxiety. Attitude toward nursing, household income, parental education and work experience were associated with resilience, negative emotional states, or both; all effect sizes were small (partial η2 = 0.003–0.074).

Resilience accounted for 31.2% of the attitude–distress association (indirect effect 3.09, 95% CI 1.33–5.43). Resilience was inversely associated with depression, anxiety and stress, and attitude toward the nursing profession showed the strongest association with both outcomes, partly through resilience. Because the design is cross-sectional, these findings identify correlates rather than causes.

Children’s Hospital, National Clinical Research Center For Children and Adolescents’ Health and Diseases, Zhejiang University School of Medicine, Hangzhou, 310000, People’s Republic of China Shaoxing University of Arts and Science, Shaoxing, 312000, People’s Republic of China Hangzhou Normal University, Hangzhou, 310000, People’s Republic of China Jinhua Vocational and Technical University, Jinhua, 321000, People’s Republic of China The authors declare no competing interests. Written informed consent has been obtained from all participants prior to participation in this study. All of our authors confirm that this study was performed in accordance with the relevant guidelines and regulations set out in the Declaration of Helsinki.

Ethical approval for the study as a whole, including data collection at all three participating institutions, was obtained from the Ethics Committee of the Children’s Hospital, Zhejiang University School of Medicine (No. 2024-IRB-0368-P-01), which reviewed the protocol as a multi-site study. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Below is the link to the electronic supplementary material.

Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material.