School of Nursing, Wenzhou Medical University, Wenzhou, 325035, China.
School of Education, Renmin University of China, Beijing, 100872, China.
BMC Psychiatry. 2023 Jun 1;23(1):388. doi: 10.1186/s12888-023-04887-6.
Anxiety may stay with nursing students throughout their internship and even persist afterwards. Although many studies have explored the effects of perceived stress on anxiety, the relationship between pre-internship perceived stress and post-internship anxiety levels has not been clarified. In addition, none had focused on the moderating roles of career adaptability and professional commitment between perceived stress and anxiety. This study aims to investigate the influence of pre-internship perceived stress on the post-internship anxiety level of nursing college students, and to analyze the moderating effects of career adaptability and professional commitment on their relationships.
A longitudinal study design was employed. Full-time nursing college students from a Chinese medical university were recruited by convenient sampling. All surveys were conducted via Wen Juan Xing ( www.wjx.cn ), a widely used web-based survey platform in China. Two waves of surveys were collected in the pre-internship and post-internship periods, with an interval of one year. Among 823 nursing students recruited, 692 students completed all two waves of the survey (response rate: 84.08%). Participants completed a series of questionnaires examining general demographic characteristics, perceived stress, anxiety, career adaptability, and professional commitment both before and after the internship. The bias-corrected bootstrap technique of the Hayes PROCESS macro (Model 2) was used to test the moderation effect.
Pre-internship perceived stress was positively associated with post-internship anxiety (β = 0.474, p < 0.001). Career adaptability would mitigate the effect of perceived stress on anxiety (β = -0.009, p < 0.01, 95% CI = [-0.013, -0.004]), and this influence became stronger for nursing college students with higher levels of career adaptability. Instead, the professional commitment would enhance the effect of perceived stress on anxiety (β = 0.004, p < 0.05, 95% CI = [0.001, 0.009]).
Adequate career adaptability was key to alleviating anxiety among nursing interns. Nursing educators and clinical nursing managers should pay attention to cultivating the career adaptability of nursing college students in order to help them successfully achieve identity transformation and career development. Meanwhile, it is crucial to guide them to develop appropriate professional commitment.
焦虑可能会伴随护理学生整个实习过程，甚至在实习后仍然存在。尽管许多研究已经探讨了感知压力对焦虑的影响，但实习前感知压力与实习后焦虑水平之间的关系尚未阐明。此外，还没有人关注职业适应性和专业承诺在感知压力和焦虑之间的调节作用。本研究旨在探讨实习前感知压力对护理专业学生实习后焦虑水平的影响，并分析职业适应性和专业承诺对两者关系的调节作用。
采用纵向研究设计。通过便利抽样，从一所中国医科大学招募全日制护理专业学生。所有调查均通过中国广泛使用的网络调查平台问卷星（www.wjx.cn）进行。在实习前和实习后两个阶段共进行了两次调查，间隔一年。在招募的 823 名护理学生中，有 692 名学生完成了两次调查（应答率：84.08%）。参与者在实习前后完成了一系列问卷，内容包括一般人口统计学特征、感知压力、焦虑、职业适应性和专业承诺。采用 Hayes PROCESS 宏的偏校正引导技术（模型 2）检验调节效应。
实习前感知压力与实习后焦虑呈正相关（β=0.474，p<0.001）。职业适应性可以减轻感知压力对焦虑的影响（β=-0.009，p<0.01，95%置信区间=-0.013 至-0.004），而且对于职业适应性较高的护理专业学生，这种影响会更强。相反，专业承诺会增强感知压力对焦虑的影响（β=0.004，p<0.05，95%置信区间=0.001 至 0.009）。
适当的职业适应性是减轻护理实习生焦虑的关键。护理教育者和临床护理管理者应关注培养护理专业学生的职业适应性，以帮助他们成功实现身份转变和职业发展。同时，引导他们培养适当的专业承诺也至关重要。
