Zhang Junhao, Wang Lijia, Yang Xue, Yang Yuwei, Wu Xuehua, Huang Huaping, Li Guirong
School of Nursing, Chengdu Medical College, Chengdu, Sichuan, China.
Department of Clinical Laboratory, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan, China.
Front Med (Lausanne). 2025 Jan 15;11:1489383. doi: 10.3389/fmed.2024.1489383. eCollection 2024.
Previous studies have reported that anxiety negatively affects professional identity (PI), and clinical belongingness is positively correlated with PI among nursing interns. However, little is known about the relationship between anxiety, PI, and clinical belongingness among nursing interns.
To explore the relationship between PI, clinical belongingness, and anxiety among nursing interns, and to demonstrate the mediating role of clinical belongingness in this relationship.
A cross-sectional study using an online questionnaire was conducted between November 2023 and January 2024 among 1,050 nursing interns from 26 teaching hospitals in Sichuan Province, China. A general information questionnaire, the Belongingness Scale-Clinical Placement Experience (BES-CPE), the Self-Rated Anxiety Scale (SAS), and the Professional Identity Questionnaire for Nursing Students (PIQNS) were used to collect data. SPSS (version 25.0) and AMOS (version 28.0) were used to analyze the data.
Nursing interns had moderate mean scores for all variables; PI (60.77 ± 12.18), clinical belongingness (115.99 ± 17.02), and anxiety (47.44 ± 8.75). Correlation analyses revealed that both PI ( = -0.129, < 0.01) and clinical belongingness ( = -0.087, < 0.01) were negatively correlated with anxiety and clinical belongingness was positively correlated with PI ( = 0.601, < 0.01). The clinical belongingness of nursing interns had a mediating effect on the relationship between anxiety and PI ( = -0.072, 95% confidence interval = -0.133 to -0.013, < 0.001), accounting for 40% of the total effect.
The anxiety level of nursing interns can have a direct impact on the prediction of PI and an indirect influence on PI mediated by clinical belongingness. Accordingly, nursing educators and managers should screen and channel the mental health problems of nursing interns in a timely manner, improving their clinical belonging, which will help improve PI and ultimately improve the stability of the nursing workforce.
既往研究报道，焦虑对职业认同感（PI）有负面影响，且临床归属感与实习护士的职业认同感呈正相关。然而，对于实习护士的焦虑、职业认同感和临床归属感之间的关系，我们知之甚少。
探讨实习护士的职业认同感、临床归属感和焦虑之间的关系，并验证临床归属感在这种关系中的中介作用。
2023年11月至2024年1月，对来自中国四川省26所教学医院的1050名实习护士进行了一项采用在线问卷的横断面研究。使用一般信息问卷、临床实习归属感量表（BES-CPE）、自评焦虑量表（SAS）和护生职业认同问卷（PIQNS）收集数据。采用SPSS（25.0版）和AMOS（28.0版）进行数据分析。
实习护士在所有变量上的平均得分适中；职业认同感（60.77±12.18）、临床归属感（115.99±17.02）和焦虑（47.44±8.75）。相关分析显示，职业认同感（r = -0.129，P < 0.01）和临床归属感（r = -0.087，P < 0.01）均与焦虑呈负相关，且临床归属感与职业认同感呈正相关（r = 0.601，P < 0.01）。实习护士的临床归属感在焦虑与职业认同感之间的关系中起中介作用（β = -0.072，95%置信区间 = -0.133至 -0.013，P < 0.001），占总效应的40%。
实习护士的焦虑水平可直接影响职业认同感的预测，并通过临床归属感对职业认同感产生间接影响。因此，护理教育工作者和管理人员应及时筛查和疏导实习护士的心理健康问题，提高其临床归属感，这将有助于提高职业认同感并最终提高护理队伍的稳定性。
