The Impact of Nursing Students' Self-Leadership on Patient Safety Management Activities : The Mediating Effect of Stress Coping Strategies

Abstract

This descriptive survey study aimed to identify the levels of self-leadership, stress coping strategies, and patient safety management activities among nursing students, and to identify the mediating effect of stress coping strategies between self-leadership and patient safety management activities. The participants were 198 third-and fourth-year nursing students, and data were collected from April 17 to June 5, 2026, and analyzed by descriptive statistics, t-test, one-way ANOVA, Pearson's correlation, and bootstrapping using SPSS 26.0 and PROCESS Macro v5.0(Model 4). The mean scores were 3.73 for self-leadership, 3.61 for stress coping strategies, and 4.30 for patient safety management activities. All three variables showed significant positive correlations with one another. After controlling for grade level, completion of a patient safety education course, and simulation practice experience, The total effect B=.575(95%CI[.444,.707]) and the direct effect B=.510(95%CI[.369,.651]) were significant, and the indirect effect through stress coping strategies B=.065 (95%CI[.013,.124]) was significant as the confidence interval did not include zero. These findings suggest the need for self-leadership enhancement programs for lower-grade students, repeated and cumulative simulation curricula, and patient safety and stress coping education prior to clinical practice.