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

Abstract

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.