Abstract :

Nursing staff shortage is an acute issue in health care across the globe and it is no exception in Henan Province, China. As nursing programs have grown, some students question whether they want to pursue a lifelong career in the field. This paper aims to provide a theoretical foundation for understanding how self-efficacy and psychological stress affect career choice intention in nursing students. Based on social cognitive theory, the model suggests that self-efficacy encourages students’ career commitment, and psychological tension may be a moderator. The paper reviews current empirical literature identifies shortcomings of current research, and develops testable conjectures for future empirical study. Implications This framework contributes to both theory and practice by highlighting the importance of confidence building and stress management interventions in nursing education. This research provides a baseline for future inquiry on how to retain students and help them to succeed in a high-stress educational program like nursing.

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Keywords :

Nursing students; Career choice intention; Self-efficacy; Psychological stress; Medical education

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References :

1. Bandura, A. (2000). Exercise of human agency through collective efficacy. Current directions in psychological science, 9(3), 75-78.
2. Bi, Y., Mou, S., Wang, G., & Liao, M. (2023). The relationship between professional self-concept and career decision-making difficulties among postgraduate nursing students in China: the mediating role of career decision-making self-efficacy. Frontiers in psychology, 14, 1198974.
3. Cheng, C., Wang, Q., & Bai, J. (2025). Factor Structure of the Brief Coping Orientation to Problems Experienced Inventory (Brief-COPE) in Chinese Nursing Students. Nursing Reports, 15(2), 46.
4. Cheng, W. L. S., Chow, P. P. K., Wong, F. M. F., & Ho, M. M. (2023). Associations among stressors, perceived stress, and psychological distress in nursing students: a mixed methods longitudinal study of a Hong Kong sample. Frontiers in psychology, 14, 1234354.
5. Kong, L., Chen, X., Shen, S., Li, G., Gao, Q., Zhu, N., … & Li, P. (2016). Professional commitment and attributional style of medical-college nursing students in China: a cross-sectional study. Nurse education today, 40, 154-160.
6. Liao, M., Xie, Z., Ou, Q., Yang, L., & Zou, L. (2024). Self-efficacy mediates the effect of professional identity on learning engagement for nursing students in higher vocational colleges: A cross-sectional study. Nurse Education Today, 139, 106225.
7. Lin, Y., Hu, Z., Danaee, M., Alias, H., & Wong, L. P. (2021). The impact of the COVID-19 pandemic on future nursing career turnover intention among nursing students. Risk management and healthcare policy, 3605-3615.
8. Lu, J., Wang, B., Dou, X., Yu, Y., Zhang, Y., Ji, H., … & Zhou, L. (2023). Moderating effects of perceived social support on self-efficacy and psychological well-being of Chinese nurses: a cross-sectional study. Frontiers in Public Health, 11, 1207723.Chicago
9. Lyu, F. F., Ramoo, V., & Wang, Y. X. (2022). Career maturity, psychological resilience, and professional self-concept of nursing students in China: A nationwide cross-sectional study. Journal of Professional Nursing, 42, 58-66.
10. Mei, X., Wang, H., Wang, X., Wu, X., Wu, J., & Ye, Z. (2022). Associations among neuroticism, self-efficacy, resilience and psychological distress in first-year nursing students: a cross-sectional study in China. BMJ open, 12(6), e059704.
11. Mohamed, N. A., Ali, S. O., Ehrahim, E. E. E., Ahmed, A. L., & Wahba, A. M. (2024). Predictors of academic and clinical stress among nursing students. SAGE Open Nursing, 10, 23779608241290392.
12. Tsai, P. H., Lai, W. Y., Lin, Y. Y., Luo, Y. H., Lin, Y. T., Chen, H. K., … & Yang, Y. P. (2021). Clinical manifestation and disease progression in COVID-19 infection. Journal of the Chinese Medical Association, 84(1), 3-8.
13. Wang, T., Chen, Y., He, Y., Shen, L., Wang, P., Zhu, M., … & Li, M. (2022). Stressors, coping strategies and intention to leave the nursing profession: A cross‐sectional nationwide study in China. Journal of nursing management, 30(8), 4398-4408.
14. Ye, J., Mao, A., Wang, J., Okoli, C. T., Zhang, Y., Shuai, H., … & Zhuang, L. (2020). From twisting to settling down as a nurse in China: a qualitative study of the commitment to nursing as a career. BMC nursing, 19, 1-11.
15. Zhao, F. F., Lei, X. L., He, W., Gu, Y. H., & Li, D. W. (2015). The study of perceived stress, coping strategy and self‐efficacy of C hinese undergraduate nursing students in clinical practice. International journal of nursing practice, 21(4), 401-409.