Observational studyFrontiers in public health2025
Exploring stress mediation: self-efficacy, sense of coherence, and self-esteem among nursing students in Poland-a multicenter cross-sectional observational study.
Observational study in Frontiers in public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
15 authors.
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Abstract
Background: Nursing students frequently encounter stressful and demanding situations during clinical training, which may hinder their well-being and professional development. A strong sense of coherence is thought to buffer the negative effects of stress and support adaptive coping. Objective: This study aimed to examine levels of sense of coherence, self-esteem, and self-efficacy among undergraduate nursing students in Poland, and to investigate whether perceived stress mediates the relationships between sense of coherence and self-esteem, as well as between sense of coherence and self-efficacy. Materials and methods: A cross-sectional observational survey was conducted among 2,689 nursing students enrolled in bachelor-level programs across multiple universities in Poland. Data collection utilized standardized tools, including the Sense of Coherence-29 Scale, the Generalized Self-Efficacy Scale, the Rosenberg Self-Esteem Scale, and the Perceived Stress Scale 10. Statistical analyses involved mediation modeling using Hayes' PROCESS macro, with bootstrapping (5,000 resamples) to assess indirect effects. Results: Participants completed sociodemographic questionnaires along with standardized measures assessing sense of coherence, self-esteem, self-efficacy, and stress. The majority of students (84.0%) reported high stress levels, while two-thirds demonstrated average self-efficacy. Sex was associated with comprehensibility and manageability, and marital status was related to comprehensibility. Stress severity significantly mediated the relationships between specific components of sense of coherence and both self-esteem and self-efficacy. Conclusion: These findings emphasize the detrimental impact of stress on key components of sense of coherence and indicate that targeted educational and psychological interventions aimed at strengthening sense of coherence may help nursing students reduce stress, enhance self-efficacy, and promote overall well-being. The study underscores the multifaceted role of stress in shaping nursing students' psychological resources and coping capacities.
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