ArticleInternational journal of nursing studies advances2026
Psychological resilience, metacognition, post-traumatic growth, and rumination among undergraduate nursing interns: A cross-sectional study.
Article in International journal of nursing studies advances, 2026. 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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Abstract
Background: Undergraduate nursing students, during their 9-12 month hospital internship in China, commonly experience rumination (repetitive negative thinking) in high-pressure clinical environments, which is closely associated with mental health problems. Previous researchers have suggested that psychological resilience, as a key protective factor, may alleviate this process. However, the underlying mechanisms remain unclear, particularly regarding the roles of metacognition and post-traumatic growth (positive psychological change following adversity), which warrant further investigation. Aims: We aimed to explore the mechanisms through which psychological resilience influenced rumination among undergraduate nursing interns and to clarify the mediating role of metacognition and the moderating role of post-traumatic growth in this relationship. Design: A descriptive, cross-sectional study. Methods: Using convenience sampling, we conducted an online questionnaire survey among 892 undergraduate nursing interns in China between and October 2025. A moderated mediation analysis was conducted. Results: Psychological resilience significantly negatively predicted rumination among participants ( Conclusions: We found that psychological resilience was associated with reduced rumination, a relationship mediated by metacognition, with this indirect effect being more pronounced in individuals with higher post-traumatic growth. To support nursing interns' role transition and well-being, cultivating metacognitive ability and fostering post-traumatic growth may be recommended.
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