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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

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Background In the context of a global shortage, uneven distribution, and structural imbalance of nursing talent, postgraduate nursing students must make appropriate decisions about their careers not only for the nursing profession but also for society as a whole. However, little research has been reported on the current status and factors influencing career decision-making difficulties among postgraduate nursing students. Objectives Exploring the mediating role of career decision-making self-efficacy between professional self-concept and career decision-making difficulties among postgraduate nursing students in China based on the social cognitive career theory. Methods 276 postgraduate nursing students from 25 universities in seven administrative regions of China were selected by stratified random sampling. Data were collected with the Career decision-making difficulties Questionnaire, Career Decision-making Self-Efficacy Scale, and Nursing Professional Self-concept Scale through an online survey, and were analyzed by univariate analysis, correlation analysis, multiple linear regression analysis, and PROCESS macro. Results The score for career decision-making difficulties was 2.84 (SD = 0.54). Professional self-concept (r = −0.496, p < 0.01) and career decision-making self-efficacy (r = −0.551, p < 0.01) were negatively associated with career decision-making difficulties. Career decision-making self-efficacy played a partial mediating role between professional self-concept and career decision-making difficulties (p < 0.01), with the mediating effect (Effect Value = −0.253, Bootstrap 95% CI: −0.349, −0.156) accounting for 53.82% of the total effect. Conclusion The high scores of career decision-making difficulties among postgraduate nursing students demand widespread attention. Nursing educators need to develop a complete and standardized career counseling curriculum for postgraduate nursing students, and should pay attention to the cultivation and development of positive professional self-concept and career decision-making self-efficacy of postgraduate nursing students to reduce their career decision-making difficulties and help them make effective career decision-making.
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Frontiers in Psychology 01 frontiersin.org
The relationship between
professional self-concept and
career decision-making diculties
among postgraduate nursing
students in China: the mediating
role of career decision-making
self-ecacy
YapingBi
1, ShaoyuMou
2, GeWang
1* and MingyanLiao
1
1 Department of Hematology, The First Aliated Hospital of Chongqing Medical University, Chongqing,
China, 2 School of Nursing, Chongqing Medical University, Chongqing, China
Background: In the context of a global shortage, uneven distribution, and
structural imbalance of nursing talent, postgraduate nursing students must make
appropriate decisions about their careers not only for the nursing profession but
also for society as a whole. However, little research has been reported on the
current status and factors influencing career decision-making diculties among
postgraduate nursing students.
Objectives: Exploring the mediating role of career decision-making self-ecacy
between professional self-concept and career decision-making diculties
among postgraduate nursing students in China based on the social cognitive
career theory.
Methods: 276 postgraduate nursing students from 25 universities in seven
administrative regions of China were selected by stratified random sampling. Data
were collected with the Career decision-making diculties Questionnaire, Career
Decision-making Self-Ecacy Scale, and Nursing Professional Self-concept Scale
through an online survey, and were analyzed by univariate analysis, correlation
analysis, multiple linear regression analysis, and PROCESS macro.
Results: The score for career decision-making diculties was 2.84 (SD =  0.54).
Professional self-concept (r =  0.496, p <  0.01) and career decision-making self-
ecacy (r =  0.551, p <  0.01) were negatively associated with career decision-
making diculties. Career decision-making self-ecacy played a partial mediating
role between professional self-concept and career decision-making diculties
(p <  0.01), with the mediating eect (Eect Value  =  0.253, Bootstrap 95% CI:
0.349, 0.156) accounting for 53.82% of the total eect.
Conclusion: The high scores of career decision-making diculties among
postgraduate nursing students demand widespread attention. Nursing educators
need to develop a complete and standardized career counseling curriculum for
postgraduate nursing students, and should pay attention to the cultivation and
development of positive professional self-concept and career decision-making
self-ecacy of postgraduate nursing students to reduce their career decision-
making diculties and help them make eective career decision-making.
OPEN ACCESS
EDITED BY
Antonio P. Gutierrez de Blume,
Georgia Southern University, UnitedStates
REVIEWED BY
Sandra T. Valadas,
University of Algarve, Portugal
Roxana Maier,
Babeș-Bolyai University, Romania
*CORRESPONDENCE
Ge Wang
1343255034@qq.com
RECEIVED 02 April 2023
ACCEPTED 14 July 2023
PUBLISHED 31 July 2023
CITATION
Bi Y, Mou S, Wang G and Liao M (2023) The
relationship between professional self-concept
and career decision-making diculties among
postgraduate nursing students in China: the
mediating role of career decision-making
self-ecacy.
Front. Psychol. 14:1198974.
doi: 10.3389/fpsyg.2023.1198974
COPYRIGHT
© 2023 Bi, Mou, Wang and Liao. This is an
open-access article distributed under the terms
of the Creative Commons Attribution License
(CC BY). The use, distribution or reproduction
in other forums is permitted, provided the
original author(s) and the copyright owner(s)
are credited and that the original publication in
this journal is cited, in accordance with
accepted academic practice. No use,
distribution or reproduction is permitted which
does not comply with these terms.
TYPE Original Research
PUBLISHED 31 July 2023
DOI 10.3389/fpsyg.2023.1198974
Bi et al. 10.3389/fpsyg.2023.1198974
Frontiers in Psychology 02 frontiersin.org
KEYWORDS
postgraduate nursing students, career decision-making diculties, career decision-
making self-ecacy, professional self-concept, mediating role, social cognitive career
theory
1. Introduction
A career has a signicant impact on an individual’s life. It is not only
a means of making a living but also a way of self-development and self-
realization. Career decision-making diculties refer to the diculties that
occur when an individual does not know what occupation to pursue or
chooses one of several occupations when facing the nal decision in the
process of a career decision, including three groups of diculties: lack of
readiness, lack of information and inconsistent information, among
which lack of readiness occurs before the career decision process begins,
the other two tend to occur aer the career decision-making process has
begun (Gati etal., 1996; Lipshits-Braziler etal., 2016).
Career decision-making diculties oen have a negative impact on
nursing students, making them unable to make a career decision at the
right time or causing them make the wrong career decision, which leads
to lower professional identity, higher job burnout and turnover intention
aer work (Gan etal., 2020; Wang, 2020; Ren etal., 2021). Considering
that postgraduate nursing students, as high-level nursing talents, are the
mainstay of the nursing industry, at the same time, in the context of a
global shortage, uneven distribution, and structural imbalance of nursing
talent (Hou etal., 2014; WHO, 2020), postgraduate nursing students must
make appropriate decisions about their careers not only for the nursing
profession but also for society as a whole (Ni etal., 2022). In addition, the
value of providing structured courses to help medical students make
career decisions has been recognized (Navarro etal., 2011; Park, 2015;
Howse etal., 2017). However, the core courses of postgraduates nursing
education in China mainly include Advanced Health Assessment,
Advanced pathophysiolog y, Advanced pharmacotherapy, Evidence-based
nursing, Nursing eory, Nursing Research, Nursing pedagogy, etc., and
there is a lack of a complete and standardized career counseling
curriculum system (Sun etal., 2015; Zhang etal., 2019; Wang etal., 2020).
A better understanding of postgraduate nursing students’ career decision-
making diculties and its related inuencing factors will provide a
reference for designing targeted interventions to alleviate postgraduate
nursing students’ career decision-making diculties. However, few
studies have focused on the career decision-making diculties of
postgraduate nursing students (Zhou etal., 2021).
Professional self-concept refers to the individual’s self-evaluation
of his or her professional knowledge, value, and skills (Kelly, 1992),
which plays an important core and driving role in the individual’s
career choice and career development (Yang etal., 2008). Studies have
shown that nurses with higher professional self-concept have a
stronger professional identity, higher job satisfaction, and lower job
burnout and turnover intention (Goliroshan et al., 2021; Li et al.,
2021). For nursing students, those with more positive professional
self-concept have more adequate preparation for career selection,
more positive career selection behavior, and more smooth career
selection process (Lee, 2019). However, the mechanism of the
inuence of professional self-concept on the career decision-making
and development of postgraduate nursing students is still unknown.
Self-ecacy is an individual’s belief in his or her ability to organize
and execute a series of actions to achieve a specic goal. According to
the social cognitive career theory (SCCT) (Lent etal., 1994), career
decision-making self-ecacy is the application of self-ecacy in the
career eld, that is, an individuals belief in his or her ability to engage
in career decision-making activities (such as collecting career
information or selecting career goals) (Betz etal., 1996). Taylor and
Betz (1983) proposed that the career decision-making self-ecacy
can explain the dierences in individual career decision-making
diculties. Relevant studies also showed that career decision-making
self-ecacy is negatively correlated with career decision-making
diculties (Penn and Lent, 2018; Santos et al., 2018), that is, the
stronger the individual’s condence in choosing a career, the lower the
degree of career decision-making diculties, and the more eective
career decision-making can bemade. At the same time, studies have
reported that career decision-making self-ecacy is positively
correlated with professional self-concept (Lv etal., 2014).
In conclusion, as previous studies have shown, both professional self-
concept and career decision-making self-ecacy can aect individuals
career decision-making. Moreover, according to SCCT (Lent etal., 1994),
individual dierences, environmental factors, and individual behavior
will aect the condence of the ability of individuals to implement
occupation-related tasks and activities through interaction, thereby
aecting the process of individual career choice and shaping occupational
behavior. However, so far, no studies have examined the comprehensive
eect of professional self-concept and career decision-making self-
ecacy on the generation of career decision-making diculties in
postgraduate nursing students, and whether career decision-making self-
ecacy plays a mediating role between professional self-concept and
career decision-making diculties. SCCT has been applied to several
disciplines (Gao etal., 2021), but it has not been used as a conceptual
framework to understand the career decisions and development of
postgraduate nursing students.
erefore, the objectives of this study were as follows: (1) to
determined what major diculties impair the career decision-making
process among postgraduate nursing students, as measured by career
decision-making diculties, (2) to explore the inuence of
professional self-concept on the career decision-making diculties
among postgraduate nursing students, and (3) to clarify the mediating
role of career decision-making self-ecacy between professional self-
concept and career decision-making diculties among postgraduate
nursing students based on SCCT.
2. Methods
2.1. Study design and participants
is study was designed as a cross-sectional study. From April
2022 to May 2022, considering the representativeness of the
Bi et al. 10.3389/fpsyg.2023.1198974
Frontiers in Psychology 03 frontiersin.org
sample, a stratied random sampling method was conducted to
select 276 postgraduate nursing students from 25 universities in
East China (seven universities), South China (four universities),
North China (four universities), Central China (two universities),
Northeast China (two universities), Northwest China (two
universities), and Southwest China (four universities) according to
the geographical distribution of China as the study participants.
Eligible participants had to befull-time enrolled postgraduate
nursing students who volunteered for this survey. e exclusion
criteria for this study included: postgraduate nursing students
who are part-time education graduate students or are employed
and o work due to medical leave or personal leave during the
investigation period. e mean age of the 276 participants was
24.75 (SD = 2.85) years, with a range from 21 to 35 years old. e
majority were female (92.03%). Among them, 89 (32.24%) were in
their rst grade, 120 (43.47%) in their second grade, and 67
(24.29%) in their third grade (as shown in Table1).
e sample size was calculated according to the principle of
Kendall estimation of sample size (Ni etal., 2010). is demonstrated
that the sample size was 5 ~ 10 times that of the independent variables.
is study contained 20 independent variables. Considering a 20%
sample loss rate, the minimum sample size was 120 cases. 276 valid
questionnaires were nally collected, with a valid recovery rate of
95.17%, which satised the minimum sample size required for
this study.
2.2. Measurements
2.2.1. Participants’ sociodemographic
characteristics
e sociodemographic characteristics of the participants included
gender, age, registered residence, grade, degree type, employment
experience before enrolling in postgraduate, and experience in a
career development program.
2.2.2. Career decision-making diculties
Career decision-making diculties were measured using a Chinese
version of the Career Decision-making Diculty Questionnaire
developed by (Wu etal., 2016). e questionnaire consists of 36 items
across three domains: Lack of Readiness (nine items), Lack of Information
(fourteen items), and Inconsistent Information (three items). e
responses were provided on a 5-point Likert scale ranging from (1)
“strongly disagree” to (5) “strongly agree.” A higher score indicates higher
career decision-making diculties. e questionnaire’s Cronbach’s alpha
was 0.816. In this study, Cronbach’s alpha was 0.933.
2.2.3. Career decision-making self-ecacy
Career decision-making self-ecacy was measured using a
Chinese version of the Career Decision-making Self-ecacy scale
revised by Long (2003). e scale consists of 25 items across ve
domains: self-appraisal (ve items), goal selection (ve items),
gathering information (ve items), planning (ve items), and
problem-solving (ve items). e responses were provided on a
5-point Likert scale ranging from (1) “not condent at all” to (5)
“completely condent.” A higher score indicates higher career
decision-making self-ecacy. e scale’s Cronbach’s alpha was 0.89.
In this study, Cronbach’s alpha was 0.969.
2.2.4. Nursing professional self-concept
Nursing professional self-concept was measured using a scale
developed by professor Arthur (Yang etal., 2008). e scale consists
of 30 items across ve domains: exibility (7 items), skills (5 items),
leadership (4 items), satisfaction (9 items), and communication (5
items). e responses were provided on a 4-point Likert scale ranging
from (1) “strongly disagree” to (5) “strongly agree.” A higher score
TABLE1 Participants characteristics and dierences of career decision-making diculties among groups (n=276).
Variable Group Frequency
(percentage)
Career decision-making
diculties (mean  ±  SD)
t / F p
Gender Male 22 (7.97) 2.59±0.55 2.270 0.024
Female 254 (92.03) 2.86±0.53
Age (years) <25 161 (58.33) 2.89±0.53 3.240 0.041
25~29 88 (31.88) 2.81±0.55
30 27 (9.79) 2.62±0.50
Registered residence Rural 158 (57.24) 2.85±0.51 0.433 0.665
Urba n 118 (42.76) 2.82±0.58
Grade 1 120 (43.47) 2.82±0.53 0.277 0.759
2 89 (32.24) 2.82±0.59
3 67 (24.29) 2.88±0.48
Degree type academic degree 81 (29.34) 2.80±0.52 0.720 0.472
professional degree 191 (70.66) 2.85±0.55
Employment experience Ye s 86 (31.16) 2.72±0.52 2.429 0.016
No 190 (68.84) 2.89±0.54
Experience in a career
development program
Ye s 51 (18.47) 2.60±0.58 3.552 0.000
No 225 (81.53) 2.89±0.52
Bi et al. 10.3389/fpsyg.2023.1198974
Frontiers in Psychology 04 frontiersin.org
indicates a more positive nursing professional self-concept. e scale’s
Cronbach’s alpha was 0.84. In this study, Cronbach’s alpha was 0.896.
2.3. Data collection procedures
e person in charge of the survey was appointed in the selected
universities to inform them of the purpose of this study and the inclusion
and exclusion criteria of the study subjects, ensure their full understanding
and obtain their cooperation, and then they were responsible for
mobilizing and instructing the postgraduate nursing students in their
universities to ll in the questionnaire. e electronic questionnaires were
distributed online through the “Wen Juan Xing” web platform, and the
research participants lled out the questionnaires anonymously by
opening the web link or scanning the WeChat QR code. e questions
were all compulsory, and the participants could only submit the
questionnaires aer completing all the questions independently. e
validity and completeness of the completed questionnaires were veried
one by one, and the questionnaires that did not meet the completion
requirements were excluded.
2.4. Data analysis
e Statistical Package for the Social Sciences (SPSS) soware
(v26) (IBM Corp., Armonk, NY, United States) was used in all
analyses. We calculated descriptive statistics for sociodemographic
information, professional self-concept, career decision-making self-
ecacy, and career decision-making diculties. Weused a t-test or an
analysis of variance to evaluate dierences among the participants in
terms of career decision-making diculties, and Pearson’s r was
calculated to test correlations among career decision-making
diculties, professional self-concept, and career decision-making self-
ecacy among nursing graduate students. Multiple linear regression
analysis was used to explore the mediating eects of professional self-
concept, career decision-making self-ecacy, and career decision-
making diculties. Finally, a nonparametric resampling method
(5,000 iterations) was applied by running the PROCESS plugin in the
SPSS Macro to test the statistical signicance of the mediating eect.
In all analyses, statistically signicant was set at p-value < 0.05.
2.5. Ethical considerations
is study protocol was approved by the ethics committee of e
First Aliated Hospital of Chongqing Medical University (No. 2022-10)
and conformed to the Helsinki Declaration. Via the web, Weprovided
brief purposes and procedures of the study to potential participants, who
were also assured that participation was completely voluntary.
3. Results
3.1. Career decision-making diculties and
its dierences among groups
e mean scores of career decision-making diculties are listed
in Table2. e total mean score of career decision-making diculties
was 2.84 (SD = 0.54). For the three dimensions of career decision-
making diculties, lack of readiness had the highest score of 2.90
(SD = 0.58), and, lack of information showed the lowest score of 2.76
(SD = 0.59).
As presented in Table1, female, younger students, students who
were never employed before enrolling in postgraduate education and
did not have experience in a career development program had
signicantly higher scores for career decision-making diculties (all
p < 0.05). Registered residence, grade, and degree type were not
signicantly associated with career decision-making diculties.
3.2. Correlation analysis
As listed in Table 2, correlation analysis showed that career
decision-making self-ecacy had a signicant negative correlation
with career decision-making diculties (r = 0.551, p < 0.01), and
professional self-concept had a signicant positive correlation with
career decision-making self-ecacy (r = 0.693, p < 0.01) and a
signicant negative correlation with career decision-making
diculties (r = 0.496, p < 0.01).
3.3. Regression analysis and mediation
eect test analysis
e results of the regression analysis are shown in Table3. With
demographic variables as controlled variables and career decision-
making diculties as the dependent variable, professional self-concept
and career decision-making self-ecacy were taken as primary
predictors in a multiple linear regression analysis. e results showed
that professional self-concept could signicantly positively predict
career decision-making self-ecacy (β = 0.654, p < 0.01), and
signicantly negatively predict career decision-making diculties
(β = 0.470, p < 0.01). Aer the introduction of career decision-
making self-ecacy, the inuence coecient (β = 0.217, p < 0.01) of
professional self-concept on career decision-making diculties
decreased. It indicated that career decision-making self-ecacy is a
partial mediator in the relationship between professional self-concept
and career decision-making diculties.
e results of the mediation eect test analysis are displayed in
Table4. Model 4in the SPSS macro program PROCESS 4.0 developed
by Hayes was used to test the mediating eect. Aer demographic
variables were controlled, professional self-concept was used as the
independent variable, career decision-making diculties as the
dependent variable, and career decision-making self-ecacy as
mediating variables, and the Bootstrap method was used to calculate
95% condence intervals for each of the 5,000 repeated draws. Result
of the mediating eect analysis showed that Bootstrap’s 95% CI of total
indirect eect did not contain 0 [Bootstrap95% CI: 0.349, 0.156],
accounting for 53.82% of the total eect. A visualization of the model
is displayed in Figure1.
4. Discussion
is study understands the current situation of career decision-
making diculties of postgraduate nursing students in China and
Bi et al. 10.3389/fpsyg.2023.1198974
Frontiers in Psychology 05 frontiersin.org
explores the mediating role of career decision-making self-ecacy
between professional self-concept and career decision-making
diculties based on SCCT. e results showed that professional self-
concept and career decision-making self-ecacy were negative
predictors of career decision-making diculties, and career decision-
making self-ecacy played a partial mediating role between
professional self-concept and career decision-making diculties. e
results of this study can provide a basis for the employment guidance
of postgraduate nursing students, to reduce their career decision-
making diculties and improve the level and quality of career
decision-making.
4.1. The career decision-making diculties
of postgraduate nursing students are at a
medium to high level
Our study showed that the total score of 2.84 (SD = 0.54) for career
decision-making diculties among postgraduate nursing students
was moderately high, which was higher than the ndings for
undergraduate nursing interns (Yin and Dong, 2019) and for medical
students (Zhu etal., 2021). e analysis may bedue to the following
reasons: In China, due to traditional beliefs and social opinions,
nurses do not have a high social status, and many students choose
nursing because of professional transfer. erefore, they tend to
bepassive in their nal career decisions. Secondly, nursing is a highly
specialized discipline, and postgraduate nursing students have two
main employment directions, becoming a teacher or a nurse, with a
narrow range of employment. Most postgraduate nursing students
prefer to beemployed in schools, but most schools require applicants
to have a doctoral degree. For healthcare organizations, the focus is
not only on academic qualications but also on clinical practice skills.
While postgraduate nursing students have a great advantage in
academic research and theoretical knowledge, clinical practice skills
may not besuperior to those of undergraduate students. Moreover, as
job seekers, postgraduate nursing students have overly high
expectations for career development prospects, salary, working
environment, prestige, and social status, which are in strong contrast
to reality. Overall, the career decision-making diculties of
postgraduate nursing students is prominent and requires active
measures by relevant departments. From the three levels of society,
school, and family, based on giving full understanding and concern to
nursing postgraduates, we should strengthen their employment
guidance, guide them to establish a correct career view, and help them
understand themselves and their employment situation, to make
satisfactory and conducive to the long-term development of career
decision-making.
In addition, the current study showed that among the three
dimensions of career decision-making diculties, the lake of readiness
dimension scored the highest, which was consistent with the results
of previous studies (Yin and Dong, 2019; Zhu etal., 2021). Since these
diculties may inhibit the initiation of the career decision-making
process, there may bemore negative career-related outcomes before
graduation if students do not deal with these diculties in the early
stages of their education (Viola et al., 2017; Kulcsar etal., 2020).
Consistent with previous research (Schnoes etal., 2018), it is not
surprising that postgraduate nursing students with experience in a
career development program have lower levels of career decision-
making diculties. Career development skills acquired during the
course can enhance students’ condence in career exploration and
decision-making. However, only 18.47% of the subjects in this study
had this experience. erefore, Nursing educators should create
awareness of early career education, pay attention to early career
education of postgraduate nursing students, build a complete and
standardized career counseling curriculum, and add career scenario
simulations inside and outside the curriculum to help postgraduate
nursing students perform career preparation activities and make
sound career decision-making.
TABLE2 Descriptive statistics and correlation analysis between variables (n = 276).
Mean  ±  SD 1 2 3 4 5 6
1. CDDQ 2.84±0.54 1
2. LR 2.90±0.58 0.916*1
3. LI 2.76±0.59 0.965*0.828*1
4. II 2.88±0.54 0.956*0.822*0.883*1
5. PSC 2.72±0.36 0.496* 0.415* 0.500* 0.477*1
6. CDMSE 3.32±0.64 0.551* 0.441* 0.564* 0.536*0.639*1
CDDQ, career decision-making diculties; LR, lack of readiness; LI, lack of information; II, inconsistent information; PSC, professional self-concept; CDMSE, career decision-making self-
ecacy. *p < 0.01.
TABLE3 Regression analysis of the relationship between variables (n =  276).
Outcome
variable
Predictor
variable
βSE t p LLCI ULCI R2F
CDMSE PSC 0.654 0.071 13.777 0.000 0.837 1.116 0.393 189.806
CDDQ PSC 0.470 0.097 8.711 0.000 1.032 0.651 0.203 75.878
CDDQ CDMSE 0.387 0.119 3.259 0.001 0.622 0.154 0.286 60.241
PSC 0.217 0.079 5.912 0.000 0.619 0.310
CDDQ, career decision-making diculties; PSC, professional self-concept; CDMSE, career decision-making self-ecacy.
Bi et al. 10.3389/fpsyg.2023.1198974
Frontiers in Psychology 06 frontiersin.org
4.2. The positive professional self-concept
can reduce the career decision-making
diculties of postgraduate nursing
students
e results of this study revealed that the professional self-concept
of postgraduate nursing students was negatively related to career
decision-making diculties and had a negative predictive eect on
career decision-making diculties (p < 0.01), indicating that the more
positive professional self-concept of postgraduate nursing students,
the lower their career decision-making diculties. Career
development theory states that professional self-concept plays an
important role in the career decision-making process and is a core
element of career value orientation (Stephenson and Bell, 2019), and
those with positive professional self-concept usually have a stronger
sense of career competence and career beliefs, which leads to better
preparation and more active collection of employment information
when choosing a career, and then making eective career decision-
making (Lv etal., 2014). It is suggested that nursing educators should
pay attention to the cultivation and development of positive
professional self-concept of postgraduate nursing students, and can
help postgraduate nursing students to correctly understand career
benets and career values and strengthen their sense of career identity
through mentorship (OARC, 2013) and peer counseling (Besnilian
et al., 2016), to cultivate their positive professional self-concept,
reduce the degree of career decision-making diculties, and improve
the level and quality of career decision- making.
4.3. Career decision-making self-ecacy
played a partial mediating role between
professional self-concept and career
decision-making diculties
e results of this study indicated that career decision-making
self-ecacy among postgraduate nursing students was negatively
associated with career decision-making diculties, which is
consistent with the ndings of several previous studies (Storme etal.,
2017; Santos etal., 2018; Jemini-Gashi etal., 2019). Furthermore, as
shown in Table 4, career decision-making self-ecacy partially
mediated the eect of professional self-concept on career decision-
making diculties (p < 0.01), suggesting that professional self-
concept can not only directly inuence career decision-making
diculties, but also indirectly through career decision-making self-
ecacy. is further conrms the important contribution of the
career choice ecacy intervention to career decision-making and
career development. According to Bandura’s self-ecacy theory
(Bandura, 1977), career decision-making self-ecacy is an
individual’s self-perception of his or her abilities, career interests, and
career aspirations during the career choice process, and this level of
self-perception inuences the individual’s thinking style, emotional
response, eort, and career choice, etc. SCCT (Lent etal., 1994) stated
that success and failure experiences related to career activities,
supportive role models, social and verbal persuasive communication,
and positive emotional responses are the main sources of information
that inuence the formation and development of career decision-
making self-ecacy. erefore, the relevant departments of the
university can enhance the career decision-making self-ecacy by
inviting outstanding nursing seniors and alumni to conduct lectures
related to disciplinary development and employment, so that
postgraduate nursing students can feel the sense of achievement,
honor, and pride brought by nursing work. In addition, the formation
of career decision-making self-ecacy is inuenced by factors such
as attribution style, goal setting, and timely feedback (Betz, 2004). So,
nursing educators should guide postgraduate nursing students to face
diculties and setbacks with an optimistic attitude, instruct them to
use correct attribution styles, and actively seek social support from
all aspects to improve career decision-making self-ecacy and make
eective career decision-making.
5. Limitations
The present study has several limitations. Firstly, this study is
a cross-sectional study, and it is not possible to directly infer
causal relationships between variables. Secondly, all data were
collected through a self-report questionnaire, which may lead to
some bias in the study results. Thirdly, the sample size was small,
which limited the generalizability of the results. Future sample
sizes could be increased and a longitudinal study could
beconducted to explore in-depth other influencing factors and
targeted interventions for career decision-making difficulties
among postgraduate nursing students. This will provide nursing
educators with ways to improve the career decision-making
difficulties of postgraduate nursing students.
TABLE4 The mediating eect of career decision-making self-ecacy
between professional self-concept and career decision-making
diculties (n =  276).
Path Eect Boot
SE
Boot
LLCI
Boot
ULCI
Relative
eect
Total eect 0.470 0.097 1.032 0.651 100%
Direct eect 0.217 0.119 0.622 0.154 46.18%
Indirect eect 0.253 0.048 0.349 0.156 53.82%
FIGURE1
Model of the mediating role of CDMSE between PSC and CDDQ
(n =  276) Career Decision-making Diculties (CDDQ), Professional
Self-concept (PSC), Career Decision-making Self-ecacy (CDMSE).
*p <  0.01. a, the standardized regression coecient between PSC and
CDMSE; b, the standardized regression coecient of CDMSE on
CDDQ; c, the total eect between PSC and CDDQ; c’, the direct
eect of PSC on CDDQ.
Bi et al. 10.3389/fpsyg.2023.1198974
Frontiers in Psychology 07 frontiersin.org
6. Conclusion
In conclusion, the career decision-making diculties of
postgraduate nursing students are at a medium to high level for
postgraduate nursing students, and professional self-concept and
career decision-making self-ecacy were negatively correlated with
career decision-making diculties, and career decision-making self-
ecacy mediated between professional self-concept and career
decision-making diculties. It is demonstrated that measures and
strategies to improve career decision-making self-ecacy are expected
to mitigate the eects of professional self-concept on career decision-
making diculties. It is suggested nursing educators need to develop
a complete and standardized career counseling curriculum for
postgraduate nursing students, and should pay attention to the
cultivation and development of positive professional self-concept and
career decision-making self-ecacy of postgraduate nursing students
to reduce their career decision-making diculties and help them
make eective career decision-making.
Data availability statement
e raw data supporting the conclusions of this article will
bemade available by the authors, without undue reservation.
Ethics statement
e studies involving human participants were reviewed and
approved by the First Aliated Hospital of Chongqing Medical
University (No. 2022-10). e patients/participants provided their
written informed consent to participate in this study.
Author contributions
YB, SM, GW, and ML made significant contributions to the
conception and design, acquisition of data, or analysis and
interpretation of data, participated in drafting the article or
critically revising important intellectual content, agreed to
submit the article to the current journal, gave final approval of
the version to bepublished, and agreed to take responsibility for
all aspects of the work. All authors contributed to the article and
approved the submitted version.
Acknowledgments
The authors would like to thank all schools who participated
in this study.
Conflict of interest
e authors declare that the research was conducted in the
absence of any commercial or nancial relationships that could
beconstrued as a potential conict of interest.
Publisher’s note
All claims expressed in this article are solely those of the authors
and do not necessarily represent those of their aliated organizations,
or those of the publisher, the editors and the reviewers. Any product
that may be evaluated in this article, or claim that may be made by its
manufacturer, is not guaranteed or endorsed by the publisher.
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... indicating a moderate to high difficulty in career decision-making. The mean score of 3.10 (SD = 0.68) was higher than the findings for nursing students (Bi et al., 2023). These difficulties can be attributed to various factors, including lack of readiness, information deficits, and inconsistent information, which align with previous research identifying these as common challenges in career decision-making (Kulcsár et al., 2020). ...
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Aims and objectives: The present study was aimed at describing the status of job burnout and exploring the mediating roles of psychological capital and professional identity on the association between organisational justice and job burnout. Background: With the shortage of nurses all over the world, nurses' job burnout has become the focus of studies in recent years. However, limited published research has examined the mediating roles of psychological capital and professional identity on the association between organisational justice and job burnout within hospital contexts in China. Design: A cross-sectional design. Methods: A total of 1,009 nurses were enrolled from a major general hospital located in Qiqihar City in the northeast of China from March-July 2018, and asked to complete questionnaires regarding organisational justice, psychological capital, professional identity and job burnout. The STROBE checklist was adhered to in this study. Results: It was observed that the overall proportion of nurses with job burnout was 58.8%. All the correlations among organisational justice, psychological capital, professional identity and job burnout were statistically significant, with coefficients ranging between -0.487-0.863. Psychological capital and professional identity had indirect effects equal to -0.072 and -0.142, respectively, on the association between organisational justice and job burnout, taking up 13.7% and 26.9% of the total effect, respectively. The serial indirect effect of psychological capital and professional identity was -0.129, accounting for 24.5% of the total effect. Conclusions: This study showed the necessity of addressing the status of job burnout among Chinese nurses. Psychological capital and professional identity may mediate the linkage between organisational justice and job burnout independently and accumulatively. Relevance to clinical practice: Nursing managers should strengthen organisational justice and improve the psychological capital and professional identity of nurses through effective strategies to prevent the job burnout of nurses.
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Aims and objectives This study aimed to implement cluster analysis of self‐concept and job satisfaction to identify subgroups in nurses with master's degree and explore the associations of turnover intention with characteristics among these clusters. Design A cross‐sectional study adhering to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). Methods A convenience sample of 408 nurses with master's degree in China filled out the survey from 19 November 2019 to 30 December 2019. A sociodemographic questionnaire, the Nurses’ Self‐Concept Questionnaire (NSCQ), Job Satisfaction Scale (JSS) and Turnover Intention Questionnaire (TIQ) were adopted to collect the data. K‐means cluster analysis was implemented on the R software, and data were analysed using SPSS 24.0. Results Three subgroups were identified based on cluster analysis of NSCQ and JSS subscales in 405 nurses (99.3%) available for statistical analysis, among whom 30.9%, 17% and 48.1% were allocated to these clusters respectively. Turnover intention significantly differed among the three clusters, with cluster 2 having the highest turnover intention and cluster 1 having the lowest turnover intention. Working department, position, professional title, clinical nurse specialist and annual income were factors differentiating TIQ scores in each cluster. Conclusions This study identified three clusters of nurses with master's degree and showed that each cluster was associated with the level of turnover intention. The unique characteristics of the three clusters may be also helpful in identifying and providing specific managerial or social support to reduce turnover rates in nurses with master's degree. Relevance to clinical practice Cluster analysis is s an unsupervised machine learning method to identify meaningful subgroups within heterogeneous population based on variables distributions and patterns underlying in the data set. Through clustering, nurses with multi‐dimensional characteristics could be allocated into subgroups associated with turnover intention. As a result, nursing managers could provide approaches for each subgroup to reduce turnover intention.