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Frontiers in Psychology 01 frontiersin.org
The relationship between
professional self-concept and
career decision-making diculties
among postgraduate nursing
students in China: the mediating
role of career decision-making
self-ecacy
YapingBi
1, ShaoyuMou
2, GeWang
1* and MingyanLiao
1
1 Department of Hematology, The First Aliated 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 diculties among
postgraduate nursing students.
Objectives: Exploring the mediating role of career decision-making self-ecacy
between professional self-concept and career decision-making diculties
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 diculties Questionnaire, Career
Decision-making Self-Ecacy 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 diculties was 2.84 (SD = 0.54).
Professional self-concept (r = −0.496, p < 0.01) and career decision-making self-
ecacy (r = −0.551, p < 0.01) were negatively associated with career decision-
making diculties. Career decision-making self-ecacy played a partial mediating
role between professional self-concept and career decision-making diculties
(p < 0.01), with the mediating eect (Eect Value = −0.253, Bootstrap 95% CI:
−0.349, −0.156) accounting for 53.82% of the total eect.
Conclusion: The high scores of career decision-making diculties 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-ecacy of postgraduate nursing students to reduce their career decision-
making diculties and help them make eective career decision-making.
OPEN ACCESS
EDITED BY
Antonio P. Gutierrez de Blume,
Georgia Southern University, UnitedStates
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 diculties among
postgraduate nursing students in China: the
mediating role of career decision-making
self-ecacy.
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 diculties, career decision-
making self-ecacy, professional self-concept, mediating role, social cognitive career
theory
1. Introduction
A career has a signicant 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 diculties refer to the diculties 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 diculties: 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 aer the career decision-making process has
begun (Gati etal., 1996; Lipshits-Braziler etal., 2016).
Career decision-making diculties oen 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
aer work (Gan etal., 2020; Wang, 2020; Ren etal., 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 etal., 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 etal., 2022). In addition, the
value of providing structured courses to help medical students make
career decisions has been recognized (Navarro etal., 2011; Park, 2015;
Howse etal., 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 etal., 2015; Zhang etal., 2019; Wang etal., 2020).
A better understanding of postgraduate nursing students’ career decision-
making diculties and its related inuencing factors will provide a
reference for designing targeted interventions to alleviate postgraduate
nursing students’ career decision-making diculties. However, few
studies have focused on the career decision-making diculties of
postgraduate nursing students (Zhou etal., 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 etal., 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
inuence of professional self-concept on the career decision-making
and development of postgraduate nursing students is still unknown.
Self-ecacy is an individual’s belief in his or her ability to organize
and execute a series of actions to achieve a specic goal. According to
the social cognitive career theory (SCCT) (Lent etal., 1994), career
decision-making self-ecacy is the application of self-ecacy in the
career eld, that is, an individual’s belief in his or her ability to engage
in career decision-making activities (such as collecting career
information or selecting career goals) (Betz etal., 1996). Taylor and
Betz (1983) proposed that the career decision-making self-ecacy
can explain the dierences in individual career decision-making
diculties. Relevant studies also showed that career decision-making
self-ecacy is negatively correlated with career decision-making
diculties (Penn and Lent, 2018; Santos et al., 2018), that is, the
stronger the individual’s condence in choosing a career, the lower the
degree of career decision-making diculties, and the more eective
career decision-making can bemade. At the same time, studies have
reported that career decision-making self-ecacy is positively
correlated with professional self-concept (Lv etal., 2014).
In conclusion, as previous studies have shown, both professional self-
concept and career decision-making self-ecacy can aect individuals’
career decision-making. Moreover, according to SCCT (Lent etal., 1994),
individual dierences, environmental factors, and individual behavior
will aect the condence of the ability of individuals to implement
occupation-related tasks and activities through interaction, thereby
aecting the process of individual career choice and shaping occupational
behavior. However, so far, no studies have examined the comprehensive
eect of professional self-concept and career decision-making self-
ecacy on the generation of career decision-making diculties in
postgraduate nursing students, and whether career decision-making self-
ecacy plays a mediating role between professional self-concept and
career decision-making diculties. SCCT has been applied to several
disciplines (Gao etal., 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 diculties impair the career decision-making
process among postgraduate nursing students, as measured by career
decision-making diculties, (2) to explore the inuence of
professional self-concept on the career decision-making diculties
among postgraduate nursing students, and (3) to clarify the mediating
role of career decision-making self-ecacy between professional self-
concept and career decision-making diculties 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
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sample, a stratied 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 befull-time enrolled postgraduate
nursing students who volunteered for this survey. e exclusion
criteria for this study included: ① postgraduate nursing students
who are part-time education graduate students or are employed
and ② 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 Table1).
e sample size was calculated according to the principle of
Kendall estimation of sample size (Ni etal., 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 satised 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 diculties
Career decision-making diculties were measured using a Chinese
version of the Career Decision-making Diculty Questionnaire
developed by (Wu etal., 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 diculties. 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-ecacy
Career decision-making self-ecacy was measured using a
Chinese version of the Career Decision-making Self-ecacy 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 condent at all” to (5)
“completely condent.” A higher score indicates higher career
decision-making self-ecacy. 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 etal., 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
TABLE1 Participants characteristics and dierences of career decision-making diculties among groups (n=276).
Variable Group Frequency
(percentage)
Career decision-making
diculties (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 aer completing all the questions independently. e
validity and completeness of the completed questionnaires were veried
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) soware
(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-
ecacy, and career decision-making diculties. Weused a t-test or an
analysis of variance to evaluate dierences among the participants in
terms of career decision-making diculties, and Pearson’s r was
calculated to test correlations among career decision-making
diculties, professional self-concept, and career decision-making self-
ecacy among nursing graduate students. Multiple linear regression
analysis was used to explore the mediating eects of professional self-
concept, career decision-making self-ecacy, and career decision-
making diculties. Finally, a nonparametric resampling method
(5,000 iterations) was applied by running the PROCESS plugin in the
SPSS Macro to test the statistical signicance of the mediating eect.
In all analyses, statistically signicant was set at p-value < 0.05.
2.5. Ethical considerations
is study protocol was approved by the ethics committee of e
First Aliated Hospital of Chongqing Medical University (No. 2022-10)
and conformed to the Helsinki Declaration. Via the web, Weprovided
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 diculties and
its dierences among groups
e mean scores of career decision-making diculties are listed
in Table2. e total mean score of career decision-making diculties
was 2.84 (SD = 0.54). For the three dimensions of career decision-
making diculties, 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 Table1, female, younger students, students who
were never employed before enrolling in postgraduate education and
did not have experience in a career development program had
signicantly higher scores for career decision-making diculties (all
p < 0.05). Registered residence, grade, and degree type were not
signicantly associated with career decision-making diculties.
3.2. Correlation analysis
As listed in Table 2, correlation analysis showed that career
decision-making self-ecacy had a signicant negative correlation
with career decision-making diculties (r = −0.551, p < 0.01), and
professional self-concept had a signicant positive correlation with
career decision-making self-ecacy (r = 0.693, p < 0.01) and a
signicant negative correlation with career decision-making
diculties (r = −0.496, p < 0.01).
3.3. Regression analysis and mediation
eect test analysis
e results of the regression analysis are shown in Table3. With
demographic variables as controlled variables and career decision-
making diculties as the dependent variable, professional self-concept
and career decision-making self-ecacy were taken as primary
predictors in a multiple linear regression analysis. e results showed
that professional self-concept could signicantly positively predict
career decision-making self-ecacy (β = 0.654, p < 0.01), and
signicantly negatively predict career decision-making diculties
(β = −0.470, p < 0.01). Aer the introduction of career decision-
making self-ecacy, the inuence coecient (β = −0.217, p < 0.01) of
professional self-concept on career decision-making diculties
decreased. It indicated that career decision-making self-ecacy is a
partial mediator in the relationship between professional self-concept
and career decision-making diculties.
e results of the mediation eect test analysis are displayed in
Table4. Model 4in the SPSS macro program PROCESS 4.0 developed
by Hayes was used to test the mediating eect. Aer demographic
variables were controlled, professional self-concept was used as the
independent variable, career decision-making diculties as the
dependent variable, and career decision-making self-ecacy as
mediating variables, and the Bootstrap method was used to calculate
95% condence intervals for each of the 5,000 repeated draws. Result
of the mediating eect analysis showed that Bootstrap’s 95% CI of total
indirect eect did not contain 0 [Bootstrap95% CI: −0.349, −0.156],
accounting for 53.82% of the total eect. A visualization of the model
is displayed in Figure1.
4. Discussion
is study understands the current situation of career decision-
making diculties 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-ecacy
between professional self-concept and career decision-making
diculties based on SCCT. e results showed that professional self-
concept and career decision-making self-ecacy were negative
predictors of career decision-making diculties, and career decision-
making self-ecacy played a partial mediating role between
professional self-concept and career decision-making diculties. e
results of this study can provide a basis for the employment guidance
of postgraduate nursing students, to reduce their career decision-
making diculties and improve the level and quality of career
decision-making.
4.1. The career decision-making diculties
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 diculties 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 etal., 2021). e analysis may bedue 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
bepassive 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 beemployed in schools, but most schools require applicants
to have a doctoral degree. For healthcare organizations, the focus is
not only on academic qualications 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 besuperior 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 diculties 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 diculties, the lake of readiness
dimension scored the highest, which was consistent with the results
of previous studies (Yin and Dong, 2019; Zhu etal., 2021). Since these
diculties may inhibit the initiation of the career decision-making
process, there may bemore negative career-related outcomes before
graduation if students do not deal with these diculties in the early
stages of their education (Viola et al., 2017; Kulcsar etal., 2020).
Consistent with previous research (Schnoes etal., 2018), it is not
surprising that postgraduate nursing students with experience in a
career development program have lower levels of career decision-
making diculties. Career development skills acquired during the
course can enhance students’ condence 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.
TABLE2 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 diculties; LR, lack of readiness; LI, lack of information; II, inconsistent information; PSC, professional self-concept; CDMSE, career decision-making self-
ecacy. *p < 0.01.
TABLE3 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 diculties; PSC, professional self-concept; CDMSE, career decision-making self-ecacy.
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
diculties 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 diculties and had a negative predictive eect on
career decision-making diculties (p < 0.01), indicating that the more
positive professional self-concept of postgraduate nursing students,
the lower their career decision-making diculties. 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 eective career decision-
making (Lv etal., 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
benets 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 diculties, and improve
the level and quality of career decision- making.
4.3. Career decision-making self-ecacy
played a partial mediating role between
professional self-concept and career
decision-making diculties
e results of this study indicated that career decision-making
self-ecacy among postgraduate nursing students was negatively
associated with career decision-making diculties, which is
consistent with the ndings of several previous studies (Storme etal.,
2017; Santos etal., 2018; Jemini-Gashi etal., 2019). Furthermore, as
shown in Table 4, career decision-making self-ecacy partially
mediated the eect of professional self-concept on career decision-
making diculties (p < 0.01), suggesting that professional self-
concept can not only directly inuence career decision-making
diculties, but also indirectly through career decision-making self-
ecacy. is further conrms the important contribution of the
career choice ecacy intervention to career decision-making and
career development. According to Bandura’s self-ecacy theory
(Bandura, 1977), career decision-making self-ecacy 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 inuences the individual’s thinking style, emotional
response, eort, and career choice, etc. SCCT (Lent etal., 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 inuence the formation and development of career decision-
making self-ecacy. erefore, the relevant departments of the
university can enhance the career decision-making self-ecacy 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-ecacy is inuenced by factors such
as attribution style, goal setting, and timely feedback (Betz, 2004). So,
nursing educators should guide postgraduate nursing students to face
diculties 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-ecacy and make
eective 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
beconducted 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.
TABLE4 The mediating eect of career decision-making self-ecacy
between professional self-concept and career decision-making
diculties (n = 276).
Path Eect Boot
SE
Boot
LLCI
Boot
ULCI
Relative
eect
Total eect −0.470 0.097 −1.032 −0.651 100%
Direct eect −0.217 0.119 −0.622 −0.154 46.18%
Indirect eect −0.253 0.048 −0.349 −0.156 53.82%
FIGURE1
Model of the mediating role of CDMSE between PSC and CDDQ
(n = 276) Career Decision-making Diculties (CDDQ), Professional
Self-concept (PSC), Career Decision-making Self-ecacy (CDMSE).
*p < 0.01. a, the standardized regression coecient between PSC and
CDMSE; b, the standardized regression coecient of CDMSE on
CDDQ; c, the total eect between PSC and CDDQ; c’, the direct
eect 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 diculties of
postgraduate nursing students are at a medium to high level for
postgraduate nursing students, and professional self-concept and
career decision-making self-ecacy were negatively correlated with
career decision-making diculties, and career decision-making self-
ecacy mediated between professional self-concept and career
decision-making diculties. It is demonstrated that measures and
strategies to improve career decision-making self-ecacy are expected
to mitigate the eects of professional self-concept on career decision-
making diculties. 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-ecacy of postgraduate nursing students
to reduce their career decision-making diculties and help them
make eective career decision-making.
Data availability statement
e raw data supporting the conclusions of this article will
bemade available by the authors, without undue reservation.
Ethics statement
e studies involving human participants were reviewed and
approved by the First Aliated 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 bepublished, 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
beconstrued as a potential conict 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 aliated 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.
References
Bandura, A. (1977). Self-ecacy: toward a unifying theory of behavioral change.
Psychol. Rev. 84, 191–215. doi: 10.1037/0033-295X.84.2.191
Besnilian, A., Goldenberg, A., and Plunkett, S. W. (2016). Promoting diversity within
the dietetics profession through a peer mentorship program. J. Acad. Nutr. Diet. 116,
198–202. doi: 10.1016/j.jand.2015.07.018
Betz, N. E. (2004). Contributions of self-ecacy theory to career counseling: a personal
perspective. Career Dev. Q. 52, 340–353. doi: 10.1002/j.2161-0045.2004.tb00950.x
Betz, N. E., Klein, K. L., and Taylor, K. M. (1996). Evaluation of a short form of the
career decision-making self-ecacy scale. J. Career Assess. 4, 47–57. doi:
10.1177/106907279600400103
Gan, L., Zhang, H. Y., Shang, W. H., Li, X., Ma, X., and Wu, Z. (2020). Nursing
turnover rate and its inuencing factors. Chin. J. Nurs. Educ. 55, 198–203.
Gao, Z., Wei, X., Yang, L., Cui, D., Kong, L., Qi, L., et al. (2021). Mediating role of
career self-ecacy between clinical learning environment and professional identity in
nursing students. J. Adv. Nurs. 78, 1012–1019. doi: 10.1111/jan.15027
Gati, I., Krausz, M., and Osipow, S. H. (1996). A taxonomy of diculties in career
decision making. J. Couns. Psychol. 43, 510–526. doi: 10.1037/0022-0167.43.4.510
Goliroshan, S., Nobahar, M., R aeisdana, N., Ebadinejad, Z., and Aziznejadroshan, P.
(2021). e protective role of professional self-concept and job embeddedness on nurses'
burnout: structural equation modeling. BMC Nurs. 20:203. doi: 10.1186/s12912-021-00727-8
Hou, J., Michaud, C., Li, Z., Dong, Z., Sun, B., Zhang, J., et a l. (2014). Transformation
of the education of health professionals in China: progress and challenges. Lancet 384,
819–827. doi: 10.1016/s0140-6736(14)61307-6
Howse, K., Harris, J., and Dalgarno, N. (2017). Canadian national guidelines and
recommendations for integrating career advising into medical school curricula. Acad
Med. 92, 1543–1548. doi: 10.1097/ACM.0000000000001720
Jemini-Gashi, L., Duraku, Z. H., and Kelmendi, K. (2019). Associations between social
support, career self-ecacy, and career indecision among youth. Curr. Psychol. 40,
4691–4697. doi: 10.1007/s12144-019-00402-x
Kelly, B. (1992). e professional self-concepts of nursing undergraduates and their
perceptions of inuential forces. J. Nurs. Educ. 31, 121–125. doi: 10.3928/
0148-4834-19920301-08
Kulcsar, V., Dobrean, A., and Balazsi, R. (2020). Does it matter if Iama worrier? e
eect of worry as a moderator between career decision-making diculties and negative
dysfunctional emotions. J. Youth Adolesc. 49, 549–564. doi: 10.1007/s10964-019-01118-8
Lee, J. L. (2019). e inuence of nursing organizational culture, professional self-
concept and career decision-making self-ecacy on career preparation behavior in
nursing students with clinical practice. J. Korean Nurs. Res. 3, 61–73. doi: 10.34089/
jknr.2019.3.3.61
Lent, R. W., Brown, S. D., and Hackett, G. (1994). Toward a unifying social cognitive
theory of career and academic interest, choice, and performance. J. Vocat. Behav. 45,
79–122. doi: 10.1006/jvbe.1994.1027
Li, X., Guo, Y., Zhao, T., Zhang, S., Yue, X., and Liu, Y. (2021). Cluster analysis of self-
concept and job satisfaction in Chinese nurses with master's degree to identify their
turnover intention: a cross-sectional study. J. Clin. Nurs. 30, 2057–2067. doi: 10.1111/
jocn.15762
Lipshits-Braziler, Y., Tatar, M., and Gati, I. (2016). e eectiveness of strategies for
coping with career indecision. J. Career Dev. 44, 453–468. doi: 10.1177/0894845316662705
Long, Y. M. (2003). e study on the career decision-making self-ecacy of the college
students. [dissertation/master’s thesis]. [China]: Shanghai Teachers Uuiversity.
Lv, F. F., He, H., Lv, P. Y., and Miu, Z. Z. (2014). Impacts of self-concept on career
decision-making self-ecacy among undergraduate nursing students. J. Nurs. Adm. 14,
190–191.
Navarro, A. M., Taylor, A. D., and Pokorny, A. P. (2011). ree innovative curricula
for addressing medical students’ career development. Acad Med. 86, 72–76. doi: 10.1097/
ACM.0b013e31817dfc
Ni, P., Chen, L., and Liu, N. (2010). e sample size estimation in quantitative nursing
research. Chin. J. Nurs. 45, 378–380.
Bi et al. 10.3389/fpsyg.2023.1198974
Frontiers in Psychology 08 frontiersin.org
Ni, J. C., Wang, W. M., and Li, D. C. (2022). Inuence of psychological separation on
master graduates' career maturity: mediating role of occupational self-ecacy. Front.
Psychol. 13:833577. doi: 10.3389/fpsyg.2022.833577
OARC, A. P. (2013). Use APIC's mentoring program to take your profession to the
next level. Am. J. Infect. Control 41:575. doi: 10.1016/j.ajic.2013.04.002
Park, S. (2015). Effects of discipline-based career course on nursing students’
career search self-efficacy, career preparation behavior, and perceptions of career
barriers. Asian Nurs Res (Korean Soc Nurs Sci). 9, 259–264. doi: 10.1016/j.
anr.2015.06.003
Penn, L. T., and Lent, R. W. (2018). e joint roles of career decision self-ecacy and
personality traits in the prediction of career decidedness and decisional diculty. J.
Career Assess. 27, 457–470. doi: 10.1177/1069072718758296
Ren, Z., Zhang, X., Li, X., He, M., Shi, H., Zhao, H., et al. (2021). Relationships of
organisational justice, psychological capital and professional identity with job burnout
among Chinese nurses: a cross-sectional study. J. Clin. Nurs. 30, 2912–2923. doi:
10.1111/jocn.15797
Santos, A., Wang, W., and Lewis, J. (2018). Emotional intelligence and career decision-
making diculties: the mediating role of career decision self-ecacy. J. Vocat. Behav.
107, 295–309. doi: 10.1016/j.jvb.2018.05.008
Schnoes, A. M., Caliendo, A., Morand, J., Dillinger, T., Naziger-Hirsch, M., Moses, B.,
et al. (2018). Internship experiences contribute to condent career decision making for
doctoral students in the life sciences. CBE Life Sci. Educ. 17:ar16. doi: 10.1187/
cbe.17-08-0164
Stephenson, A. L., and Bell, N. (2019). Social identity and the prison health worker:
implications for practitioner satisfaction and turnover intentions. Health Care Manag.
Re v. 44, 286–295. doi: 10.1097/HMR.0000000000000179
Storme, M., Celik, P., and Myszkowski, N. (2017). Career decision ambiguity
tolerance and career decision-making diculties in a French sample: the mediating
role of career decision self-ecacy. J. Career Assess. 27, 273–288. doi:
10.1177/1069072717748958
Sun, H. Y., Zhu, L. N., and Dang, Y. (2015). Introduction of national guidelines and
core curriculums of master of nursing specialist programs. Chin. J. Nurs. Educ. 12,
725–729.
Taylor, K. M., and Betz, N. E. (1983). Applications of self-ecacy theory to the
understanding and treatment of career indecision. J. Vocat. Behav. 22, 63–81. doi:
10.1016/0001-8791(83)90006-4
Viola, M. M., Musso, P., Ingoglia, S., Lo Coco, A., and Inguglia, C. (2017).
Relationships between career indecision, search for work self-ecacy, and psychological
well-being in Italian never-employed young adults. Eur. J. Psychol. 13, 231–250. doi:
10.5964/ejop.v13i2.1277
Wang, X. (2020). e inuence of career decision making self-ecacy and professional
identication on career decision-making diculty of nursing undergraduates. Chin. J.
Nurs. Educ. 17, 1097–1100.
Wang, J. Y., Wei, Z. X., Jin, X. Y., and Hou, L. Y. (2020). e status of enrollment and
course setting of master of nursing specialist in 75 colleges. Chin. J. Nurs. Educ. 17,
1089–1093.
WHO. (2020). State of the world's nursing 2020: Investing in education, jobs and
leadership. Available at: (https://www.who.int/publications/i/item/9789240003279).
Wu, K. R., Sun, L., and Xu, T. (2016). e revision of the career decision-making
diculties questionnaire of universities. Chin. J. Health Psychol. 24, 1050–1055. doi:
10.13342/j.cnki.cjhp.2016.07.025
Yang, G. R., Lin, X. Y., Yang, G. Z., and Wang, L. H. (2008). e reliability and validity
of self-concept of nurses instrument used in the baccalaureate nursing students. J. Nurs.
Sci. 1, 4–6.
Yin, Q., and Dong, C. M. (2019). e correlation between career decision-making
diculties and social support for undergraduate nursing students. Chin. J. Nurs. Educ.
16, 133–137.
Zhang, L. B., Jiang, A. L., Zhang, B., and Liu, L. (2019). Current status of curricula for
nursing academic master’s degree program in China: a nationwide survey. J. Nurs. Sci.
34, 59–62.
Zhou, H. Z., Hou, J., Yang, L., Tu, Y., Liu, Y., and Hu, R. (2021). Analysis of the status
of career decision- making and its inuencing factors among nursing postgraduate
students. Chin. J. Pract. Nurs. 37, 831–837.
Zhu, Y., Zuo, T., Lai, Y., Zhao, S., and Qu, B. (2021). e associations between coping
strategies, psychological health, and career indecision among medical students: a cross-
sectional study in China. BMC Med. Educ. 21:334. doi: 10.1186/s12909-021-02781-x
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