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Relationship between sense of coherence and professional identity in nursing students: the chain mediating effect of academic emotion and self-esteem

BMC Nursing volume 24, Article number: 556 (2025) Cite this article

Abstract

Background

The psychological conditions of nursing students are quite important, and professional identity is an important part of the stable development of the nursing profession. Nursing students’ sense of coherence, academic emotion, and self-esteem may be related to professional identity. This study was designed to examine the specific relationships and effect pathways between sense of coherence, professional identity, academic emotion, and self-esteem in nursing students, and to evaluate the chain mediating role of academic emotion and self-esteem between sense of coherence and professional identity.

Methods

This study used a cross-sectional design for data collection and analysis. A total of 286 Chinese nursing undergraduates participated in this cross-sectional study and completed the sense of coherence scale, professional identity questionnaire for nursing students, general academic emotion questionnaire for college students, and self-esteem scale. A structural equation model was established to examine the effect pathways, and the chain mediating effect was verified by path analysis and bootstrap method.

Results

Pearson correlation analysis found significant relationships among sense of coherence, professional identity, academic emotion, and self-esteem. Path analysis indicated that sense of coherence not only directly predicted professional identity (effect value = 0.33), but also indirectly predicted professional identity through the mediating effect of academic emotion and self-esteem respectively: sense of coherence→ positive academic emotion→ professional identity (effect value = 0.32); sense of coherence→ self-esteem→ professional identity (effect value = 0.04). In addition, academic emotion and self-esteem played a chain mediating role between sense of coherence and professional identity: sense of coherence→ positive academic emotion→ self-esteem→ professional identity (effect value = 0.05); sense of coherence→ negative academic emotion→ self-esteem→ professional identity (effect value = 0.02).

Conclusion

The study contributes to the understanding of the relationship between sense of coherence and professional identity among nursing students. Moreover, the results may provide insights for educators and health professionals, potentially contributing to improving the quality of nursing education and strengthening the professional identity of nursing students.

Clinical trial number

Not applicable.

Peer Review reports

Introduction

Nursing students play a critical role in the advancement of the nursing profession and serve as a valuable reserve force, their contribution is vital for the overall development of nursing. Professional identity is crucial for nursing students and nurses and potentially influences retention rates, and a positive professional identity benefits not only the quality of nursing, but also other medical staff [1]. The good psychological state of nursing students is conducive to their professional identity [2]. Sense of coherence may reflect individual’s psychological condition to some extent [3], and higher sense of coherence could contribute to professional identity [4]. In addition, academic emotion and self-esteem may also be associated with professional identity. Academic emotions hold significant implications for students’ academic performance and professional goals [5], and professional identity can be informed by educational and emotional factors [6]. Moreover, self-esteem may influence nursing students’ professional identity [7]. There seems to be a link between sense of coherence, self-esteem, academic emotion, and professional identity, but the specific relationship is still unknown. Therefore, it is crucial to delve into the relationship between sense of coherence, academic emotion, self-esteem and professional identity in nursing students.

Sense of coherence (SOC) refers to the pervasive, enduring and dynamic feeling of confidence people have when under stress, and as a “stabilizer”, it promotes and maintains people’s psychological health, and the level of SOC reflects an individual’s psychological state [3]. Under stressful conditions, individuals with higher levels of SOC experience more positive emotions and exhibit faster emotional recovery, while individuals with lower levels of SOC experience more mental health problems and are more prone to experience negative emotions like anxiety, depression, or low self-esteem [8, 9]. This suggests that SOC may affect individuals’ emotions and self-esteem. According to a study conducted in Norway, nursing students’ quality of life and satisfaction during their internship can be seriously affected by heavy pressure and a decrease in SOC levels [10]. At present, research on the sense of coherence of undergraduate nursing students is limited.

Professional identity in nursing refers to the beliefs and values individuals hold about their profession, and prior to embarking on nursing education, students may have already formed values and views about the profession. However, students’ professional identity may change as they go through the process of learning and working, consequently shaping their values and beliefs in nursing [1]. In China, factors such as the lower social status and income and the traditional stereotype about nurses may influence nursing students’ career choices, and less than 50% of nursing graduates express willingness to work as nurses out of passion and interest, with the majority of students choosing nursing as a career because of job prospects or parental expectations [11]. In addition to social status and income, relationship with patients, and work environment, one’s psychological state also plays a crucial role in professional identity [2, 12]. SOC reflects people’s psychological state, so we can speculate that SOC is related to professional identity.

Academic emotions are individuals’ various emotional experiences in learning activities, especially those emotions experienced by students in the school environment [5]. Academic emotions hold significant implications for students’ academic performance, social interactions, and future career planning. Based on Pekrun’s control-value theory, students attach importance to learning when they perceive it as valuable for their professional goals, and their emotional reactions to learning could be more intense [5]. Due to academic pressure, educational quality, and clinical internship, the academic emotional experience of Chinese nursing students is alarming [13]. Academic emotions are closely related to learning motivation and psychological well-being, and negative academic emotions significantly affect students’ perceptions and behaviors [14]. A study on medical students has found that academic emotions affect psychological health. And positive academic emotions are associated with better psychological health [15]. Therefore, we speculate that academic emotions may correlate with professional identity and sense of coherence.

Self-esteem is a individual’s evaluation and affirmation of his or her self-worth, which can affect one’s academic and professional achievements, interpersonal relationships, and physical-mental health [16, 17]. A study shows that the self-esteem of nursing students is a factor that significantly influences their professional identity [7]. Students with high self-esteem tend to possess a strong sense of security. They can fully recognize their self-worth and have strong ability to recover from negative emotions [18]. Furthermore, research indicates that self-esteem and emotions are interrelated, and that high self-esteem can promote individuals’ effective self-regulation [19]. A study on nurses has shown that self-esteem is correlated with sense of coherence, and that self-esteem affects coping strategies for stress through the mediating effect of sense of coherence [20]. Therefore, it is speculated that self-esteem could be associated with professional identity, academic emotions, and sense of coherence.

From the above description we learn that sense of coherence correlates with academic emotion, self-esteem, and professional identity; academic emotion is related to self-esteem and professional identity; and self-esteem affects professional identity. However, the pathways “SOC→ (academic) emotion→ professional identity”, “SOC→ self-esteem→ professional identity” and “SOC→ (academic) emotion→ self-esteem” are still unclear and need to be supported by theoretical foundations. Sense of coherence is the key theory in the Salutogenic Model of Health, Antonovsky, the author of this theory, pointed out that SOC is a rather stable property for an individual, it is in early adulthood that one’s SOC becomes more or less fixed, and a (strong) sense of coherence could mobilize people’s physical, cognitive, emotional, valuative-attitudinal, and interpersonal-relational characteristics [3, 21, 22]. The theory of sense of coherence indicates that individuals’ sense of coherence could recognize and evaluate people or things through general resistance resources (such as good self-cognition, emotional state, physical condition, etc.), and finally form their perspectives and reactions to people and things [23]. Self-esteem is an individual’s cognition and view of themselves, and professional identity refers to beliefs and perspectives about one’s profession. Thus, paths “SOC→ (academic) emotion / self-esteem→ professional identity” and “SOC→ (academic) emotion→ self-esteem” are supported theoretically. Combined with the above information about the correlations between the four variables, the initial structural equation model was constructed. The initial hypothetical model is shown in Fig. 1.

Fig. 1
figure 1

The initial hypothetical model

Full size image

This study intends to examine the specific relationships between sense of coherence, professional identity, academic emotion, and self-esteem in nursing students, and to evaluate whether there is a chain mediating effect and to identify the chain mediating variables in the relationship.

Methods

Design and sample

This study was a descriptive cross-sectional survey of undergraduate nursing students to test the structural equation model (SEM). A convenience sampling method was utilized to recruit participants, and the study was carried out between September and December 2022 at a university in Xi’an City, China. Inclusion criteria included age ≥ 18 years, undergraduate nursing students, consenting to participate, and no psychosomatic disorders. The calculator “Monte Carlo Power Analysis for Indirect Effects” [24] was used to calculate the sample size based on the following criteria: input method (correlations), model (two serial mediators), objective (set power, vary N), target power (0.8), etc. Based on the input, the required sample size was 243. The number of eligible participants invited was 315, and the final valid questionnaires were 286.

Measures

Demographic variables

The items of participants’ general characteristics include age, gender, educational level (grade), birthplace, family income level, and status as an only child.

Sense of coherence scale (SOC-13)

The SOC-13 scale consists of 3 dimensions (comprehensibility, manageability, and meaningfulness) and 13 items with 7-point Likert scoring method [25]. The total scale score ranges from 13 to 91, higher scores indicate higher levels of sense of coherence. Scores between 13 and 63 are classified as low level, scores between 64 and 79 as medium level, and scores between 80 and 91 as high level. The Chinese version of the SOC-13 has been widely used with good internal consistency. Cronbach’s α of the scale in this study achieved 0.87.

Professional identity questionnaire for nursing students (PIQNS)

The PIQNS was designed by a Chinese researcher, which is widely used in Chinese nursing students to assess professional identity [26]. It is a 17-item questionnaire with 5-point Likert scoring method, and the 5 dimensions of it include professional self-image, benefit of retention and risk of turnover, social comparison and self-reflection, independence of career choice, and social modeling. The total score ranges from 17 to 85, with higher scores indicating higher levels of professional identity. Cronbach’s α of the questionnaire was 0.80 in this study.

The general academic emotion questionnaire (GAEQ)

The GAEQ is an 88-item questionnaire with a 5-point Likert scale rating. The questionnaire includes two kinds of academic emotions as follows: positive emotions and negative emotions [27]. Each of the two emotions is classified into two types respectively, namely positive activating emotions (interest, enjoyment, hope), positive deactivating emotions (pride, relief), negative activating emotions (shame, anxiety, anger), and negative deactivating emotions (hopelessness, boredom). With good reliability and validity, the questionnaire has been widely used among university students in China. Cronbach’s α in this study was 0.92 for positive academic emotions and 0.88 for negative emotions.

The self-esteem scale (SES)

The original version of the SES was developed by Rosenberg, the translated and modified Chinese version of the self-esteem scale is used in this study, which has been widely used by Chinese scholars to evaluate students’ self-esteem [28]. The scale consists of 10 items with a 4-point Likert rating method. The total score ranges from 10 to 40, and a higher score indicates a higher level of self-esteem. SES is a unidimensional variable with 10 entries, thus a factorial balance method was used to categorise SES into two-item groups and construct a model. The SES is widely used to assess self-esteem with good reliability and validity, while the Cronbach’s α of the scale in this study was 0.58. This may be due to potential item heterogeneity, which underestimates internal consistency. However, the high CR (0.90) and AVE (0.82) values of this scale indicated good reliability and validity at the SEM construct level.

Data collection

This study was conducted among undergraduate nursing students at a university. Students studying in university (freshmen, sophomores and juniors) completed questionnaires on site in classrooms. The researchers, with the assistance of class teachers, planned the appropriate times of the investigations after knowing about the students’ class timetables. The researchers explained the purpose, method, and anonymity of this study to students and emphasized that students had the right to withdraw at any time. Informed consent was obtained, and students were then instructed to complete the questionnaires on the spot within a period of 35 min. The researchers collected the questionnaires after students had finished them independently. While seniors interning in hospital completed e-questionnaires online. The online survey used Wenjuanxing to distribute the questionnaires. Survey links were sent to participants’ class groups on widely-used Chinese social platforms like WeChat or QQ. The online questionnaire included detailed information before proceeding to the actual survey, explaining the anonymity, voluntariness, and purpose of the study. Participants could complete the electronic consent form by selecting an option indicating their agreement to participate. A total of 286 valid questionnaires were received between September and December 2022.

Data analysis

The database was created using Epidata 3.1. SPSS 22.0 was used for descriptive statistics and correlation analysis. Amos 24.0 was employed to construct the structural equation model for path analysis and to test the chain mediating effect. A two-tailed p-value < 0.05 was considered statistically significant.

The common method bias was examined by Harman’s single-factor test [29]. Exploratory factor analysis on the variables involved. The test showed that 26 factors had eigenvalues higher than 1, and the first factor-explained variation was 30.96%, which was less than 40%. Thus, common method bias of this study was not apparent.

Ethical consideration

The study was performed in line with the principles of the Declaration of Helsinki. The study was approved by Xi’an Jiaotong University City College and the ethics committee of The Second Affiliated Hospital of Xi’an Medical University (No. X2Y202358). This approval ensured ethical access to students as participants. Informed consent was obtained from all respondents before they participated in this study, and students were informed that they were completely free to choose whether or not to participate. The survey ensured anonymity and did not collect any personally identifiable information.

Results

Descriptive statistics and correlation analysis

The participants’ ages ranged from 18 to 23 years (M = 20.80, SD = 1.55). The majority of students were female (88.8%, n = 254), of whom 102 (35.7%) were junior students, and mostly from rural areas (66.4%, n = 190). About half of the students’ family incomes were at a average level, and 67 (23.4%) of them were only children.

The mean values, standard deviations, and correlation coefficients of all variables were calculated, the results are shown in Table 1. Pearson correlation analysis showed that the correlations between sense of coherence, professional identity, academic emotion, and self-esteem were significantly related to each other (P < 0.01). Sense of coherence, professional identity, and self-esteem were positively correlated with positive academic emotion and negatively correlated with negative academic emotion.

Table 1 Means, standard deviations, and correlation coefficients
Full size table

The mediation model

In order to examine the specific relationships between sense of coherence, academic emotion, self-esteem, and professional identity, and to test the mediating effects, we established the structural equation model (SEM). The result of confirmatory factor analysis (CFA) presented the factor loadings, average variance extracted (AVE), and composite reliability (CR) of sense of coherence, professional identity, academic emotion, and self-esteem (Table 2). Table 2 shows that the factor loadings of variables items are all above 0.5 and AVE are all above 0.6, indicating satisfactory convergent validity [30].

Table 2 Reliability and validity analysis
Full size table

The fit indexes of the model were x2/df = 2.430, root mean square error of approximation (RMSEA) = 0.071, normed fit index (NFI) = 0.997, incremental fit index (IFI) = 0.998, Tucker-Lewis index (TLI) = 0.984, comparative fit index (CFI) = 0.998. All fit indexes indicated that the model matched well [31]. The SEM is shown in Fig. 2.

Fig. 2
figure 2

The mediation model with standardized path coefficients. Note: * P < 0.05; *** P < 0.001

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The chain mediating effect analysis

The path analysis illustrated that academic emotion and self-esteem played a chain mediating role between sense of coherence and professional identity. The mediating effects of academic emotion and self-esteem between sense of coherence and professional identity included four paths: (1) Path 1: SOC→ positive academic emotion→ self-esteem→ professional identity; (2) Path 2: SOC→ negative academic emotion→ self-esteem→ professional identity; (3) Path 3: SOC→ positive academic emotion→ professional identity; (4) Path 4: SOC→ self-esteem→ professional identity. The effect values of these four paths were 0.05, 0.02, 0.32, and 0.04 respectively. Bootstrap 95% confidence intervals of these mediating effects did not include 0, indicating the significance of the mediating effects. In addition, SOC had a direct effect on professional identity and its effect value was 0.33. The mediation model and its path analysis are shown in Fig. 2; Table 3.

Table 3 The chain mediating effect of academic emotion and self-esteem between sense of coherence and professional identity (2000 bootstrap samples)
Full size table

Discussion

This study explored the influence mechanism of sense of coherence on professional identity in undergraduate nursing students by introducing academic emotion and self-esteem. The results revealed that sense of coherence not only directly affected professional identity, but also indirectly affected professional identity through the independent mediating effects of academic emotion and self-esteem respectively. Furthermore, academic emotion and self-esteem played a chain mediating role between sense of coherence and professional identity, verifying the hypotheses of this study.

Firstly, nursing students’ sense of coherence could predict their professional identity, with higher sense of coherence being associated with greater identification with the nursing profession. It was consistent with Wu’s study [4]. This could be attributed to the positive influence of sense of coherence, which is a type of positive psychology that promotes individuals’ positive attitudes and cognition toward things [8]. Research suggests that nursing students with strong sense of coherence are more capable of coping with the challenges associated with college life as comparison to their peers [32]. Additionally, they express higher satisfaction when facing difficulties (high job demands, emotional issues, pressure and suffering) in their professions. These students are more likely to have positive professional perceptions and better career prospects. One possible explanation is that students who possess higher sense of coherence may have greater mental stability and a positive outlook on life, despite being in a high-pressure environment, and these individuals may have better mental health [3, 8]. A positive correlation has been found between medical students’ mental health and professional identity [33]. This is probably because students with good mental health are more likely to have higher professional satisfaction and to consider their professions valuable and important.

Secondly, sense of coherence indirectly influenced nursing students’ professional identity through positive academic emotion. It indicates that higher sense of coherence is associated with more positive academic emotion, which in turn increases professional identity among nursing students and vice versa. Perhaps students with high levels of sense of coherence incline to hold a strong motivation to learn, which allows them to adjust learning pressure and complete tasks effectively [32]. Besides that, sense of coherence refers to the universal, persistent, and dynamic confidence that individuals possess when encountering challenges [3]. Thus, those students with higher sense of coherence are more likely to have positive academic emotions. Positive academic emotions play a crucial role in fostering college students’ motivation and interest in their academic domains [34]. If students can experience positive emotions during the learning process, they are more inclined to develop interests and passion for their majors, which may be conducive to promoting their professional identity.

Moreover, The path “sense of coherence→ negative academic emotion→ professional identity” was found non-significantly. This finding suggests that negative academic emotion was not a mediator between sense of coherence and professional identity. This could be due to several factors. First, negative academic emotions might be buffered by positive psychological resources, such as a strong sense of coherence, which might mitigate their detrimental effects on professional identity. Second, the relationship between sense of coherence, negative academic emotions, and professional identity may be more complex and indirect, involving other mediating mechanisms that were not captured in the study. Future research could further explore the indirect pathways and potential moderators that may link negative academic emotions to professional identity, thereby providing a more specific interpretation of this relationship. Despite this non-significant path, including negative academic emotion in the model is still justified as it contributes to a more comprehensive understanding of the factors influencing professional identity.

Additionally, sense of coherence indirectly influenced nursing students’ professional identity through its impact on self-esteem. As previously mentioned, high levels of sense of coherence are linked to various positive outcomes. The higher one’s sense of coherence is, the more stable and healthy one’s mental state is, which can contribute to positive self-cognition and self-evaluation [8]. Therefore, nursing students with strong sense of coherence are also likely to possess higher levels of self-esteem. It has shown that self-esteem is a reliable predictor of nursing students’ professional identity [7]. The possible reason could be that students with high levels of sense of coherence and self-esteem could fully develop their potential and effectively access available resources to solve difficulties in adverse work circumstances. Positive self-evaluation, combined with the sense of accomplishment obtained from the nursing profession, might significantly enhance their professional identity.

Lastly but most importantly, this study found that academic emotion and self-esteem played a chain mediating role between sense of coherence and professional identity, the pathway was “sense of coherence→ academic emotion→ self-esteem→ professional identity”. There are several possible reasons as follows. First of all, Sense of coherence comprises three essential components: comprehensibility, manageability, and meaningfulness [3]. Meaningfulness is particularly significant because individuals invest their time and strength to overcome obstacles only when they perceive life as meaningful and valuable. Emotions can reflect people’s psychological state. People with higher sense of coherence have an increased sense of meaningfulness, and these people tend to believe that learning is valuable for self-development and professional goals. These people can handle emotional issues rationally and objectively while learning and have stronger academic motivation [32]. In addition, the better academic performance of individuals with higher sense of coherence may be related to positive self-regulation and academic emotions [35]. Students’ perceptions about emotional issues may have an impact on professional identity formation [36]. Positive academic emotions help nursing students receive more positive feedback in learning, further promoting the formation of their positive self-cognition. This may enhance students’ identification and confidence in their ability and value, ultimately causing an increase in self-esteem levels. Lastly, higher self-esteem is correlated with higher professional satisfaction [37], possibly because self-esteem can boost one’s confidence [38], which could then be transformed into confidence in one’s professional abilities, and it makes people proud of their work contributions and achievements, thus facilitating the formation of professional identity and professional values.

Limitations

The study contains some limitations. Firstly, this study was designed as a cross-sectional study to examine the specific relationship between sense of coherence, academic emotion, self-esteem, and professional identity. While it is still unclear whether the impact of sense of coherence on professional identity and the mediating effect of academic emotion and self-esteem change over time. Future longitudinal studies are necessary to better understand the time dynamics among these variables. Secondly, the convenience sampling and the predominance of female participants limit the representativeness of the findings, and the study recruited participants from a single university. Although this approach ensured feasibility, it may introduce selection bias and limit the generalizability of findings to broader populations of nursing students across diverse educational or cultural contexts. Future studies should involve broader populations of nursing students from different backgrounds to enhance representativeness.

Additionally, the large number of questionnaire items may have contributed to respondent fatigue, and the mixed modes of data collection (online and face-to-face) could have influenced participant responses, potentially affecting data quality. The relatively low Cronbach’s alpha of the self-esteem scale may destabilize statistical outcomes and undermine the validity of research conclusions. Future studies should choose scales with fewer items and higher authority, reliability, and validity. Researchers should prioritize critical questions early through pre-survey and using visual/interactive elements such as progress bars and gamification in online e-questionnaires to relieve respondent fatigue, and remove extreme values in scales or delete invalid scales before statistical analysis, and validate scale reliability through multiple methods like split-half, test-retest, and factor analysis. Lastly, this study was conducted using a quantitative approach and did not involve any intervention in the psychological and behavioral conditions of the participants. Therefore, it is recommended that further qualitative research and intervention studies be conducted to obtain a more comprehensive understanding of nursing students.

Implications for research and practice

This study provides a theoretical basis for improving professional identity among nursing students and might suggest directions for educators and medical staff to strengthen the quality of the future nursing workforce and reduce the wastage rate of nursing staff by enhancing sense of coherence, academic emotions, and self-esteem. It provides meaningful insights for both research and practice. On the research front, the study has contributed to a deeper comprehension of how psychological attributes and academic emotions jointly shape the professional identity of nursing students. From a practical standpoint, educators and healthcare practitioners should focus on cultivating nursing students’ sense of coherence, academic emotions, and self-esteem as a means to strengthen professional identity. This could be achieved by creating a supportive and motivating learning environment, providing students with appropriate guidance and resources to regulate academic emotions, and designing interventions aimed at enhancing students’ sense of coherence and self-esteem.

Moreover, the study highlights the necessity for future research to explore the dynamic processes underlying these variables over time. Longitudinal studies and interventions should be conducted to further validate the findings and to develop effective strategies for promoting professional identity among nursing students. Such efforts will be important in improving the quality of nursing education and ensuring the sustainable development of the nursing profession.

Conclusion

This study explored the specific relationships and effect pathways between sense of coherence, academic emotion, self-esteem, and professional identity in nursing students. It showed that academic emotion and self-esteem played a chain mediating role between sense of coherence and professional identity. Our study contributes to the understanding of the relationship between sense of coherence and professional identity. Moreover, the results could provide useful perspectives for educators and health professionals, potentially contributing to improving the nursing education quality and strengthening the professional identity of nursing students. It is noteworthy that the psychological conditions of nursing students are quite important, and professional identity is an important part of the stable development of the nursing profession. Therefore, educators and medical staff should pay more attention to nursing students’ professional identity, and cultivate students’ professional identity through the way of promoting their sense of coherence, academic emotion, and self-esteem.

Data availability

The data are available from the corresponding author on reasonable request.

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Acknowledgements

The authors thank all the participants and staff involved with this study.

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Not applicable.

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Authors and Affiliations

  1. School of Nursing and Rehabilitation, Xi’an Jiaotong University City College, 8715 Shangji Road, Xi’an, Shaanxi Province, 710018, China

    Huan Liu, Xiujuan Feng, Rui Liang & Yanan Qi

  2. Faculty of Nursing, Health Science Center, Xi’an Jiaotong University, Xi’an, China

    Jin Li

  3. Department of Cardiology, The Second Affiliated Hospital of Xi’an Medical University, Xi’an, China

    Jing Zhang

Authors
  1. Huan Liu
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Contributions

Huan Liu: Writing-original draft, writing-review & editing, project administration, methodology, investigation, data analysis, data curation. Jin Li: Writing-review & editing, investigation, supervision, data analysis, data curation. Xiujuan Feng, Rui Liang: Writing-review & editing, investigation, data curation. Yanan Qi, Jing Zhang: Investigation, analysis, supervision. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Huan Liu.

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Ethics approval and consent to participate

The study was performed in line with the principles of the Declaration of Helsinki. The study was approved by Xi’an Jiaotong University City College and the ethics committee of The Second Affiliated Hospital of Xi’an Medical University (No. X2Y202358). Informed consent was obtained and all participants took part in the study voluntarily.

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Not applicable.

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The authors declare no competing interests.

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Liu, H., Li, J., Feng, X. et al. Relationship between sense of coherence and professional identity in nursing students: the chain mediating effect of academic emotion and self-esteem. BMC Nurs 24, 556 (2025). https://doi.org/10.1186/s12912-025-03174-x

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Keywords

BMC Nursing

ISSN: 1472-6955

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