Clinical Internship Stressors, Self-Efficacy, And Mental Health Among Young Nursing Interns In China A Cross-Sectional Survey Study Of The Clinical Learning Transition

Abstract

Background: Clinical internship is the point at which nursing students must convert classroom knowledge into accountable patient care. The transition can produce stress even when students appear to be functioning well. This study examined the association between internship stressors, general self-efficacy, and mental health among young nursing interns in China. Methods: A cross-sectional survey was conducted among 434 nursing interns. Participants completed an internship stressor measure, the General Self-Efficacy Scale, and the Depression, Anxiety, and Stress Scale-21. Descriptive statistics and Spearman correlation analysis were used. Results: The overall stressor score was low-to-moderate (M = 1.76), while general self-efficacy was relatively high (M = 3.08). The most salient stressors concerned clinical instructors’ teaching attitudes and the intern’s role positioning within the ward. Depression, anxiety, and stress scores remained within the normal interpretive range, although stress was the most prominent of the three DASS-21 domains. Internship stressors were positively associated with depression, anxiety, and stress (ρ = .344–.370, p < .001), whereas self-efficacy showed an inverse relationship with negative mental-health indicators. Conclusion: Apparent psychological stability should not be interpreted as the absence of vulnerability. The findings support a preventive model that improves the relational and instructional conditions of clinical education while strengthening students’ efficacy beliefs through structured feedback, graduated responsibility, and timely psychological support.