Stress, coping and professional identity among nursing students during the COVID-19 pandemic: a latent profile analysis

Background This study aimed to characterize the patterns of psychological stress among nursing students during the COVID-19 pandemic, and evaluate for profile differences in demographic characteristics, coping styles and professional identity. Methods A cross-sectional study was conducted among nursing students with convenient sampling from four colleges in China from April to June 2022. A total of 1978 nursing students completed an online questionnaire of psychological stress, coping styles and professional identity. Latent profile analysis (LPA) was performed to identify subgroups of nursing students with distinct stress profiles. Results Four distinct profiles were identified: high employment stress (HES, 18.0% of the sample), low stress (LS, 40.2%), moderate stress (MS, 20.4%), and high stress (HS, 21.4%). HES nursing students were more likely to be fourth-year students and had chosen nursing program primarily for easy employment, while HS students were more likely to have transferred to nursing program. LS students scored highest in problem-solving coping, while HS students scored highest in negative coping (i.e., expectancy, avoidance). LS students had highest level of professional identity compared to the other three subgroups. No gender differed among the four classes (P > 0.05). Conclusion Psychological stress among nursing students is at an overall moderate to high level and shows heterogeneity during the COVID-19 pandemic. Early identification of stress characteristics of high-risk groups and development of targeted interventions to manage stress and coping are recommended to promote nursing students' professional adaptability and identity.