Factors influencing higher vocational nursing students' mental health during internships: a cross-sectional study

Internship is an important transition stage for nursing students from school to clinical work. However, students often suffer from mental health problems such as depression, anxiety and stress during internship, which further affects the effect of internship and career choice.

This study aims to explore the mental health problems of higher vocational nursing students and its influencing factors.

This study used a cross-sectional design to investigate 432 nursing students during internship who were studying at Binzhou Polytechnic from May to June 2025. The general information questionnaire, General Self-Efficacy Scale (GSES) and Depression, Anxiety and Stress Scale (DASS-21) were used to collect data to understand the mental health status of higher vocational nursing interns and analyze the influence of different factors on mental health problems.

24.7% of the nursing interns had depression problems, 26.5% had anxiety problems, and 22.8% felt great pressure. Binary logistic regression analysis showed that internship in a tertiary grade A hospital and male students were associated with an increased risk of psychological problems (OR > 1). However, often or sometimes feeling cared for during internship, liking for the nursing profession, thinking that the nursing profession was respected, and high self-efficacy were associated with reduced risk of psychological problems (OR < 1). Conclusions: Hospital, gender, liking for the nursing profession, thinking that the nursing profession was respected, feeling cared for during internship and self-efficacy were all significantly associated with the mental health of higher vocational nursing students during internship. These findings provide a basis for the development of targeted mental health interventions to help improve the mental health of nursing students.