Career uncertainty, professional identity, and future workforce intention among students in ageing care-related...

To examine the relationships among social support, career clarity, career uncertainty, professional identity, anxiety, and future workforce intention among students enrolled in ageing care-related majors in China, with particular attention to how professional identity and career uncertainty were associated with anxiety and intention to work in ageing care after graduation.

Population ageing has increased the demand for a sustainable ageing-care workforce. However, evidence remains limited on the psychological and career-development factors associated with students' preparedness for and intention to enter ageing-care professions.

An explanatory sequential mixed-methods study.

A cross-sectional survey was conducted among 1342 students from five educational institutions in China, followed by semi-structured interviews with 23 students. Anxiety and intention to work in ageing care after graduation were the primary quantitative outcomes, with professional identity and career uncertainty as the principal explanatory variables. Multivariable linear regression was used to examine associations with anxiety, and cumulative ordinal and multinomial logistic regression models were used for career intention. Qualitative interviews provided context and further insight into the quantitative findings, which were integrated with the qualitative findings through a joint display.

Overall, 45.6% of students reported at least mild anxiety symptoms. Stronger professional identity was associated with lower anxiety and greater intention to work in ageing care. Because the proportional-odds assumption was not supported for several predictors of career intention, category-specific multinomial estimates were also examined. In the multinomial model, professional identity was positively associated with the willing and very willing categories relative to the very unwilling category, although these estimates did not establish differences in the magnitude of associations between career-intention categories. Greater career uncertainty was associated with higher anxiety and lower career intention in the ordinal model, although the association with career intention was not consistently supported by category-specific multinomial estimates. Career clarity was independently associated with lower anxiety. Overall social support was not independently associated with anxiety or with career intention in the adjusted ordinal model. However, the multinomial model identified an association for the unwilling versus very unwilling comparison (OR = 0.429, 95% CI 0.196 to 0.940), which should be interpreted cautiously given the multiple category-specific comparisons. Qualitative findings contextualised these patterns, highlighting uncertainty about career pathways, concerns about professional recognition and working conditions, meaningful practical experiences, and perceptions of the professional value of ageing-care work. Participants also described educational and interpersonal support as important in shaping their career experiences, despite the absence of consistent adjusted associations between overall social support and the primary outcomes.

Professional identity was associated with lower anxiety and greater career intention, although the multinomial estimates did not establish differences in association strength between career-intention categories. Career uncertainty was strongly associated with higher anxiety, whereas its association with career intention was less consistent across modelling approaches. Overall social support was not associated with anxiety or career intention in the adjusted linear and ordinal models, respectively, although one category-specific association was observed in the multinomial model. The findings highlight the importance of clearer career pathways, meaningful practical exposure, and opportunities to develop professional identity within ageing-care education. Longitudinal research is needed to determine whether these associations persist over time and are reflected in subsequent workforce entry and retention.