Stress is a complicated psychobiological process that is experienced when an individual perceives a threat or danger from the environment [1]. When individuals feel that a situation is threatening, they evaluate the resources available to them to deal with it. These assessments interact, leading to a perception of stress and the ensuing physical and emotional responses[2]. The topic of stress has gained a considerable amount of attention in the literature and continues to be the subject of much research in the nursing field [3]. Stress among nursing students is often reported to come from the pressure of practical training in education. [4]Furthermore, a lack of knowledge and skills is one of the common stressors for many students. Nursing students face additional stressors from their first experiences in clinical practice, including a fear of making mistakes and having to deal with emergencies [5]. Stress is an obstacle to concentration, problem-solving skills, and other abilities essential to student learning [6]. According to cognitive transactional stress theory [7], differences in each person's response to potential stressors can affect individual assessment levels and problem-solving abilities. Resilience appears to be a determinant of perceived stress [8]. Research shows that people with high resilience can feel more capable of coping with stress, decrease stress from stressors, and reduce general stress; people who are more resilient will reflect lower levels of chronic stress [9] According to Andrea, perceived stress is negatively correlated with optimism [10].Self-efficacy along with emotional intelligence are predictors of perceived stress by nursing professionals[11]. Studies have indicated that perceived stress levels are lower, and emotional intelligence scores are higher [12]. Low emotional intelligence scores tend to adopt inappropriate coping strategies that are positively associated with maladaptive school behaviors and negatively associated with negative life events. Further, inappropriate coping regarding perceived stress may interfere in learning, decision-making, and thinking processes, lead to drowsiness, as well as neurosis or mental breakdowns that deteriorate professional competence[13].
Positive psychology has been receiving increasing attention recently. Some scholars have proposed that there is a link between the psychological capital of nursing students and improvements in their mental health. The introduction and application of the concept of psychological capital has provided a new perspective for nursing students to effectively cope with stress [14]. Psychological capital concerns how individuals behave in the face of stress and challenges. It has four main dimensions: self-efficacy, hope, resilience, and optimism. These dimensions may be regarded as positive states of psychological development exhibited by individuals in the growth and developmental process. Studies have shown that optimism and hope are statistically negatively and substantially associated with psychological distress in the subcategory of psychological capital [15]. Previous research shows that high levels of psychological capital weaken psychological distress [16]. It has been reported that nursing students’ positive psychological capital has a significant role in helping them cope with stress and ensure strong mental health [17]. Psychological capital and distress are closely related in connotation as well as extension [18].
Psychological distress is a common concern among nursing professionals[19]. It is known to be associated with a variety of factors, such as occupations and geographical settings [20]. It ranges from normal feelings of vulnerability and sadness to mental health problems, for instance depression, social isolation, and sleep disorders [21]. Psychological distress impacts not only job performance, it also impacts overall life satisfaction and happiness, and affects the team work atmosphere [15].A survey of 622 undergraduate nursing students in Italy noted more than 70% of nursing students experienced significant levels of psychological distress[22]. Nursing students may face traumatic events during their initial educational training; such experiences may lead to adverse psychological health outcomes, such as anxiety, depression, and sleep disorders. Existing research indicates that negative mental health issues are a major cause of nursing student attrition[23].
Although a link between perceived stress and psychological stress has been evidenced [24], the mechanisms behind this link are not well understood by nursing students. Based on these facts, three assumptions were made about Chinese nursing students: (1) demographic characteristics, like age, gender, and educational level, may be significantly associated with perceived stress among nurses; (2) psychological distress, psychological capital, and perceived stress are related; and (3) psychological capital may mediate the association between psychological distress and perceived stress.