Effects of perceived stress and professional values on clinical performance in practice nursing students: A structural equation modeling approach

Background: Clinical performance is regarded as a basic and core content of nursing quality. Professional values of nursing students may play an important role in improving clinical performance. Few studies reveal the relationship between professional values, perceived stress and clinical performance. This research has found that professional values play a moderating role in the relationship between perceived stress and clinical performance. Objective: To examine the negative association between perceived stress and clinical performance among practice nursing students, and to determine whether professional values plays a moderating role in the relationship between perceived stress and clinical performance among Chinese practice nursing students. Design: A cross-sectional descriptive design has been used. Methods: From May to June 2017, a total of 435 Chinese practice nursing students from 4 hospitals filled out the questionnaires. The response rate was 94.57%. Three questionnaires including the Perceived Stress Scale (PSS), Nursing Professional Value Scale-Revised (NPVS-R), and Clinical Performance Scale (CPS). Structural equation modeling was used to deal with the relationships among perceived stress, professional values, and clinical performance. Results: Perceived stress was negatively associated with clinical performance (P < 0.01). Professional values significantly affected clinical performance (P < 0.01) and moderated the relationship between perceived stress and clinical performance (P < 0.01). Conclusions: Perceived stress is negatively related to clinical performance among Chinese practice nursing students, and professional values moderates the relationship between perceived stress and clinical performance, which can form scientific evidence to develop intervention strategies to improve clinical performance.