Psychological Positive Energy in Medical Students: Framework, Influencing Factors and Mental Health Implications

Yueqin Li,1,* Xiaofang Feng,1,* Weifang Ju,1 Yanyan Su,1 Xia Cheng,2 Tao Xu,2 Liping Cui3 1Department of General Medical, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, Taiyuan, 030032, People’s Republic of China; 2Nursing College, Shanxi Medical University, Taiyuan, 030032, People’s Republic of China; 3Department of Nursing, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, Taiyuan, 030032, People’s Republic of China*These authors contributed equally to this workCorrespondence: Liping Cui, Department of Nursing, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, No. 99, Longcheng Street, Xiaodian District, Taiyuan, Shanxi, 030032, People’s Republic of China, Tel +8613934154909, Email [email protected]: This study aimed to explore the structure, developmental characteristics and influencing factors of psychological positive energy (PPE) in medical students as well as its relationship with mental health. Psychological positive energy refers to a positive mindset comprising optimism, emotional resilience and proactive behaviours, which contribute to overall well-being.Methods: A mixed-methods design was adopted. Semi-structured interviews (n=650, stratified by year/gender/speciality) were analysed via grounded theory to construct a PPE framework (theoretical saturation reached). A cross-sectional survey (n=650, 562 valid) used a self-developed PPE scale (Cronbach’s α=0.89, good fit) and three validated scales. Data were analysed via SPSS 26.0 with Pearson correlation and multiple linear regression.Results: Qualitative analysis identified a four-dimensional PPE framework: positive cognitive orientation (tendency to interpret life events optimistically), emotional feelings (experience of stable positive emotions such as hope), behavioural patterns (proactive engagement in problem-solving) and self-development (intrinsic motivation for professional/personal growth). This framework was confirmed after reaching data saturation The quantitative results showed the following: (1) Medical students’ PPE levels were high (M = 5.5– 6.0/7-point scale), with significant demographic patterns (higher in men than in women; increasing with academic seniority). (2) Perceived social support, family care and trait self-control were key predictors of PPE, collectively explaining 72.1% of its variance (with social support as the strongest predictor). (3) Psychological positive energy was positively associated with adaptive psychological outcomes (meaning in life, cognitive reappraisal) and negatively associated with mental health risks (anxiety, depression, aggression) (all p < 0.001), indicating the protective role of PPE.Conclusion: This study clarifies the four-dimensional structure of PPE in medical students and confirms its critical protective role in mental health (eg reducing anxiety/depression). Key influencing factors – perceived social support (strongest predictor), family care and trait self-control – provide actionable targets for universities to design targeted interventions.Keywords: psychological positive energy, medical students, influencing factors, mental health