Factors associated with role strain among male nursing students: Insights from stress-coping and stress-buffering frameworks

Background Men remain markedly underrepresented in the global nursing workforce, and male nursing students frequently encounter gender stereotypes, limited clinical opportunities, and inadequate professional support during their training. These gender-related experiences may hinder professional socialization and contribute to greater role strain. Although previous studies have examined stress and role strain among nursing students, comprehensive quantitative evidence on the prevalence and associated factors of role strain among male nursing students, particularly those in Western China, remains limited. Aim To assess the level of role strain among male nursing students and identify factors associated with it. Methods A multicenter cross-sectional survey was conducted from September to November 2025 at six nursing colleges in Sichuan Province, China. A total of 291 valid responses were obtained using convenience sampling. Data were collected using a general information questionnaire and three standardized instruments: the Role Strain Scale for Male Nursing Students (RSS-MNS), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Nurse Professional Identity Scale. Statistical analyses included independent-samples t- tests, one-way analysis of variance (ANOVA), Pearson correlation analysis, and stepwise multiple linear regression. Results Male nursing students experienced a moderate level of role strain (M = 31.90 ± 7.67), with patient-related role strain scoring highest among the assessed dimensions. Role strain was negatively correlated with perceived social support ( r = −0.196, P < 0.01) and professional identity ( r = −0.353, P < 0.01). Stepwise multiple linear regression analysis showed that professional identity, intention to enter clinical nursing practice, and award experience were independently associated with role strain. Conclusion Male nursing students experienced a moderate level of role strain. These findings highlight the importance of understanding role strain within a broader educational and psychosocial context, where multiple individual and contextual factors may be associated with students' experiences. These findings may inform educational strategies to better support male nursing students and promote more gender-inclusive nursing education.