Professional identity as a longitudinal mediator between humanistic care and moral sensitivity in nursing students during clinical placement

Objective To examine professional identity as a longitudinal mediator of the association between humanistic care and moral sensitivity among nursing students during clinical practice. Methods This study was a multi - center longitudinal survey. Nursing students from 15 colleges and universities in China were selected as the research objects. The Caring Ability Inventory, the Moral Sensitivity Questionnaire for Nursing, and the Professional Identity Questionnaire for Students and Nurses were used to track the students at the early stage of practice (T1), the middle of the internship (T2), and the end of the internship (T3), respectively. The unconditional potential growth model, structural equation, and the Bootstrap method were used for statistical analysis. Results A total of 286 valid questionnaires were collected. There were significant correlations among the scores of humanistic care, moral sensitivity, and professional identity of nursing students at three time points ( p < 0.05). From T1 to T3, the humanistic care, professional identity, and moral sensitivity of nursing students showed an upward trend. The intercept of humanistic care significantly and positively predicted the intercept of moral sensitivity (beta = 0.446, p = 0.001), and the slope of humanistic care positively predicted the intercept of moral sensitivity (beta = 0.550, p < 0.001). In the longitudinal mediation model, the intercept of humanistic care significantly and positively predicted the intercept of Professional identity (beta = 0.435, p = 0.003), and the slope of humanistic care significantly and positively predicted the slope of professional identity (beta = 0.610, p < 0.001). The intercept of professional identity significantly and positively predicted the intercept of moral sensitivity (beta = 0.555, p < 0.001) and significantly and positively predicted the slope of moral sensitivity (beta = 0.365, p = 0.005). The slope of professional identity could also significantly and positively predict the slope of moral sensitivity (beta = 0.508, p = 0.014). Conclusion These findings highlight the potential value of baseline assessment of humanistic care in the early stage of internship and of a professional identity support system across the placement, which warrant evaluation in future intervention studies.