Meaning in Life and Professional Identity Among Nursing Students: The Parallel Mediating Role of Death Attitudes and the Moderating Role of Peer Support

Aim: Professional identity is considered important for nursing students’ professional commitment and future career development. Meaning in life, attitudes toward death, and peer support may be related to professional identity formation. This study aimed to examine the association between meaning in life and professional identity among nursing students, test the parallel mediating roles of positive and negative death attitudes, and explore whether peer support moderated these associations. Design: A cross-sectional observational study was conducted. Methods: A total of 361 nursing interns from mainland China were recruited using convenience sampling and completed structured questionnaires, including a demographic questionnaire, the Death Attitude Profile-Revised, the Professional Identity Questionnaire, the Chinese version of the Meaning in Life Questionnaire, and the Friends Support Scale. Data were analyzed using correlation analysis, hierarchical regression analysis, and moderated parallel mediation analysis. Results: Professional identity was positively associated with meaning in life, positive death attitudes, and peer support, and was negatively associated with negative death attitudes. Positive and negative death attitudes showed partial parallel mediating roles in the association between meaning in life and professional identity. Peer support significantly moderated the direct association between meaning in life and professional identity, but did not significantly moderate the associations between death attitudes and professional identity. Conclusion: The findings suggest that nursing students’ professional identity is associated with both internal meaning-making and external peer support, and that death attitudes may represent potential psychological mechanisms linking meaning in life and professional identity. Nursing education may benefit from strategies that address students’ sense of meaning, incorporate reflective death education, and support peer networks. Given the cross-sectional design, these findings should be interpreted as associations rather than causal relationships.