Social support, financial threat, psychological distress, burnout and nursing clinical competence in mental health courses: self-efficacy and professional identity moderators

Purpose This study aims to examine the psychosocial factors related to burnout and perceived clinical competence among undergraduate nursing students, with particular attention to perceived social support, psychological distress and financial threat, and whether self-efficacy and professional identity moderated key associations. Design/methodology/approach A cross-sectional analytical study was conducted among 351 third- and fourth-year nursing students at Jerash University, Jordan. Perceived social support, psychological distress, financial threat, self-efficacy, professional identity, burnout and perceived clinical competence were assessed using established self-report measures. Four moderated regression models were estimated, adjusting for age, years of nursing experience, GPA, sleep and internet use. Predictors and moderators were mean-centered, interaction terms were tested and simple slopes were examined. Findings Perceived social support was negatively associated with burnout and positively associated with perceived clinical competence. Psychological distress was positively associated with burnout and negatively associated with clinical competence, while financial threat was positively associated with burnout. Four interaction terms were statistically significant. Financial threat × self-efficacy (B = 0.055, p < 0.001) and financial threat × professional identity (B = 0.023, p < 0.001) were associated with burnout. Psychological distress × professional identity (B = 0.018, p < 0.001) and psychological distress × self-efficacy (B = 0.022, p = 0.033) were associated with clinical competence. Conditional effects varied across moderator levels. These findings indicate meaningful heterogeneity in psychosocial associations across nursing students. Research limitations/implications The cross-sectional, single-university design limits temporal and causal inference. Longitudinal and intervention studies are needed to clarify how psychosocial and professional resources relate to changes in student well-being and competence. Practical implications Nursing programs may consider integrated psychological, social, financial and professional support within student-support structures, while recognizing that the present findings do not establish intervention effects. Social implications The findings highlight the relevance of perceived social support and psychological well-being within the educational environment and suggest that financial and psychological strain may intersect with students’ engagement in academic and clinical learning and access to available support. Originality/value This study extends nursing-student research by examining social support, psychological distress and financial threat alongside conditional associations of these psychosocial pressures with burnout and perceived clinical competence across levels of self-efficacy and professional identity.