Resilience, coping strategies and psychological well-being across academic years in nursing students: a multicentre cross-sectional study

Nursing students face high academic and clinical demands, and the COVID-19 pandemic created an exceptional context in which coping and psychological well-being may have been altered. This study examined psychological well-being and its cross-sectional associations with resilience, different kinds of coping strategies and academic year in undergraduate nursing students during the 2021–2022 academic year. A multicentre cross-sectional analytical study was reported in accordance with the STROBE guidelines. Participants: Undergraduate nursing students enrolled at three Spanish public universities completed an anonymous online questionnaire. The questionnaire included sociodemographic and academic variables, the 10-item Connor–Davidson Resilience Scale, the Coping with Stress Questionnaire and the Ryff Psychological Well-being Scale. Convenience sampling was used; therefore, inference is limited to the participating cohorts and should not be interpreted as representative of all Spanish nursing students. The analytic sample comprised 682 students. Psychological well-being was positively associated with resilience and problem-focused coping (Seeking Social Support and Positive Reappraisal) and negatively associated with emotion-focused coping (Negative Self-Talk). In the hierarchical model, resilience accounted for 26.7% of the variance; adding coping specific strategies increased explained variance to 46.5%. Adding academic year as an ordinal term produced a small additional contribution (ΔR² =0.008; final R²=0.475, p = .002). In the categorical sensitivity model, the academic-year block added ΔR² = 0.009 (F change(3, 671) = 3.79, p = .010), with fourth year lower than first year (B = − 6.31, 95% CI − 10.05 to − 2.58, p = .001). After additional adjustment for age, sex/gender, university and academic record, the year-specific coefficients were no longer statistically significant; resilience and the coping dimensions remained associated with well-being, and University 2 versus University 1 was also independently associated with lower well-being (B = − 5.02, p = .003). Resilience and problem-focused coping, in particular Seeking Social Support, were positively associated with psychological well-being, whereas emotion-focused coping, specifically Negative Self-Talk, was negatively associated. Academic year contributed only a minimal increment to explained variance, and the year-specific associations were no longer statistically significant after adjustment for a broader set of covariates. The cross-sectional convenience design precludes causal inference and limits generalisability.