The mediating effects of coping on the stress and health relationships among nursing students: a structural equation modelling approach




To test the impact of stress on psychological and physical health, and examine the mediating effects of coping on the stress–health relationships among nursing students.


Stress is associated with various physical and psychological symptoms in nursing students. Numerous studies examined the relationships among stress, coping and health; nevertheless, a mechanism of coping has not been fully explored in Thai nursing students.


This study adopted a cross-sectional, descriptive correlational research design.


A convenience sample of 335 nursing students were recruited from a University in Thailand from 2005–2007. We used self-reported questionnaires to collect information; and analysed data using descriptive statistics and structural equation modelling.


Nursing students with high levels of stress reported poorer physical health and higher psychological distress. Stress had a stronger effect and explained more variances on psychological distress than on poor physical health. The partial mediation of coping was observed. Specifically, 77·00% of the effects of stress on poor physical health and 11·30% on psychological distress were mediated by coping.


Evidence from this study contributes to the nursing science and has implications to nursing practice. Stress among nursing students should be monitored and effectively managed to prevent deleterious effects on their health. Nursing interventions focusing on coping skill training could be developed and delivered. Future research may examine the effectiveness of the interventions and/or to further explore variables associated with psychological distress in nursing students.