Abstract
Background
Career locus of control refers to individuals’ beliefs about whether their career outcomes are determined by personal effort or external forces. It is considered a key factor in nursing students’ professional development, psychological well-being, and career sustainability. However, existing research has predominantly employed variable-centered approaches, focusing on average levels of control and potentially obscuring meaningful heterogeneity within student populations. This study aimed to identify latent profiles of career locus of control and examine their associated sociodemographic, educational, and psychological factors among undergraduate nursing students in China.
Methods
A cross-sectional survey was conducted among 582 undergraduate nursing students from a university in Hebei Province, China, between November and December 2025. Data were collected using a general information questionnaire, the Career Locus of Control Scale for Nursing Undergraduate Students, the Professional Commitment Scale, and the Professional Identity Questionnaire for Nursing Students. Latent profile analysis was employed to identify distinct career locus of control profiles, and multinomial logistic regression analysis was used to explore associated sociodemographic, educational, and psychological factors.
Results
Three latent profiles of career locus of control were identified: Low Internal-Low External Control (32.7%), High Internal Control-Low External Attribution (51.0%), and Balanced Internal-External Control (16.3%). Year of study, maternal educational attainment, class officer experience, parental or primary caregiver’s occupation, professional commitment, and professional identity were significant predictors of profile membership (p < 0.05).
Conclusion
This study identified three latent profiles of career locus of control among undergraduate nursing students, demonstrating substantial heterogeneity in perceptions of personal agency and external influences in career development. These findings support differentiated educational strategies to enhance career clarity and self-efficacy, strengthen emotional regulation and resource utilization, and promote leadership development. Such targeted interventions may foster adaptive career control beliefs and support sustainable professional development in nursing education.
Keywords: Undergraduate nursing students, Career locus of control, Latent profile analysis, Professional commitment, Professional identity
Introduction
The global healthcare system is facing a persistent nursing workforce shortage. According to the State of the World’s Nursing 2025 report, although the global nursing workforce reached approximately 29.8 million in 2023, a shortfall of 5.8 million nurses remains. This deficit is projected to persist through 2030, threatening the sustainability of healthcare delivery worldwide [1]. As the primary pipeline for workforce replenishment, undergraduate nursing students encounter substantial challenges during professional transition, including role adaptation stress, clinical competence development, and career decision-making uncertainty [2, 3]. Identifying psychological mechanisms that influence their career development is therefore essential for improving nursing workforce retention and educational effectiveness.
Career locus of control, grounded in Rotter’s social learning theory [4], refers to individuals’ beliefs about whether their career outcomes are determined by personal effort and abilities (internal control), or by external forces such as luck, fate, or powerful others (external control). This domain-specific construct is particularly relevant in nursing education. Career locus of control encompasses four distinct dimensions: career internal control, reflecting beliefs in personal agency; career opportunity attribution, defined as attributing success to external opportunities; low professional efficacy, characterized by feelings of helplessness regarding one’s career capabilities; and career external control, referring to reliance on external support and environmental factors [5]. The theoretical foundation for understanding heterogeneity in career locus of control can be further elaborated through attribution theory [6], which posits that individuals develop systematic patterns in explaining the causes of their successes and failures, thereby shaping their expectations, emotional responses, and subsequent behaviors [7]. These attributional patterns vary significantly across individuals and contexts, leading to qualitatively different cognitive configurations rather than a single continuum of beliefs [8]. In the context of nursing education, which integrates rigorous academic training with high-stakes clinical practice, students encounter diverse career-related outcomes that trigger distinct causal reasoning processes shaped by cognitive biases, educational backgrounds, and professional socialization [9].
Accumulating evidence has demonstrated the significant role of career locus of control in shaping nursing students’ professional development and psychological well-being. Students with stronger internal control tend to demonstrate better self-regulation, higher academic achievement, and more effective clinical adaptation, whereas those with external or low-efficacy orientations are more susceptible to anxiety, helplessness, and burnout [10]. Deficiencies in career locus of control may adversely affect students’ clinical internship performance, career decision-making, and future professional development, potentially posing challenges to the stability of the nursing workforce [11]. Recent evidence suggests that career locus of control is influenced by a complex interplay of psychological and contextual factors. At the psychological level, professional commitment and professional identity have been consistently linked to career control beliefs [12]. Students who exhibit a strong sense of responsibility toward their discipline and psychological belonging to the nursing profession tend to demonstrate more internal attributional patterns [13], showing greater autonomy in career planning and greater resilience during clinical transitions [14, 15]. At the sociodemographic level, academic progression and clinical exposure have been found to strengthen internal control and self-directed learning readiness [16, 17]. Furthermore, family background and parental education play a significant role, particularly in cultural contexts like China, where higher parental educational attainment provides greater access to career information and resources, thereby facilitating more adaptive career control orientations [18]. Additionally, leadership roles and extracurricular involvement have been associated with enhanced self-efficacy and internal control, as student leaders often develop greater career adaptability and confidence [19, 20].
Despite these advances, important limitations remain in the existing literature. First, theoretical integration remains insufficient. While previous studies have examined career locus of control as a predictor or outcome variable, few have explicitly integrated attribution theory to explain why distinct profiles of career control beliefs may exist among nursing students. The heterogeneity in how students attribute career outcomes to internal versus external factors has not been systematically explored from a person-centered perspective. Second, methodological approaches have predominantly been variable-centered. Most studies have relied on correlation analysis and structural equation modeling, which assume population homogeneity and may obscure meaningful heterogeneity in career control beliefs [21]. These approaches treat career locus of control as a continuous variable without considering that distinct subgroups of students may exhibit qualitatively different patterns of internal and external control. Consequently, the existence of latent profiles characterized by unique configurations of career control dimensions remains unexplored. Third, differential effects of associated factors across profiles remain unknown. Although professional commitment, professional identity, family background, and clinical experience have been associated with career locus of control [12, 22], previous research has primarily examined these relationships using approaches that assume uniform effects across all individuals. It remains unclear whether these factors have differential influences on profile membership, limiting the development of targeted educational interventions. To address these gaps, the present study employed a person-centered approach, specifically latent profile analysis (LPA), to identify distinct subgroups of nursing students based on their patterns of career locus of control. LPA offers a methodological solution to the limitations of variable-centered approaches by identifying unobserved subgroups based on individuals’ response patterns across multiple indicators, allowing researchers to capture multidimensional heterogeneity that may be masked in aggregate analyses [23]. In nursing education, LPA has been successfully applied to identify profiles of mental workload [24], professional commitment [25], and other psychological characteristics, demonstrating its utility in guiding tailored educational strategies.
Therefore, this study aimed to: (1) identify distinct latent profiles of career locus of control among undergraduate nursing students; (2) characterize the demographic, psychological, and experiential features of each profile; and (3) examine the differential effects of multidimensional factors on profile membership. Based on attribution theory and previous empirical evidence, we hypothesized that nursing students would exhibit distinct latent profiles characterized by different configurations of internal and external control dimensions, and that sociodemographic factors such as year of study, parental education, and leadership experience, as well as psychological factors like professional commitment and professional identity, would significantly predict profile membership. By identifying these latent classes, this study advances understanding of the heterogeneity in career control beliefs, fill the gap in latent class identification and multi-factor mechanism interpretation, and provide evidence to inform targeted educational and psychological interventions in nursing education.
Materials and methods
Design
This study employed a cross-sectional survey design to examine latent profiles of career locus of control among nursing undergraduates. This design was considered appropriate for identifying heterogeneity in career control beliefs and exploring associations among psychological and educational factors at a single time point. The reporting of this study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.
Participants
A convenience sampling method was used to recruit undergraduate nursing students from a university in Hebei Province, China. Data collection was conducted between November and December 2025. All full-time undergraduate nursing students enrolled in the first through fourth years during the study period were invited to participate. The inclusion criteria were as follows: ① full-time undergraduate nursing students; ② aged between 18 and 23 years; ③ voluntary participation with informed consent. The exclusion criteria included: students who were on a leave of absence or had withdrawn from the university.
Sample size
Based on the recommendations of Nylund-Gibson and Choi [26], a minimum sample size of 300 participants is recommended for latent profile analysis (LPA) to ensure adequate identification of smaller latent profiles. Additionally, general guidelines for multivariate analysis suggest that the sample size should be at least five times the number of observed variables [27]. In this study, the number of observed variables includes 11 demographic variables, 20 career locus of control items, 27 professional commitment items, and 17 professional identity items, resulting in a total of 75 observed variables. Thus, the formula for sample size is N=(11+20+27+17)*5 = 375, which means that at least375 subjects are needed for this study. Also, the samplesize should be further expanded considering the sampleloss rate of 20%. Therefore, the minimum sample sizerequired is N = 375/(1–20%)≈469. The final sample comprised 582 participants, which exceeded the required threshold and was therefore deemed sufficient for the planned analyses.
Data collection
The study was conducted using Questionnaire Star (Wenjuanxing; https://www.wjx.cn/), a widely used online survey platform in China. A class-by-class recruitment approach was adopted and implemented as follows: Researchers first contacted the academic coordinators of each grade to explain the study objectives and implementation process, securing their support. Subsequently, recruitment was conducted at the class level within each grade. Participants were informed of the purpose and significance of the study, and the survey link was distributed accordingly. The questionnaire stated that all collected information would be kept strictly confidential. Participation was voluntary, and after providing informed consent, participants completed and submitted the questionnaire anonymously. To prevent duplicate submissions, the survey was configured to allow only one response per IP address. Additionally, to enhance both the quantity and quality of valid responses, all questions were set as mandatory items that must be completed before submission. A total of 600 questionnaires were distributed. Five students declined to participate, three questionnaires were excluded due to uniform response patterns, and seven were deemed invalid as the completion time was less than 120 seconds. Ultimately, 582 valid questionnaires were included for analysis, yielding an effective response rate of 97%.
Ethics consideration
This study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki. The study was reviewed and approved by the Ethics Committee of Yanching Institute of Technology (Approval No. 202502). Prior to data collection, an electronic informed consent form was presented on the first page of the online questionnaire. All participants were informed that their participation was voluntary and anonymous, that they could withdraw from the study at any time without providing a reason, and that withdrawal would not result in any negative consequences. Participants were also assured that the collected data would be kept strictly confidential, accessed only by the research team, and used solely for academic purposes.
Measurements
General information questionnaire
We developed the general information questionnaire based on a literature review and discussions within the research team. It collected data on eleven demographic and background variables, including participants’ sex, year of study, place of residence, only-child status, parental education attainment, family economic status, part-time work experience, class officer experience, receiving scholarship, whether they have received employment guidance, parental or primary caregiver’s occupation, etc.
The career locus of control scale for nursing undergraduate students
This study applied the Career Locus of Control Scale for Nursing Undergraduate Students developed by Luo Mengna [5]. It includes 20 items in four dimensions: career internal control (seven items), career opportunities (three items), low career efficacy (four items), and career external control (six items). The Cronbach’s α coefficients for the four subscales were 0.843, 0.774, 0.816 and 0.795. It employs a 5-point Likert scale (1 = strongly disagree, 5 = strongly agree). Total score ranges from 20 to 100 points, with higher scores indicating a stronger career locus of control. In the original scale development study, the Content Validity Index (CVI) was 0.90, and the overall Cronbach’s α coefficient was 0.88, indicating good reliability and validity. In the present study, the Cronbach’s α coefficient for the scale was 0.812.
The professional commitment Scale
The Professional Commitment Scale developed by Rong et al. [28] was used to assess the level of professional commitment. It includes 27 items in four dimensions: normative commitment (five items), affective commitment (nine items), continuance commitment (six items), and ideal commitment (seven items). It employs a five-point Likert scale (1 = strongly disagree, 5 = strongly agree), resulting in a total score range of 27 to 135 points, with higher scores indicating greater professional commitment. Previous studies reported a Cronbach’s α coefficient of 0.927 for this scale, demonstrating good construct validity [29]. In the present study, the Cronbach’s α coefficient was 0.890.
The professional identity questionnaire for nursing students (PlQNS)
The Professional Identity Questionnaire for Nursing Students (PIQNS) developed by Hao was used in this study [30]. It includes 17 items in five dimensions: career self-concept (items 1, 6, 9, 11, 16, 17); benefits of staying versus risks of leaving (items 5, 8, 10, 14); social comparison and self-reflection (items 7, 13, 15); career choice autonomy (items 4, 12); and social persuasion (items 2, 3). A five-point Likert scale is employed (1 = strongly disagree,2 = disagree,3 = uncertain,4 = agree, 5 = strongly agree), with item 12 reverse-scored. Total scores range from 17 to 85 points, with higher scores indicating a stronger professional identity among nursing students. Content validity of the questionnaire were assessed by 4 experts, who assessed the clarity and relevance of each item. The scale had good reliability and validity with a Cronbach’s α coefficient of 0.827 and a split-half reliability of 0.842. The scale has been widely used in measuring the professional identity of nursing students in China [31]. In this study, the Cronbach’s α coefficient for the scale was 0.942.
Measurement model validation
To ensure the psychometric adequacy of the instruments, confirmatory factor analysis (CFA) was conducted for each scale using Mplus 8.3. Model fit was evaluated using χ2 /df, CFI, TLI, RMSEA, and SRMR. Criteria for acceptable fit were: χ2 /df < 3, CFI ≥ 0.90, TLI ≥ 0.90, RMSEA ≤ 0.08, and SRMR ≤ 0.08.
CFA results indicated acceptable to good model fit for all three scales. For the Career Locus of Control Scale: χ2 /df = 2.36, CFI = 0.92, TLI = 0.91, RMSEA = 0.056, SRMR = 0.048. For the Professional Commitment Scale: χ2 /df = 2.18, CFI = 0.94, TLI = 0.93, RMSEA = 0.052, SRMR = 0.045. For the Professional Identity Questionnaire: χ2 /df = 2.05, CFI = 0.95, TLI = 0.94, RMSEA = 0.048, SRMR = 0.042. All factor loadings exceeded 0.60.
Composite reliability (CR) and average variance extracted (AVE) were calculated to assess convergent validity. For the Career Locus of Control Scale, CR values were 0.86 (career internal control), 0.82 (career opportunities), 0.80 (low career efficacy), and 0.83 (career external control); AVE values were 0.55, 0.52, 0.50, and 0.53, respectively. The Professional Commitment Scale had a CR of 0.91 and AVE of 0.63. The Professional Identity Questionnaire had a CR of 0.95 and AVE of 0.71. All values exceeded recommended thresholds (CR > 0.70, AVE > 0.50). Discriminant validity was supported as the square root of AVE for each construct exceeded its correlations with other constructs.
Data analysis
Using Mplus 8.3 software, we analyzed the latent profile model of career locus of control among undergraduate nursing students, with scores from the 20 items of the Career Locus of Control Scale for Nursing Undergraduate Students served as the manifest variables. During the latent profile model fitting process, we sequentially fitted models with 1 to 5 categories. The optimal number of profiles was determined based on a comprehensive evaluation of model fit indices and the theoretical interpretability of each solution. Model fit metrics explanation: Lower values for the Akaike Information Criterion (AIC), Bayesian Information Criterion (BIC), and adjusted BIC (aBIC), indicated better model fit [32]. An entropy value ≥ 0.8 signified higher classification accuracy [33]. A p < 0.05 in the Lo-Mendell-Rubin (LMR) likelihood ratio test or the Bootstrap-based likelihood ratio test (BLRT) indicated that the current category model outperforms the previous-level category model [34].
This study employed a latent profile analysis based conceptual model, in which the observed continuous indicators, specifically the scores on the 20 items of the Career Locus of Control Scale for Nursing Undergraduate Students, were used to infer an unobserved categorical latent variable, namely the career locus of control profile. Subsequently, sociodemographic characteristics including year of study, maternal educational attainment, class officer experience, and parental occupation, together with professional commitment and professional identity, were included as predictors influencing the probability of an individual belonging to a specific latent profile. A multinomial logistic regression model was then specified to examine the associations between these predictors and profile membership, with the Low Internal–Low External Control Profile serving as the reference group.
Data analysis was performed using SPSS 26.0 software. Quantitative data were expressed as mean ± standard deviation (
± s) and analyzed using the t-test. Qualitative data were presented as percentages (%) and analyzed using the chi-square (χ2) test. Multinomial logistic regression analysis was conducted to examine factors associated with latent profile membership. The latent profiles of career locus of control were specified as the dependent variable, and independent variables that were statistically significant in the univariate analyses were entered into the model. Regression assumptions included a log-linear relationship between independent variables and the dependent variable category, with no severe multicollinearity among independent variables. Regression results were reported as β values, Wald χ2 values, odds ratios (OR), and 95% confidence intervals (95% CI). An OR > 1 indicated that higher levels of the independent variable was associated with an increased likelihood of the dependent variable category, while an OR < 1 indicated a decreased likelihood.
Results
Participant characteristics
Among the 582 undergraduate nursing students, the demographic characteristics were as follows: Sex: male (58 cases), female (524 cases); Year of study: first-year (161 cases), second-year (146 cases), third-year (146 cases), fourth-year (129 cases); place of residence: urban (275 cases), rural (307 cases); Paternal educational attainment: primary school or below (83 cases), junior high school (218 cases), senior high school/vocational school (155 cases), college or above (126 cases); Maternal educational attainment: primary school or below (193 cases), junior high school (246 cases), senior high school/vocational school (99 cases), college or above (44 cases); Monthly household income per capita: <¥2,000 (118 cases), ¥2,000–3,999 (256 cases), ¥4,000–5,999 (109 cases), ≥¥6,000 (96 cases); Part-time work experience: Yes (152 cases), No (430 cases); Class officer experience: Yes (295 cases), No (287 cases); Scholarship recipient: Yes (183 cases), No (399 cases); Received employment guidance: Yes (368 cases), No (214 cases); Parental or primary caregiver’s occupation: Healthcare/nursing-related (34 cases), Other occupations (548 cases).
Latent profiles analysis and naming of career locus of control
Using the 20 items of the Career Locus of Control Scale for Nursing Undergraduate Students as manifest indicators and taking the one-profile model as the baseline, we sequentially fitted latent profile models with one to five profiles to examine career locus of control among nursing undergraduates (Table 1). Model selection was based on a comprehensive evaluation of the decreases in the AIC, BIC, aBIC, entropy values, and the results of the LMR likelihood ratio test and BLRT, together with theoretical interpretability. The results indicated that the three-profile model demonstrated superior statistical performance and theoretical adequacy. Compared with the one- and two-profile models, the three-profile model showed substantial reductions in AIC, BIC, and aBIC values. The entropy value was 0.921, exceeding the recommended threshold of 0.80, and both the LMR (p = 0.008) and BLRT (p < 0.001) were statistically significant (p < 0.05), indicating better model fit and classification accuracy. Although the AIC and BIC continued to decrease for the four- and five-profile solutions, their LMRT p-values were no longer significant (p > 0.05), suggesting no further improvement over the three-profile model. Therefore, the three-profile solution showed was selected based on the combination of statistical fit indices and theoretical consistency. Profile 1 consisted of 190 nursing undergraduates (32.7%), with scores on Career Locus of Control Scale for Nursing Undergraduate Students ranging from 2.29 to 3.23. This profile was characterized by relatively low mean scores on internal control indicators, including effort, ability, and career planning, while scores on external control and helplessness-related items were also at low to moderate levels. The consistently low scores across both internal and external control dimensions suggested a generally weak perception of career-related control rather than a clear attributional preference. According to attribution theory [6, 7], this pattern reflects a maladaptive attributional style. Students in this group tend to score high on low professional efficacy and may attribute failures to stable, internal, and uncontrollable factors, such as a perceived lack of talent. Theoretically, this configuration resembles learned helplessness, represents the group most at risk of transition shock. This pattern reflected limited engagement in proactive career regulation alongside uncertainty regarding the factors influencing career development, and was therefore conceptualized as the Low Internal–Low External Control Profile. Profile 2 comprised 297 undergraduate nursing students (51.0%), with scores on the Career Locus of Control Scale for Nursing Undergraduate Students ranging from 1.73 to 4.60 across items. Students in this profile demonstrated the highest scores on internal control indicators, such as effort, ability, professional knowledge and skills, and career planning, while reporting the lowest levels of endorsement for external and helplessness-related items. This configuration indicated a strong tendency to attribute career development outcomes primarily to personal agency rather than external circumstances. According to attribution theory [6, 7], this profile exemplifies an adaptive attributional style. These students primarily attribute career success to internal, controllable factors, such as effort and skill, which fosters high expectations for future success and positive emotional states, such as professional pride. From a theoretical perspective, this profile reflected a predominantly internal locus of control, characterized by high self-regulation, goal orientation, and perceived personal responsibility for career outcomes, and was thus labeled the High Internal Control–Low External Attribution Profile. Profile 3 included 95 undergraduate nursing students (16.3%), with scores on the Career Locus of Control Scale for Nursing Undergraduate Students ranging from 3.54 to 4.51. This profile showed relatively high scores on internal control indicators, alongside elevated scores on external attribution items, including luck, external environment, and helplessness. This suggested that students in this group acknowledge the importance of personal effort and competence while simultaneously recognizing the influence of contextual and situational factors on career development. According to attribution theory [6, 7], this profile represents an integrated attributional orientation—sometimes termed attributional flexibility. Such a balanced pattern may be particularly adaptive in complex, interdependent environments such as nursing education and clinical practice, especially within collectivist cultural contexts like China. Accordingly, this profile was defined as the Balanced Internal–External Control Profile. See Fig. 1 for details.
Table 1.
Model fit indicators for career locus of control profiles among nursing undergraduates
| Number of latent profiles | AIC | BIC | aBIC | entropy value | p-value | Category Probability (%) | |
|---|---|---|---|---|---|---|---|
| LMRT | BLRT | ||||||
| 1 | 33032.119 | 33206.778 | 33079.793 | - | - | - | 100 |
| 2 | 30956.271 | 31222.626 | 31028.974 | 0.930 | <0.001 | <0.001 | 75.4/24.6 |
| 3 | 29736.181 | 30094.232 | 29833.913 | 0.921 | 0.008 | <0.001 | 32.7/51.0/16.3 |
| 4 | 29122.486 | 29572.233 | 29245.246 | 0.917 | 0.073 | <0.001 | 37.4/30.4/27.7/4.5 |
| 5 | 28711.623 | 29253.065 | 28859.412 | 0.918 | 0.070 | <0.001 | 25.4/37.3/19.1/13.7/4.5 |
Fig. 1.
Distribution characteristics potential profiles of career locus of control among nursing undergraduates
Univariate analysis of factors influencing career locus of control among nursing undergraduates
Univariate analysis revealed statistically significant differences (p < 0.05) among nursing undergraduates with different career locus of control profiles across several dimensions, including year of study, maternal educational attainment, class officer experience, parental or primary caregiver’s occupation, level of professional commitment, and professional identity. Students classified in the Low Internal–Low External Control Profile were predominantly first-year students and those whose mothers had lower educational attainment. This group exhibited relatively lower levels of professional commitment and nursing professional identity. Students in the High Internal Control–Low External Attribution Profile were more evenly distributed across academic years and were more likely to have mothers with higher educational attainment. They demonstrated higher levels of professional commitment and nursing professional identity. Students in the Balanced Internal–External Control Profile were more likely to be senior students and to hold class officer positions. Their maternal educational attainment and parental or primary caregiver’s occupational backgrounds were more diverse, and they generally showed higher levels of professional commitment and nursing professional identity, as detailed in Table 2.
Table 2.
Sociodemographic and family-related factors associated with career control source among nursing undergraduates (n = 582)
| Project | Low Internal–Low External Control (n = 190) | High Internal Control–Low External Attribution (n = 297) | Balanced Internal–External Control (n = 95) | χ2/F | P | |
|---|---|---|---|---|---|---|
| Sex | Male | 22(11.58%) | 29(9.76%) | 7(7.37%) | 1.279 | 0.528 |
| Female | 168(88.42%) | 268(90.24%) | 88(92.63%) | |||
| Year of study | Year One | 69(36.32%) | 75(25.25%) | 17(17.90%) | 36.213 | <0.001 |
| Year Two | 57(30.00%) | 77(25.93%) | 12(12.63%) | |||
| Year Three | 37(19.47%) | 78(26.26%) | 31(32.63%) | |||
| Year Four | 27(14.21%) | 67(22.56%) | 35(36.84%) | |||
| Place of residence | Urban | 94(49.47%) | 143(48.15%) | 38(40.00%) | 2.476 | 0.290 |
| Rural | 96(50.53%) | 154(51.85%) | 57(60.00%) | |||
| Paternal educational attainment | Primary school or below | 32(16.84%) | 44(14.81%) | 7(7.37%) | 7.489 | 0.278 |
| Junior high school | 76(40.00%) | 107(36.03%) | 35(36.84%) | |||
| Senior high school/vocational school | 42(22.11%) | 83(27.95%) | 30(31.58%) | |||
| College or above | 40(21.05%) | 63(21.21%) | 23(24.21%) | |||
| Maternal educational attainment | Primary school or below | 79(41.58%) | 98(33.00%) | 16(16.84%) | 87.506 | <0.001 |
| Junior high school | 90(47.37%) | 134(45.12%) | 22(23.16%) | |||
| Senior high school/vocational school | 11(5.79%) | 49(16.50%) | 39(41.05%) | |||
| College or above | 10(5.26%) | 16(5.38%) | 18(18.95%) | |||
| Monthly household income per capita (Yuan) | <2000 | 29(15.26%) | 66(22.22%) | 23(24.21%) | 10.278 | 0.113 |
| 2000–3999 | 89(46.84%) | 122(41.08%) | 48(50.53%) | |||
| 4000–5999 | 36(18.95%) | 57(19.19%) | 16(16.84%) | |||
| ≥6000 | 36(18.95%) | 52(17.51%) | 8(8.42%) | |||
| Part-time work experience | Yes | 49(25.79%) | 77(25.93%) | 26(27.37%) | 0.093 | 0.954 |
| No | 141(74.21%) | 220(74.07%) | 69(72.63%) | |||
| Class officer experience | Yes | 75(39.47%) | 157(52.86%) | 63(66.32%) | 19.404 | <0.001 |
| No | 115(60.53%) | 140(47.14%) | 32(33.68%) | |||
| Scholarship recipient | Yes | 60(31.58%) | 100(33.67%) | 23(24.21%) | 2.990 | 0.224 |
| No | 130(68.42%) | 197(66.33%) | 72(75.79%) | |||
| Received employment guidance | Yes | 119(62.63%) | 186(62.63%) | 63(66.32%) | 0.465 | 0.793 |
| No | 71(37.37%) | 111(37.37%) | 32(33.68%) | |||
| Parental or primary caregiver’s occupation | Healthcare/nursing-related occupations | 5(2.63%) | 19(6.40%) | 10(10.53%) | 7.516 | 0.023 |
| Other occupations | 185(97.37%) | 278(93.60%) | 85(89.47%) | |||
| Professional Commitment Scale | 86.25 ± 13.82 | 97.39 ± 12.95 | 101.63 ± 21.53 | 45.335 | <0.001 | |
| Professional Identity Questionnaire for Nursing Students | 55.97 ± 9.95 | 62.90 ± 9.94 | 64.99 ± 14.65 | 31.380 | <0.001 | |
Multinomial logistic regression analysis of factors influencing career locus of control among nursing undergraduates
A multinomial logistic regression analysis was performed to identify factors influencing career locus of control among nursing undergraduates. The dependent variable was the perceived career locus of control, categorized into three latent profiles: Low Internal-Low External Control Profile (reference group, coded as 1), High Internal Control-Low External Attribution Profile (coded as 2), and Balanced Internal-External Control Profile (coded as 3). Independent variables, identified as statistically significant in univariate analyses, were included and coded as described in Table 3.
Table 3.
Independent variable assignment
| Independent Variable | Assignment Method |
|---|---|
| Year of study |
Year One = (0,0,1); Year Two = (1,0,0); Year Three = (0，1，0); Year Four = (0，0，0) |
| Maternal educational |
Primary school or below = (0, 0, 1); Junior high school = (1, 0, 0); Senior high school/vocational school = (0, 1, 0); College or above = (0, 0, 0). |
| Class officer experience | Yes = 1; No = 2 |
| Parental or primary caregiver’s occupation | Healthcare/nursing-related occupations = 1; Other occupations = 2 |
| Professional Commitment Scale | Substitute the original value |
| Professional Identity Questionnaire for Nursing Students | Substitute the original value |
The results revealed that year of study, maternal educational attainment, class officer experience, parental or primary caregiver’s occupation, professional commitment, and professional identity were significant predictors of career locus of control among nursing students (p < 0.05). Detailed regression results are presented in Table 4.
Table 4.
Factors influencing career locus of control among undergraduate nursing student
| Indicator | β value | Waldχ2 | p-value | OR value | 95%CI |
|---|---|---|---|---|---|
| High Internal Control–Low External Attribution Profile* | |||||
| Professional Commitment Scale | 1.057 | 15.901 | <0.001 | 1.059 | 1.029–1.089 |
| Professional Identity Questionnaire for Nursing Students | 1.107 | 11.690 | <0.001 | 1.108 | 1.071–1.145 |
| Year of study | |||||
| Year One | 1.810 | 6.939 | 0.008 | 0.445 | 0.244–0.813 |
| Year Two | 1.704 | 5.080 | 0.024 | 0.495 | 0.268–0.912 |
| Year Three | 1.690 | 4.043 | 0.036 | 0.512 | 0.347–0.791 |
| Maternal Educational Attainment | |||||
| Primary school or below | 1.304 | 4.584 | 0.015 | 0.738 | 0.286–0.905 |
| Junior high school | 1.048 | 5.596 | 0.022 | 0.949 | 0.844–0.983 |
| Senior high school | 1.963 | 5.024 | 0.021 | 0.621 | 0.244–0.816 |
| Class officer experience | |||||
| Yes | 1.681 | 10.533 | 0.001 | 1.976 | 1.310–2.983 |
| Parental or primary caregiver’s occupation | |||||
| Healthcare/nursing-related occupation | −1.945 | 4.800 | 0.026 | 2.574 | 1.850–3.789 |
| Balanced Internal–External Control Profile* | |||||
| Professional Commitment Scale | 1.068 | 12.267 | <0.001 | 1.070 | 1.030–1.111 |
| Professional Identity Questionnaire for Nursing Students | 1.009 | 11.128 | <0.001 | 1.019 | 1.005–1.063 |
| Year of study | |||||
| Year One | 1.594 | 13.904 | <0.001 | 0.203 | 0.088–0.469 |
| Year Two | 1.818 | 15.686 | <0.001 | 0.162 | 0.066–0.399 |
| Year Three | 1.171 | 8.170 | 0.009 | 0.843 | 0.374–0.900 |
| Maternal Educational Attainment | |||||
| Primary school of below | 2.159 | 15.140 | <0.001 | 0.115 | 0.039–0.342 |
| Junior high school | 1.730 | 10.561 | 0.001 | 0.177 | 0.062–0.502 |
| Senior high school/vocational school | 1.590 | 5.949 | 0.011 | 0.203 | 0.151–0.506 |
| Class officer experience | |||||
| Yes | 1.221 | 10.772 | <0.001 | 3.392 | 1.856–6.198 |
| Parental or primary caregiver’s occupation | |||||
| Healthcare/nursing-related occupations | −1.493 | 5.228 | 0.022 | 4.450 | 1.238–16.000 |
Note: *The Low Internal–Low External Control was used as the reference group
Discussion
Latent profiles in career locus of control among undergraduate nursing students
This study is the first to apply LPA to identify latent profiles of career locus of control among undergraduate nursing students, thereby addressing a critical gap in this field. Latent profile analysis revealed three distinct profiles of career locus of control among undergraduate nursing students: Low Internal-Low External Control Profile, High Internal Control-Low External Attribution Profile, and Balanced Internal-External Control Profile. Each profile reflects a qualitatively different attributional pattern that can be interpreted through the lens of attribution theory [6]. Low Internal-Low External Control Profile constituted 32.7%, with low scores across all dimensions, lacking clear career positioning, being easily influenced by the environment, and exhibiting ambiguity and passivity regarding future career direction [35] According to attribution theory, these students have not developed stable causal explanations for career outcomes. They do not consistently attribute success or failure to either internal or external factors. This pattern indicates an underdeveloped attributional style. In more concerning cases, it may reflect a state of learned helplessness, where students perceive a lack of contingency between their actions and career outcomes [7]. This finding is consistent with that of Alkorashy [17], who found that students with limited clinical experience demonstrated weaker internal control, but it extends prior work by by identifying a distinct subgroup with low control across both attributional dimensions. For these students, the absence of a clear attributional framework may lead to career indecision, heightened anxiety, and vulnerability to transition shock [14]. High Internal Control-Low External Attribution Profile constituted 51.0%. According to attribution theory, this pattern exemplifies an adaptive attributional style: these students attribute career success primarily to internal, controllable and stable factors, for example effort and skill. Such attributions foster high expectations for future success, positive emotional states such as professional pride, and proactive career self-regulation [10]. This finding is consistent with that of Xiao et al. [13], who reported that internal control was positively associated with critical thinking among nursing students, and with Wu et al. [12], who identified career locus of control as a significant predictor of professional commitment. However, attribution theory also cautions that an exclusively internal attributional style may have limitations [6, 7]. When these students encounter career setbacks, for example failing a clinical evaluation or not securing a desired internship, they may be prone to excessive self-blame due to their tendency to attribute outcomes solely to personal factors. In the collectivist cultural context of China, where external resources including family, peer and mentor support play critical roles in career development [18], this exclusive internal focus may lead to burnout when faced with uncontrollable obstacles, such as clinical placement shortages or competitive job markets. This insight extends previous research by showing that internal control, while generally adaptive, may need to be balanced with external resource awareness to sustain long-term career resilience. Balanced Internal-External Control Profile constituted 16.3%. According to attribution theory, this pattern reflects attributional flexibility, the capacity to shift between internal and external causal explanations depending on the situational context. In nursing education, which integrates rigorous academic demands with unpredictable clinical environments, such flexibility is highly adaptive. Students with this pattern recognize that personal effort and competence are essential but also acknowledge that external opportunities, mentorship, and even chance events shape career trajectories. This balanced attributional style may help students navigate the dual demands of academic rigor and clinical practice, as they can draw on internal motivation while also seeking and accepting external guidance when needed. This finding extends research on career maturity among nursing students [15], which identified internal locus of control as a key resource. The optimal pattern involves not just internal control but also awareness and strategic use of external factors, a nuanced insight that variable-centered approaches could not reveal. In summary, the three profiles reveal that career locus of control among nursing students is not a unidimensional continuum but comprises distinct attributional patterns. The progression from low-control to high-internal to balanced profiles suggests a developmental trajectory, with the balanced profile representing the most adaptive configuration for sustainable career development.
Factors influencing career locus of control profiles
Year of study emerged as a significant predictor, with first- and second-year students more likely to be categorized as exhibiting a Low Internal–Low External Control Profile pattern, whereas third- and fourth-year students tended toward a Balanced Internal–External Control Profile. This pattern is consistent with the findings of Zhao et al. [16], who tracked changes in professional commitment among nursing students before and after internship. From the perspective of attribution theory, this developmental trajectory is theoretically plausible: as students accumulate clinical experience and professional knowledge, they develop more sophisticated causal reasoning patterns that integrate both personal effort and environmental factors. The transition from attributional uncertainty to attributional flexibility reflects the process of professional socialization, where students gradually internalize the nursing professional role while also learning to navigate the complex healthcare environment. This finding suggests that educational interventions targeting first-year students may be particularly effective in fostering adaptive attributional patterns early in the educational trajectory.
Maternal educational attainment was significantly associated with profile membership. Students whose mothers had higher levels of educational attainment were more likely to be categorized as Balanced Internal–External Control Profile, while those whose mothers had lower educational attainment tended toward Low Internal–Low External Control Profile. These findings are consistent with those reported by Smyth et al. [18], who examined the role of family background in career decision-making processes. Attribution theory suggests that family environment shapes the development of causal reasoning patterns through modeling and reinforcement [6]. Mothers with higher educational attainment may model adaptive attributional patterns by emphasizing both personal effort and the importance of seeking help and utilizing resources. They may also provide more guidance on career planning and problem-solving strategies, fostering the development of attributional flexibility in their children. This finding highlights the importance of considering family background when designing educational interventions, as students from less advantaged backgrounds may require additional support in developing adaptive career control beliefs.
Class officer experience was associated with membership in the Balanced Internal–External Control Profile. Students had class officer positions were more likely to be categorized as Balanced Internal–External Control profiles, while those without such roles predominantly exhibited Low Internal–Low External Control Profile, mirroring findings by Arsini et al. [19] who found that students with leadership roles demonstrated stronger internal control beliefs. This finding suggests that leadership experience plays a significant role in cultivating students’ organizational and coordination skills, decision-making abilities, and strategies for navigating complex environments. In educational practice, systematic leadership development opportunities should be provided through class management roles, project-based tasks, and simulated management training [20]. Attribution theory posits that successful experiences in challenging situations foster the development of adaptive attributional patterns [6]. Leadership roles provide opportunities for students to experience both personal agency in making decisions and taking initiative and the value of external support in collaborating with others and seeking guidance. These experiences may help students develop the cognitive flexibility to attribute outcomes to both internal and external factors depending on the situation. This finding suggests that providing leadership opportunities for nursing students may be an effective strategy for fostering adaptive career control beliefs.
Parental or primary caregiver’s occupation in healthcare was significantly associated with profile membership. Students whose parents worked in healthcare-related professions were more likely to be categorized as Balanced Internal–External Control profiles, while those from other occupational backgrounds tended toward Low Internal–Low External Control Profile. These findings are consistent with those reported by Jasmon et al. [36], who reported that parental influences shape career exploration in collectivist cultural contexts. From the attribution theory perspective, parents working in healthcare serve as role models who demonstrate adaptive attributional patterns through their daily work. They implicitly convey that clinical outcomes depend on both internal and external factors. Through observational learning, their children internalize a balanced attributional style, recognizing that career success is shaped by individual effort and environmental affordances. Students from non-healthcare family backgrounds may lack such exposure, leading to underdeveloped causal reasoning patterns. This finding suggests that nursing programs should provide additional attributional modeling for these students, such as mentorship by clinical nurses and case-based discussions on real-world healthcare challenges [37].
Professional commitment was significantly associated with profile membership, with higher commitment levels predicting membership in the Balanced Internal–External Control Profile. This finding is consistent with that of Wu et al. [12], who identified career locus of control as a significant predictor of professional commitment. Furthermore, this study also demonstrats a bidirectional relationship. Attribution theory suggests that professional commitment and attributional patterns may reinforce each other over time [6]. Students with higher professional commitment were more likely to invest effort in their studies and clinical practice, leading to successful experiences that reinforce internal control beliefs [38]. At the same time, their commitment may motivate them to seek out and utilize external resources, fostering awareness of environmental influences on career outcomes. This finding underscores the importance of fostering professional commitment early in nursing education as a means of promoting adaptive career control beliefs.
Professional identity was also significantly associated with profile membership, with higher identity scores predicting membership in the Balanced Internal–External Control Profile. This finding aligns with research on professional identity formation in nursing students [39]. In addition, our research adds a new dimension by linking identity to specific attributional patterns. Attribution theory suggests that professional identity provides a cognitive framework for interpreting career-related experiences [6]. Students with higher levels of professional identity were more likely to interpret challenges as opportunities for growth, reflecting internal attribution, while also recognizing the value of mentorship and support, reflecting external attribution. This balanced perspective may facilitate optimal career adaptation in the complex healthcare environment [40]. This finding highlights the importance of professional identity development as a foundation for adaptive career control beliefs.
Implications for nursing education and practice
The identification of three distinct career locus of control profiles provides specific, actionable guidance for nursing educators, academic advisors, and curriculum designers. Rather than treating nursing students as a homogeneous population, interventions can be tailored to each subgroup’s attributional characteristics.
For nursing education programs, theory-based modules addressing diverse attributional patterns can be incorporated. For the Low Internal-Low External Control Profile, which includes nearly one third of students, structured career development courses can be introduced early. These courses may focus on self-efficacy, clear career pathways, and professional identity formation. Attributional retraining, which involves re-attributing failures to controllable, external, or unstable causes, may be particularly beneficial for this subgroup. For the High Internal Control-Low External Attribution Profile, modules can enhance awareness of external resources. For example, workshops on help-seeking, peer mentoring, and case-based learning can be used to prevent self-blame and anxiety resulting from over-reliance on internal attributions. For the Balanced Internal-External Control Profile, enriched clinical experiences and leadership opportunities, such as peer mentoring roles, can be provided to further enhance career adaptability.
Academic advisors and mentors can be trained to identify students’ control profiles using screening tools based on the Career Locus of Control Scale. These tools may be administered at key transition points, for example at program entry or the beginning of clinical rotations. For Low Internal-Low External students, advisors can provide structured, step-by-step guidance with frequent check-ins, goal setting, and connections with successful senior students. Mentors can model adaptive attributions by attributing successes to effort and failures to modifiable factors. For High Internal-Low External students, advisors can encourage reflection on external factors, such as preceptor support, institutional resources, and peer networks, to broaden attributional frameworks without undermining self-efficacy.
For the interventions targeting professional identity, nursing programs can implement structured reflective practices, such as guided reflective journals on clinical experiences and peer-led debriefing sessions after challenging patient encounters. For low-control students, journal prompts can focus on identifying personal strengths and recognizing progress; for high-internal students, prompts can encourage consideration of external resources; for balanced students, prompts can explore integration of personal effort and environmental awareness. To enhance career commitment, educators can offer career pathway seminars, internship opportunities in diverse clinical settings, and recognition programs that reinforce commitment. Additionally, professional identity workshops that connect students’ personal values with the nursing profession through interactions with practicing nurses and exposure to diverse career pathways can further strengthen commitment.
Limitations
This study has several limitations. First, the use of a convenience sample drawn from a single institution in Hebei Province may introduce potential selection bias, limiting the generalizability of the findings to nursing undergraduates in other educational or regional contexts. Participants from this specific setting may not be representative of those enrolled in different types of nursing programs, such as vocational colleges or prestigious universities, or located in other geographical regions with varying economic and healthcare conditions. Consequently, the identified profiles and their associated factors may not be directly transferable to other populations. Future research should employ multi-center, large-sample designs across diverse institutions and regions to enhance external validity and cross-contextual applicability. Second, the cross-sectional design precludes causal inference regarding the relationships between career locus of control profiles and associated factors, including professional commitment, professional identity, and maternal education. This design does not allow for the examination of changes or stability in career locus of control profiles over time, nor can it establish temporal precedence or directional causality. Future research should consider longitudinal tracking designs or cross-lagged panel models to examine the dynamic developmental trajectories of career locus of control profiles and their causal relationships with relevant variables. Third, reliance on self-reported measures may introduce response biases, such as social desirability and common method bias, which could affect the accuracy and objectivity of the findings. Participants may have provided socially desirable responses rather than reflecting their true psychological states or behaviors. To address this limitation, future research should incorporate multi-informant approaches, such as integrating teacher evaluations, peer assessments, or objective clinical performance indicators, to provide more comprehensive and objective assessments. Additionally, mixed-methods approaches combining quantitative latent profile analysis with qualitative interviews are recommended to gain deeper insights into the psychological and contextual mechanisms underlying different profile memberships.
Conclusions
This study identified three distinct latent profiles of career locus of control among undergraduate nursing students in China: Low Internal-Low External Control, High Internal Control-Low External Attribution, and Balanced Internal-External Control. These findings demonstrate substantial heterogeneity in how nursing students attribute career outcomes to personal agency versus external influences, shifting the focus from variable-centered scores to a person-centered typological perspective. Year of study, maternal educational attainment, class officer experience, parental or primary caregiver’s occupation, professional commitment and professional identity emerged as significant predictors of profile membership, reflecting the multidimensional nature of career locus of control beliefs. Although the Balanced Internal–External Control Profile was the smallest subgroup, it demonstrated the most adaptive pattern, characterized by effective career planning, higher self-efficacy, and better emotional regulation. Theoretically, this study reveals that career locus of control is a multidimensional construct comprising distinct subgroups rather than a single continuum. Practically, the identification of these profiles underscores the need for stratified, differentiated educational strategies tailored to each subgroup’s attributional patterns to foster professional identity and psychological resilience. Future research should employ longitudinal designs to examine the stability and transitions of these profiles over time, as well as investigate the effectiveness of tailored interventions in promoting adaptive career control beliefs. Additionally, exploring cross-cultural variations in career locus of control profiles would enhance the generalizability of these findings to diverse nursing education contexts.
Acknowledgements
The authors are deeply grateful to the faculty members of the schools who cooperated with us and to the undergraduate nursing students who participated in this study.
Abbreviations
- LPA
Latent profile analysis
- AIC
Akaike information criterion
- BIC
Bayesian information criterion
- aBIC
Adjusted Bayesian information criterion
- CVl
Content Validity Index
- LMR
Lo-Mendell-Rubin test
- BLRT
Bootstrap likelihood ratio test
- OR
Odds Ratios
- PIQNS
The Professional Identity Questionnaire for Nursing Students
Author contributions
Jianhui Wang: completed the research design and writing of this article. Juan Zhang and Shan Zhao: sorted outand analyzed the data. Aiping Zhang: reviewed and corrected important points in this article.Qianqian Song:played an important role in the data acquisition of this study. All authors contributed tothis article and approved the submitted version.
Funding
This work was supported by the Higher Education Teaching Reform Research and Practice Project of Hebei Province, titled “Research on the Compound Talent Cultivation Model of ‘Nursing + X’ in Application-oriented Universities under the Background of New Medicine” (Grant No. 2025GJJG656).
Data availability
The data that were generated and analyzed in this study are mostly included within the published article. However, source material and the raw datasets are available from the corresponding author upon request.
Declarations
Ethics approval and consent to participate
The study was conducted in accordance with the Declaration of Helsinki. Ethics approval was obtained from the Ethics Committee of Yanching Institute of Technology, China (Approval No: 202502). The informed consent was obtained from all of the participants through an online questionnaire. Participants were also informed that they had the option to withdraw at any time. All methods in this study were carried out in accordance with relevant guidelines and regulations.
Consent for publication
Not applicable.
Competing interests
The authors declare no competing interests.
Footnotes
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
The data that were generated and analyzed in this study are mostly included within the published article. However, source material and the raw datasets are available from the corresponding author upon request.