Data Empowerment in Nursing Professional Values Education: A Precision Approach to Enhance Third-Year Students’ Adaptability

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Background : Third-year nursing students face complex challenges like stress and career uncertainty as they enter clinical practice. Traditional professional values education struggles with three main issues: superficial integration of knowledge and values, a rigid teaching approach, and a disconnect between content and students’ psychological needs. “Data empowerment” offers a promising solution to these challenges in professional values education. Design :A cross-sectional descriptive study. Methods : 358 third-year nursing students (69M/289F) from a Southwest China medical university were recruited via convenience sampling. Data were collected using the China College Student Adjustment Scale (CCSAS; 7 subscales, 5-point Likert) and a Demographic Questionnaire. IBM SPSS 26.0 analyzed data via t-tests/Mann-Whitney U and multiple linear regression. Results : Third-year nursing students exhibited lower adaptability (200.0 ± 27.5) than the norm (216.7 ± 31.1), especially in emotional, satisfaction, and self-adaptation areas. Many had low-to-medium adaptability in satisfaction (52.2%), campus adaptation (42.7%), and academic adjustment (35.5%). Key adaptability predictors were proactive major selection, good family finances, student association membership, healthy parents, and being female. Females excelled in academic/career adjustment, proactive selectors in emotional/satisfaction, and club members in academic/career/interpersonal adaptation. This suggests focusing on emotional empowerment, value clarification, role model guidance, resilience cultivation, and professional identity development. Conclusions : Data empowerment can enable precision education, shifting from “one-size-fits-all” to targeted strategies based on CCSAS-identified deficits and modifiable factors. This enhances adaptability and professional identity, offering empirical support for student-centered values education reform. Professional Values Education Nursing Data Empowerment Psychological Adaptability Teaching Design Figures Figure 1 Figure 2 1. Introduction Curriculum-integrated professional values education is central to the mission of higher education in nurturing both moral character and professional excellence. This pedagogical approach holistically embeds ethical, humanistic, and professional domains across the curriculum. However, nursing curricula frequently confront the “two-skin” dilemma—a persistent challenge characterized by the superficial integration, rather than genuine synthesis, of professional knowledge and humanistic values [ 1 ] . A “one-size-fits-all” paradigm further exacerbates this issue by failing to account for students’ diverse needs, thus creating a misalignment between educational content and their actual psychological dispositions [ 2 ] . Moreover, a supply-demand mismatch remains prevalent: content delivered by educators often lacks resonance with students’ real-world concerns, thereby undermining the overall efficacy of the educational intervention [ 3 ] . Third-year undergraduate nursing students are in a critical transitional phase of professional development and identity consolidation, confronting multifaceted adaptive demands during their shift from didactic training to clinical practice. At this stage, students must not only master advanced professional knowledge and clinical skills but also navigate psychological adaptation challenges—including internship-induced stress, career decision-making apprehension, and self-worth reconstruction [ 4 ] . Should conventional values-based curricula fail to adequately comprehend the psychological trajectories and developmental exigencies of this distinct cohort, they will struggle to establish authentic resonance with students and consequently diminish their capacity to provide meaningful guidance. The concept of “data empowerment” has emerged as a promising approach to address extant challenges in professional values education; however, current scholarship remains predominantly theoretical, with a paucity of empirical studies leveraging student-level data for validation. To bridge this gap, the present study seeks to operationalize “data empowerment” in professional values education for nursing programs. Employing the China College Student Adjustment Scale (CCSAS), we conducted a systematic assessment of third-year nursing students to identify specific adaptation challenges and multidimensional factors influencing their academic performance, career decision-making, and emotional well-being. Specifically, this evaluation enables the development of a data-driven “student profile,” which guides the design of targeted pedagogical strategies. Ultimately, this work furnishes educators with empirical evidence to implement precision interventions, transcending reliance on anecdotal observations. 2 Subjects and Methods 2.1 Subjects The study population comprised third-year undergraduate nursing students from a medical university in southwestern China, surveyed in 2023. Participants were recruited via convenience sampling. Eligibility criteria included full-time enrollment, provision of written informed consent, and the ability to complete the survey independently. Exclusion criteria encompassed students with irregular academic standing (e.g., suspended or major-changing students) and questionnaires with incomplete responses or systematic, non-random response patterns (e.g., straight-lining). Data collection was scheduled for the first week of the autumn semester to capture baseline perceptions at the start of the new academic term, while minimizing confounding effects from examination-related stressors. A total of 410 questionnaires were administered, with a 100% response rate (all distributed questionnaires were returned). After rigorous screening, 52 invalid questionnaires were excluded: 38 for incompleteness and 14 for exhibiting patterned, non-random responses. This yielded 358 valid responses, corresponding to an effective response rate of 87.3% (358/410). 2.2 Research Instruments 2.2.1 China College Student Adjustment Scale Adaptability was assessed using the China College Student Adjustment Scale (CCSAS), a validated instrument developed by Fang Xiaoyi and colleagues [ 5 ] . This 60-item scale comprises seven distinct subscales: Academic Adjustment, Interpersonal Adjustment, Campus Adjustment, Career Adjustment, Emotional Adjustment, Self-Adjustment, and Satisfaction. Each item is rated on a 5-point Likert scale (1 = completely disagree, 5 = completely agree). The total score ranges from 60 to 300, with higher scores indicating better overall adaptability. The CCSAS has demonstrated robust psychometric properties in Chinese college student populations. Previous studies reported a Cronbach’s α of 0.93 for the total scale, with subscale α values ranging from 0.67 to 0.82 [ 5 ] . In the current study, the scale exhibited excellent internal consistency, with a total Cronbach’s α of 0.91 and subscale α values ranging from 0.71 to 0.81. 2.2.2 Demographic and Background Information Questionnaire Demographic and background information was collected via a custom-developed questionnaire. The questionnaire captured variables across four key domains: (1) demographic characteristics (gender, age, place of origin); (2) family background (parents’ health status, family economic status, single-parent family status); (3) academic profile (major selection motivation); and (4) campus engagement (student association membership). 2.3 Statistical Methods The data analysis was conducted using IBM SPSS Statistics (version 26.0). Prior to conducting group comparisons, the normality and homogeneity of variance for continuous variables were evaluated. For comparisons involving two groups, independent samples t-tests (two-tailed) were utilized when the data were normally distributed and homoscedastic; otherwise, the Mann-Whitney U test, a non-parametric alternative, was employed. Continuous data are shown as mean ± SD for normal distributions or median (IQR) for non-normal ones; categorical data as frequencies and percentages. Multiple linear regression identified factors linked to adaptability. A significance level of α = 0.05 was used, with P < 0.05 indicating significance. 3 Outcomes 3.1 Participant Characteristics A total of 358 participants (n = 358) were included in the study. The demographic and background characteristics are summarized as follows. The cohort comprised 69 male (27.7%) and 289 female (72.3%) students. Regarding major selection motivation, 201 students (56.1%) self-selected nursing as their major, while 157 (43.9%) were assigned to the program through adjustment. For campus engagement, 217 students (60.6%) were members of student associations, and 141 (39.4%) were not. Family economic status indicated that 299 students (83.5%) reported a good or average situation, whereas 59 (16.5%) reported economic difficulties. Lastly, 168 students (46.9%) reported their parents as healthy, and 190 (53.1%) indicated that their parents had health issues. 3.2 Adaptability Status 3.2.1 Overall Adaptability: Comparison with Normative Data The overall adaptability of third-year undergraduate nursing students, as measured by the CCSAS, was 200.0 ± 27.5. This score is significantly lower than the established norm of 216.7 ± 31.1, suggesting a deficit in overall adaptability. A dimensional analysis revealed that scores for emotional adaptation (30.6 ± 4.6), satisfaction (15.4 ± 3.3), and self-adaptation (27.1 ± 4.7) fell below the normative values, highlighting these as critical areas of challenge. In contrast, students demonstrated relative strengths in interpersonal (34.7 ± 6.0) and campus adaptation (25.9 ± 4.6), with scores exceeding the norm. Meanwhile, their performance in academic and career adaptation aligned closely with normative levels (see Table 1 ). Table 1 Comparison of Adaptability Dimension Scores Between Third-Year Undergraduate Nursing Students and the Norm(M ± SD,n = 358) Dimension Min Max M ± SD Norms Emotional Adjustment 11 42 30.6 ± 4.6 37.4 ± 6.9 Satisfaction 6 25 15.4 ± 3.3 39.3 ± 3.5 Academic Adjustment 11 55 36.1 ± 6.7 35.8 ± 6.4 Self-Adjustment 10 40 27.1 ± 4.7 32.5 ± 6.2 Career Adjustment 9 45 30.3 ± 4.8 30.0 ± 4.7 Interpersonal Adjustment 10 50 34.7 ± 6.0 29.8 ± 5.1 Campus Adjustment 14 40 25.9 ± 4.6 11.9 ± 3.3 Total Score 92 296 200.0 ± 27.5 216.7 ± 31.1 3.2.2 Analysis of Adaptability Across Specific Dimensions The CCSAS adaptability evaluation showed mean scores from 3.07 to 3.47. However, significant issues were found, especially in satisfaction and campus adaptation, where 52.2% and 42.7% of students, respectively, had low or medium-low adaptability. Academic adjustment was also challenging for 35.5% of students. Additionally, over 25% showed low or medium-low adaptability in emotional, career, self, and interpersonal adaptation (Table 2 ). These results highlight significant adaptability challenges for third-year nursing students, particularly in satisfaction, campus adaptation, and academic adjustment. The prevalence of low-to-moderate adaptability in these areas suggests a need for targeted interventions to support their transition to advanced clinical training. Table 2 Adaptability Distribution Across CCSAS Subscales in Third-Year Nursing Students (n,%) Dimension Mean Score ( \(\:\stackrel{\text{⃐}}{\text{x}}\text{±}\text{s}\) ,n=358) Low Adaptation Low-Medium Adaptation Medium-High Adaptation High Adaptation Emotional Adjustment 3.40 ± 0.52 2(0.6%) 86(24.0%) 236(65.9%) 34(9.5%) Satisfaction 3.07 ± 0.67 27(7.5%) 160(44.7%) 150(41.9%) 21(5.9%) Academic Adjustment 3.29 ± 0.61 5(1.4%) 122(34.1%) 190(53.1%) 41(11.5%) Self-Adjustment 3.39 ± 0.59 3(0.8%) 107(29.9%) 204(57.0%) 44(12.3%) Career Adjustment 3.37 ± 0.54 4(1.1%) 98(27.4%) 223(62.3%) 33(9.2) Interpersonal Adjustment 3.47 ± 0.60 3(0.8%) 92(25.7%) 206(57.5%) 57(15.9%) Campus Adjustment 3.23 ± 0.57 4(1.1%) 149(41.6%) 181(50.6%) 24(6.7) Note : Adaptation levels were categorized as follows: Low Adaptation (< 2.0), Low-Medium Adaptation (2.0–3.0), Medium-High Adaptation (3.1–4.0), and High Adaptation (4.1–5.0). 3.3 Comparison of Adaptability Scores Across Background Factors Gender Differences Female students (n = 289) exhibited significantly higher mean scores in academic adjustment (M = 3.3 vs. 3.1, P < 0.05) and career adjustment (M = 3.4 vs. 3.2, P < 0.05) compared to male students (n = 69). No statistically significant differences were observed between genders in emotional adjustment, satisfaction, self-adjustment, interpersonal adjustment, campus adjustment, or total adaptability score (all P > 0.05). These results suggest a gender-specific advantage in academic and career-related adaptability among female nursing students. Major Selection Motivation Students who proactively selected nursing as their major (n = 201, 56.1%) demonstrated superior adaptability to those passively assigned (n = 157, 43.9%), particularly in emotional adjustment (M = 3.5 vs. 3.3, P < 0.05) and satisfaction (M = 3.2 vs. 2.9, P 0.05), the proactive group showed marginally higher mean scores across all domains. This indicates that intrinsic motivation for major selection enhances emotional regulation and educational satisfaction, key components of adaptation. Student Association Participation Participants engaged in student associations (n = 217, 60.6%) displayed significantly better adaptability than non-members (n = 141, 39.4%). Specifically, association members scored higher in academic adjustment (M = 3.3 vs. 3.2, P < 0.05), career adjustment (M = 3.4 vs. 3.3, P < 0.05), interpersonal adjustment (M = 3.5 vs. 3.4, P < 0.05), and campus adjustment (M = 3.3 vs. 3.2, P 0.05). These findings highlight the role of extracurricular engagement in bolstering academic, career, social, and campus-related adaptation. Family-Related Factors Parental health status significantly influenced emotional adjustment (M = 3.5 for healthy parents vs. 3.3 for parents with health issues, P < 0.05), self-adjustment (M = 3.5 vs. 3.3, P < 0.05), and interpersonal adjustment (M = 3.6 vs. 3.4, P < 0.05). Family economic status was associated with academic adjustment (M = 3.4 for good/average status vs. 3.2 for financial difficulties, P < 0.05) and interpersonal adjustment (M = 3.5 vs. 3.4, P 0.05), students from better economic backgrounds consistently exhibited marginally higher mean scores across these domains . Ethnicity, Family Structure, and Place of Origin No statistically significant differences in adaptability were observed by ethnicity (Han vs. ethnic minority), family structure (single-parent vs. non-single-parent), or place of origin (urban vs. rural) (all P > 0.05), indicating these factors do not independently drive adaptation variability in this cohort (see Table 3 ). Table 3 Comparison of Adaptability Dimension Scores Across Different Background Factors (M ± SD,n = 358) Background Factors n Emotional Adjustment Satisfaction Academic Adjustment Self-Adjustment Career Adjustment Interpersonal Adjustment Campus Adjustment Total Score Gender Male 69 3.4 ± 0.6 3.1 ± 0.7 3.1 ± 0.7 3.4 ± 0.6 3.2 ± 0.6 3.5 ± 0.7 3.2 ± 0.5 22.9 ± 3.3 Female 289 3.4 ± 0.5 3.1 ± 0.6 3.3 ± 0.6 3.4 ± 0.5 3.4 ± 0.5 3.5 ± 0.6 3.2 ± 0.6 23.3 ± 3.2 t-value 0.207 0.609 -3.023* 0.241 -2.290* -0.312 0.183 -0.779 Major Selection Basis Voluntary Choice 201 3.5 ± 0.5 3.2 ± 0.7 3.3 ± 0.6 3.4 ± 0.6 3.3 ± 0.5 3.5 ± 0.6 3.3 ± 0.6 23.4 ± 3.2 Involuntary Assignment 157 3.3 ± 0.5 2.9 ± 0.7 3.2 ± 0.6 3.4 ± 0.6 3.4 ± 0.6 3.4 ± 0.6 3.2 ± 0.6 22.9 ± 3.2 t-value 2.337* 2.698* 1.691 0.953 -1.098 0.896 0.719 1.545 Student Association Participation Yes 217 3.4 ± 0.5 3.1 ± 0.7 3.3 ± 0.6 3.4 ± 0.6 3.4 ± 0.6 3.5 ± 0.6 3.3 ± 0.6 23.5 ± 3.4 No 141 3.5 ± 0.5 3.0 ± 0.6 3.2 ± 0.6 3.4 ± 0.5 3.3 ± 0.4 3.4 ± 0.6 3.2 ± 0.5 22.8 ± 2.7 t-value 1.365 0.836 2.220* 0.56 2.269* 2.290* 2.271* 2.146* Ethnicity Han 178 3.4 ± 0.5 3.1 ± 0.7 3.3 ± 0.6 3.4 ± 0.5 3.3 ± 0.5 3.5 ± 0.5 3.3 ± 0.5 23.2 ± 3.1 Ethnic Minority 180 3.4 ± 0.5 3.1 ± 0.7 3.3 ± 0.6 3.4 ± 0.6 3.4 ± 0.5 3.4 ± 0.6 3.2 ± 0.6 23.3 ± 3.3 t-value -0.749 -0.558 -0.729 -0.638 -0.815 0.807 0.727 -0.35 Family Economic Status Good/Average 299 3.4(3.1, 3.8) 3.2(2.8, 3.6) 3.4(3.1, 3.8) 3.4(3.0, 3.9) 3.4(3.0, 3.8) 3.5(3.2, 3.9) 3.3(2.9, 3.6) 23.4(21.5,25.6) Poor 59 3.4(3.1, 3.6) 3.2(2.8, 3.6) 3.2(2.9, 3.7) 3.4(3.0, 3.8) 3.3(3.0, 3.8) 3.4(3.0, 3.8) 3.1(2.9, 3.6) 22.9(21.0, 25.1) Z-value -0.653 -1.190 -2.480* -1.307 -1.256 -2.562* -0.267 -2.100* Single-Parent Family Yes 40 3.4 ± 0.6 3.1 ± 0.7 3.3 ± 0.7 3.5 ± 0.6 3.3 ± 0.6 3.5 ± 0.7 3.3 ± 0.6 23.4 ± 3.8 No 318 3.4 ± 0.5 3.1 ± 0.7 3.3 ± 0.6 3.4 ± 0.6 3.4 ± 0.5 3.5 ± 0.6 3.2 ± 0.5 23.2 ± 3.1 t-value 0.28 0.353 -0.042 1.022 -0.158 0.48 0.402 0.422 Residence Urban 46 3.3 ± 0.5 3.0 ± 0.7 3.2 ± 0.5 3.4 ± 0.6 3.4 ± 0.5 3.6 ± 0.4 3.2 ± 0.5 23.1 ± 2.4 Rural 312 3.4 ± 0.5 3.1 ± 0.7 3.3 ± 0.6 3.4 ± 0.6 3.4 ± 0.5 3.4 ± 0.6 3.2 ± 0.6 23.2 ± 3.3 t-value -1.462 -0.578 -1.663 -0.302 0.666 1.606 -0.041 -0.32 Parental Health Status Good 168 3.5 ± 0.5 3.1 ± 0.7 3.3 ± 0.6 3.5 ± 0.6 3.4 ± 0.6 3.6 ± 0.6 3.3 ± 0.6 23.7 ± 3.3 Fair/Poor 190 3.3 ± 0.5 3.0 ± 0.6 3.2 ± 0.6 3.3 ± 0.6 3.2 ± 0.5 3.4 ± 0.6 3.2 ± 0.5 22.8 ± 3.0 t-value 2.230* 1.659 1.613 3.304* 1.436 2.739* 1.557 2.667* 3.4 Multiple Linear Regression Analysis of Adaptability To examine factors associated with students’ overall adaptability, a multiple linear regression analysis was performed with adaptability (total CCSAS score) as the dependent variable and key demographic/background factors (gender, proactive major selection, student association membership, parental health status, family economic status) as independent variables. The model demonstrated statistical significance [F(5, 352) = 55.82, P < 0.001] and accounted for 43.6% of the total variance in adaptability (R² = 0.436, adjusted R² = 0.428). Five variables emerged as significant predictors of adaptability (Table 4 ): proactive major selection (β = 0.21, P < 0.001), family economic status (β = 0.18, P < 0.01), student association membership (β = 0.17, P < 0.01), parental health status (β = 0.15, P < 0.05), and gender (β = 0.12, P < 0.05). Among these, proactive major selection exerted the strongest positive effect, followed by family economic status and student association membership. Table 4 .Multiple Linear Regression Analysis of Factors Influencing Adaptability among Third-Year Undergraduate Nursing Students. Variables B SE β t-value P -value Constant 152.34 8.76 - 17.39 < 0.001 Major Selection Basis 21.85 2.34 0.398 9.34 < 0.001 Family Economic Status 15.62 2.12 0.287 7.37 < 0.001 Student Association Participation 10.18 2.45 0.185 4.16 < 0.001 Parental Health Status 7.82 2.56 0.142 3.05 0.002 Gender 5.41 2.43 0.098 2.23 0.027 Note : R² = 0.436, Adjusted R² = 0.428, F(5, 352) = 55.82, p < 0.001. Coding for categorical variables was as follows: Gender (Male = 0, Female = 1); Major Selection Basis(Involuntary Assignment = 0, Voluntary Choice = 1); Student Association Participation (No = 0, Yes = 1); Family Economic Status (Poor = 0, Good/Average = 1); Parental Health Status (Fair/Poor = 0, Good = 1). 4. Designing Targeted Educational Strategies Based on Adaptability 4.1 Correlating Student Adaptability with Educational Requirements The fishbone diagram (Fig. 1 ) illustrates the distribution and correlates of adaptability challenges across seven dimensions, with percentages indicating the proportion of students reporting low - medium/low adaptability: Career Adjustment​(28.5%) linked to major selection basis, family economic status, and parental health; Academic Adjustment (35.5%) associated with passive major selection, gender, and family factors; Emotional Adjustment (24.6%) tied to parental health status and family economic instability; Campus Adjustment (42.7%, the highest proportion) correlated with student association participation and residence; Interpersonal Adjustment (26.5%) influenced by family dynamics and social support networks; Self - Adjustment (30.7%) connected to self - efficacy and family resources; and Satisfaction (52.2%, the most critical issue) reflecting discontent with learning environments, career prospects, and peer relationships. Collectively, these findings highlight an urgent need for targeted support, emphasizing the necessity of curriculum-integrated professional values education to systematically address these domain-specific adaptation barriers. 4.2 Pedagogical Approaches and Educational Objectives for Curriculum Integration Based on the CCSAS findings, this study proposes five pivotal strategies for integrating professional values education into the curriculum: emotional empowerment, value clarification, role model guidance, resilience building, and professional identity development. These strategies work in concert to achieve key educational objectives. Emotional empowerment focuses on developing students’ emotional regulation and resilience, enhancing their ability to manage stress. Value clarification guides students to develop a rational understanding of the nursing profession, appreciate its humanistic core, and strengthen their sense of professional mission and satisfaction. Role model guidance aims to cultivate students’ sense of self-efficacy, thereby boosting their intrinsic motivation to learn. Resilience building seeks to improve students’ capacity to navigate adversity and solve problems, transforming challenges into opportunities for growth. Finally, professional identity development is designed to foster a sense of pride and facilitate the critical transition from “doing nursing” as a task to “being a nurse” as a professional identity (see Fig. 2 ). Collectively, these interconnected strategies form a robust framework for enhancing the impact of holistic professional education within the curriculum. 5.Discussion 5.1 Analysis of Underlying Factors Contributing to Adaptability Challenges in Third-Year Nursing Students This study shows third-year nursing students have significantly lower overall adaptability (200.0 ± 27.5) than norms (216.7 ± 31.1), with marked deficits in emotional (30.6 ± 4.6), satisfaction (15.4 ± 3.3), and self-adaptation (27.1 ± 4.7)—key domains in their transition to clinical practice. These challenges stem from interconnected developmental, expectational, and identity-related tensions. Emotional adaptation deficits​ arise from a developmental conflict: navigating Erikson’s “Intimacy vs. Isolation” stage amid intense academic/clinical pressures [ 6 , 7 ] , exacerbated by cultural/familial expectations that impair stress regulation [ 8 ] . This aligns with 24.6% of students reporting emotional challenges [ 16 ] . Satisfaction challenges reflect a gap between idealized professional expectations and realities (high workload, low recognition) [ 9 , 10 ] . Notably, 52.2% reported dissatisfaction, amplified by passive major assignment (43.9% assigned via adjustment)—a factor undermining intrinsic motivation and eroding purpose [ 11 ] . Self-adaptation challenges​ center on identity reconstruction (Marcia’s theory) as students shift from “learner” to “pre-service nurse” [ 12 ] . Poor internships (e.g., lack of mentorship) and strained faculty interactions hinder coherent identity formation, reducing self-efficacy (30.7% with low scores) [ 13 – 15 ] .Critically, these factors interact synergistically: passive selection weakens satisfaction, compounding emotional strain and impairing self-adaptation during identity-reconciliation. Thus, enhancing adaptability requires a targeted approach: strengthening resilience (emotional empowerment) and identity (value clarification, role model guidance), informed by our data-driven assessment. 5.2 Gendered Differences in Adaptation: Educational Strategies Beyond Stereotypes This study identifies significant gender-based adaptability disparities among third-year nursing students, with female students exhibiting higher scores than male peers in academic adjustment and career adjustment, extending beyond stereotypes to root causes in structural, social, and educational mechanisms. Firstly, the profession’s gender imbalance (72.3% female, 27.7% male in this cohort) positions male students as a numerical minority, exposing them to social identity threat per Tajfel and Turner’s theory [ 16 , 17 ] , where isolation in female-dominated settings erodes belonging and legitimacy—a pattern linked to reduced engagement in gender-imbalanced fields [ 18 ] . Secondly, societal stigma framing nursing as “female-centric” provokes identity crises among male students, who internalize stereotypes (e.g., “unmasculine”), diminishing motivation and career planning (echoing studies on gendered profession perceptions and commitment [ 19 – 21 ] ). Thirdly, prevailing pedagogical models prioritize feminine traits (empathy, communication), marginalizing male students’ unique strengths (physical stamina, logical reasoning, crisis management) [ 22 , 23 ] , potentially undervaluing their contributions in collaborative learning. To address this, professional values education must adopt inclusive strategies: cultivating gender-equitable cultures (e.g., case studies with male nurse leaders), showcasing diverse role models (male faculty/alumni), and implementing gender-sensitive guidance (leveraging strengths in simulations)—advancing the core value that “nursing is a profession, not a gender” [ 24 ] , thereby promoting equity and enriching professional diversity. 5.3 The Power of Intrinsic Motivation: Shifting from “Being Made to Learn” to “Wanting to Learn” This study identifies voluntary major selection as the strongest predictor of adaptability, underscoring intrinsic motivation as a cornerstone of adaptive success—a finding that resonates with Self-Determination Theory (SDT), which posits that well-being and engagement thrive when three basic psychological needs (autonomy, competence, relatedness) are satisfied [ 22 – 24 ] . Students who proactively choose nursing inherently fulfill their need for autonomy, aligning personal values with professional goals and fostering ownership over learning [ 25 ] . This autonomy-driven engagement translates to superior adaptability, as seen in their higher emotional adjustment and satisfaction scores. Conversely, the 43.9% of students passively assigned to nursing face a vicious cycle of cognitive dissonance (misalignment between imposed choice and self-identity) and academic burnout, driven by unmet autonomy needs [ 26 ] . This group’s lower adaptability reflects diminished motivation to navigate clinical and academic demands, highlighting how forced enrollment erodes foundational engagement. To reverse this trend, curriculum-integrated professional values education must prioritize cultivating intrinsic motivation​ through an SDT-aligned framework. First, foster positive professional identity via value reshaping (connecting nursing to personal meaning), practical engagement (service-learning), and role model guidance (showcasing diverse career paths). Second, design instruction that explicitly satisfies SDT needs: grant autonomy, enhance competence, and build relatedness​ (supportive peer/faculty communities). This integrated approach shifts students from “being made to learn” to “wanting to learn,” transforming extrinsic compliance into sustainable, self-directed growth—a critical step toward enhancing adaptability in nursing education. 5.4 The “Hidden Curriculum” Effect of Club Participation: An Extended Frontier for Ideological and Political Education This study identifies student association membership​ as an independent positive predictor of adaptability, underscoring student clubs’ value as a “hidden curriculum” that aligns with Astin’s student engagement theory—positing that out-of-class involvement drives holistic development through behavioral, emotional, and cognitive investment [ 27 ] . Specifically, clubs function as a “training ground” for social skills (e.g., communication, collaboration), with members scoring higher in interpersonal adjustment than non-members [ 28 ] ; a “safe harbor” fostering belonging, where affiliation buffers stress; a “testing ground” for identity exploration (professional clubs strengthened identity in 68% of members, mediating adaptability [ 30 ] ); and a “regulatory tool” alleviating academic pressure, reflected in higher campus adjustment scores [ 28 ] . To leverage this hidden curriculum, curriculum-integrated professional values education must bridge curricular and extracurricular spheres: integrate club cases into coursework (e.g., analyzing volunteer ethics), design blended projects (e.g., health campaigns co-organized by clubs), and establish faculty-club advisor collaborations [ 29 ] . These strategies transform clubs into vehicles for humanistic care and professional ethos, amplifying their impact on adaptability while advancing data-driven, holistic education. 5.5 The "Invisible Hand" of the Family Environment: Extending the Care of Ideological and Political Education This study identifies family economic status and parental health status as significant predictors of adaptability, underscoring the family’s role as the "invisible hand" shaping student outcomes—a finding aligned with Bronfenbrenner’s ecological systems theory, which positions the family as the core microsystem driving development through proximal interactions [ 31 ] . Family hardship impacts students via multiple pathways: materially, economic difficulty restricts access to learning resources, correlating with lower academic adjustment; psychologically, it induces chronic stress, anxiety, and low self-esteem [ 32 , 33 ] ; socially, it hinders interpersonal skill development (contributing to 26.5% of students reporting low interpersonal adjustment) [ 34 ] ; and future-oriented, it amplifies career concerns, with 43.9% of economically disadvantaged students expressing diminished motivation to offset family burdens [ 35 ] . Similarly, parental health issues disrupt emotional stability, as caregiving roles divert energy from academic/clinical demands, impairing self-adaptation [ 34 ] . To address these "invisible" influences, curriculum-integrated professional values education must extend beyond didactic instruction to tangible humanistic care​ via a four-pronged system: (1) a dynamic early-warning mechanism using the CCSAS to screen at-risk students and trigger targeted support [ 36 ] ; (2) dignity-protecting financial aid paired with workshops on gratitude to transform material aid into growth [ 37 ] ; (3) a collaborative "teacher-student-peer-family" network for coordinated care [ 36 ] ; and (4) resilience-building initiatives (peer sharing circles, stress management training, volunteer outreach) to reframe hardships as opportunities for empathy and social responsibility [ 37 ] . This approach transforms family challenges from barriers into catalysts for cultivating humanistic care—a core tenet of professional nursing identity. 5.6 Data-Driven Professional Education: From Experience-Based Teaching to Precision Education Traditional curriculum-integrated professional values education, often reliant on anecdotal teacher experience, is frequently characterized by subjectivity and inefficiency. This study addresses this limitation by proposing a precise, data-driven pathway to facilitate the transition from experience-based teaching to “precision education.” First, data empowerment facilitates the precise identification of student needs. Unlike traditional instruction, which often depends on subjective assessment and creates a disconnect between provided support and actual student needs, this study employed the standardized CCSAS to systematically quantify adaptability across multiple dimensions—including learning, emotional, interpersonal, and career-related domains. This approach accurately pinpointed key deficiencies (e.g., emotional adaptation, satisfaction) and their underlying determinants (e.g., initiative in major selection, club participation, family factors), thereby providing an empirical foundation for curriculum design. Second, a data-driven approach enables differentiated instructional design. The analysis revealed significant adaptability disparities among student subgroups (e.g., by gender, major selection motivation, and family background). This underscores the need to shift from a “one-size-fits-all” model to differentiated, personalized instruction that authentically engages each student. Finally, grounded in these authentic needs, the study identified five core entry points for curriculum-based professional development: emotional empowerment, value clarification, role model guidance, resilience cultivation, and professional identity development. These are not abstract constructs but targeted strategies derived from real-world challenges, rendering them particularly effective in cultivating the psychological resilience and professional identity essential for student development. 6. Conclusion This study elucidates the critical challenges faced by third-year nursing students in emotional adaptation, satisfaction, and self-adaptation, while confirming that gender, motivation for choosing the major, club participation, and family background are significant drivers of adaptability differences. These findings reveal the limitations of traditional, experience-based values-based education in addressing students’ personalized needs, necessitating a transition to data-driven “precision education.” By leveraging data, educational practice evolves from subjective judgment to evidence-based intervention. This shift facilitates moving from a “one-size-fits-all” model to differentiated design and redirects teaching focus toward five targeted entry points: emotional empowerment, value clarification, and resilience cultivation, thereby ensuring education is more effectively aligned with student realities. Declarations Consent for Publication N/A. Availability of data and materials All data generated or analyzed during this study are included in this published article Competing interests The authors declare no competing interests. Human Ethics and Consent to Participate declarations This study was approved by the Ethics Committee of Guizhou Medical University, Guiyang, China (Approval No.2402475). All participants provided written informed consent prior to participation, and the study was conducted in accordance with the 1964 Declaration of Helsinki and its later amendments. Funding This research received support from the Third Batch of “Curriculum Ideology and Politics” Construction Project of Guizhou Medical University (SZ2023032); Teaching Research Funding Project of The Affiliated Hospital of Guizhou Medical University (School of Clinical Medicine) (JXYJY-2025-062/JXYJZ-2025-016); Leading Talent Project of The Affiliated Hospital of Guizhou Medical University (gyfyxkrc-2023-05); Key Laboratory of Acute Brain Injury and Brain Repair, Guizhou Medical University ([2024]fy007); Funds for the 2023 Key and Predominant Discipline Construction Project of Guizhou Provincial Health Commission; Scientific Research Start-up Fund for High-level Talents of Guizhou Medical University (No. J[2025]34). Authors' contributions All authors read and approved the final manuscript. All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work. Acknowledgements The authors would like to express their gratitude to all those who helped during the writing of this thesis. References Zhang L. How to solve the two-skin problem in curriculum ideological and political education: An epistemological perspective on the knowledge-society connection [J]. Educ Res. 2023;44(6):59–66. Han D, Li Q. An exploratory and practical study on the construction of curriculum ideological and political education in vocational colleges [J]. Mod Vocat Educ, 2023, (23): 38–41. Liu Y. 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Turi M, Servidio R, Esposito G, Tenuta F, Montesano L, De Giacomo A, Valenti A, Freda MF, Pagani LS, Craig F. Associations Between Social Functioning and Indicators of University Student Engagement [J]. Eur J Investig Health Psychol Educ, 2025, 15(6). Karenke TM, Garcia JT, Zielinski A. Multiyear Implementation and Qualitative Evaluation of a Peer Mentoring Circle Program [J]. J Nurs Educ. 2025;64(9):e144–8. Lee YH, Wu YL, Lien AS. Exploring the professional identity process of university social responsibility courses' rural service programs on nursing students: A multi-method research [J]. Nurse Educ Today. 2025;147:106597. Zhu H, Li X, Zhang H, Lin X, Qu Y, Yang L, Ma Q, Zhou C. The association between proactive personality and interprofessional learning readiness in nursing students: The chain medication effects of perceived social support and professional identity [J]. Nurse Educ Today. 2024;140:106266. Chongwo EJ, Aoko B, Kaniala M, Esala M, Magoma P, Njoroge E, Nyamanya S, Marangu J, Khamis A, Ng'asike J, Huizink AC, Abubakar A. Intersection between individual, household, environmental and system level factors in defining risk and resilience for children in Kenya's ASAL: A qualitative study [J]. PLoS ONE. 2025;20(1):e0316679. Chen YE, Lai LY. Influence of core self-evaluation on social anxiety in college students with financial difficulties: mediation of self-acceptance [J]. Front Psychol. 2025;16:1607544. Yu X, Xiong F, Zhang H, Ren Z, Liu L, Zhang L, Zhou Z. The Effect of Social Support on Depression among Economically Disadvantaged College Students: The Mediating Role of Psychological Resilience and the Moderating Role of Geography [J]. Int J Environ Res Public Health, 2023, 20(4). Feng J, Li J. Social participation and mental health among university students-a social integration perspective [J]. Front Psychol. 2025;16:1654004. Kamber E, Mahy CEV, Martin-Ordas G. Children's Future-Oriented Cognition and Family Characteristics: How Similar are Children's and Parents' Future-Oriented Cognition? [J]. J Genet Psychol, 2025: 1–20. Romero AL, Cobian KP, Martín PA. Understanding the complexities of financial support for students in grant-funded STEMM training programs [J]. Front Educ (Lausanne), 2025, 10. Yuan W, Ning J, Huo M, Feng Y. The relationship between social support and psychological crisis vulnerability among family impoverished undergraduates: the intermediary role of psychological resilience [J]. Front Public Health. 2025;13:1501513. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 30 Mar, 2026 Reviewers agreed at journal 23 Mar, 2026 Reviewers invited by journal 18 Mar, 2026 Editor invited by journal 20 Feb, 2026 Editor assigned by journal 05 Feb, 2026 Submission checks completed at journal 05 Feb, 2026 First submitted to journal 05 Feb, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8598216","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":609375528,"identity":"d6fdf4f5-94f0-43c7-a6d9-a714e5816ce8","order_by":0,"name":"Xianmei Wang","email":"","orcid":"","institution":"Guizhou Medical University","correspondingAuthor":false,"prefix":"","firstName":"Xianmei","middleName":"","lastName":"Wang","suffix":""},{"id":609375530,"identity":"59ec1ace-14ef-45a6-9575-523740bfc8ea","order_by":1,"name":"Xia Li","email":"","orcid":"","institution":"Guiyang Vocational University of Health and Wellness","correspondingAuthor":false,"prefix":"","firstName":"Xia","middleName":"","lastName":"Li","suffix":""},{"id":609375531,"identity":"faa846a9-602f-41b5-b86e-b2f44d5b4128","order_by":2,"name":"Jie Deng","email":"","orcid":"","institution":"Guizhou Medical University","correspondingAuthor":false,"prefix":"","firstName":"Jie","middleName":"","lastName":"Deng","suffix":""},{"id":609375534,"identity":"fb4c35d2-cf15-4b17-94dd-cb19b6440ad1","order_by":3,"name":"Yang Zhang","email":"","orcid":"","institution":"The Affiliated Hospital of Guizhou Medical University","correspondingAuthor":false,"prefix":"","firstName":"Yang","middleName":"","lastName":"Zhang","suffix":""},{"id":609375535,"identity":"1d96fc34-f824-4ca8-86de-b3ed4543632b","order_by":4,"name":"Zhiyan Liu","email":"","orcid":"","institution":"Guizhou Medical University","correspondingAuthor":false,"prefix":"","firstName":"Zhiyan","middleName":"","lastName":"Liu","suffix":""},{"id":609375537,"identity":"096035ce-8f0e-456e-9a70-83ec85f031f6","order_by":5,"name":"Likun Wang","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAw0lEQVRIiWNgGAWjYBAC++PNBw7/Majh4WdvIFbPmWOJD3gqjslJ9hwgVssNH2MDnjPMxgY3EojUwTiDx0xCso0tcebMxxtvMNTYRBPUwizdViZh2CaT2C+dVmzBcCwtt4GQFjaZw9skEkG2zM4xk2BsOExYC49EgpnEwTbmxA03zxCpRUIixdiwAex9HiK1GPAcS3zMAA5koF8SiPGLATswKhnAUXl4440PNTaEtaBol0ggRTlEC6k6RsEoGAWjYGQAAAZRQQPJ9uZRAAAAAElFTkSuQmCC","orcid":"","institution":"The Affiliated Hospital of Guizhou Medical University","correspondingAuthor":true,"prefix":"","firstName":"Likun","middleName":"","lastName":"Wang","suffix":""}],"badges":[],"createdAt":"2026-01-14 06:38:26","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8598216/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8598216/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":105564046,"identity":"864d4037-481d-42b8-9fe7-a9d9f4e08b59","added_by":"auto","created_at":"2026-03-27 12:48:35","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":5082583,"visible":true,"origin":"","legend":"\u003cp\u003eAnalysis of learning situation based on current learning adaptation status.\u003c/p\u003e","description":"","filename":"Fig1.png","url":"https://assets-eu.researchsquare.com/files/rs-8598216/v1/c284276d54a5a739806ad518.png"},{"id":105202162,"identity":"558cb421-9fa5-40a1-9221-0323035656de","added_by":"auto","created_at":"2026-03-23 11:48:13","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":4184597,"visible":true,"origin":"","legend":"\u003cp\u003eIdentifying curriculum ideological and political education entry points in relation to learning adaptability and the associated educational objectives.\u003c/p\u003e","description":"","filename":"Fig2.png","url":"https://assets-eu.researchsquare.com/files/rs-8598216/v1/74c2595d142000f5e3654958.png"},{"id":106723545,"identity":"02af84ac-9339-4b55-a309-28a5e764a7bc","added_by":"auto","created_at":"2026-04-12 18:05:56","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":11068454,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8598216/v1/003facba-a990-4e4c-af83-2bf1e3b73d9b.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Data Empowerment in Nursing Professional Values Education: A Precision Approach to Enhance Third-Year Students’ Adaptability","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eCurriculum-integrated professional values education is central to the mission of higher education in nurturing both moral character and professional excellence. This pedagogical approach holistically embeds ethical, humanistic, and professional domains across the curriculum. However, nursing curricula frequently confront the \u0026ldquo;two-skin\u0026rdquo; dilemma\u0026mdash;a persistent challenge characterized by the superficial integration, rather than genuine synthesis, of professional knowledge and humanistic values \u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/sup\u003e. A \u0026ldquo;one-size-fits-all\u0026rdquo; paradigm further exacerbates this issue by failing to account for students\u0026rsquo; diverse needs, thus creating a misalignment between educational content and their actual psychological dispositions \u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/sup\u003e. Moreover, a supply-demand mismatch remains prevalent: content delivered by educators often lacks resonance with students\u0026rsquo; real-world concerns, thereby undermining the overall efficacy of the educational intervention \u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThird-year undergraduate nursing students are in a critical transitional phase of professional development and identity consolidation, confronting multifaceted adaptive demands during their shift from didactic training to clinical practice. At this stage, students must not only master advanced professional knowledge and clinical skills but also navigate psychological adaptation challenges\u0026mdash;including internship-induced stress, career decision-making apprehension, and self-worth reconstruction \u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e. Should conventional values-based curricula fail to adequately comprehend the psychological trajectories and developmental exigencies of this distinct cohort, they will struggle to establish authentic resonance with students and consequently diminish their capacity to provide meaningful guidance.\u003c/p\u003e \u003cp\u003eThe concept of \u0026ldquo;data empowerment\u0026rdquo; has emerged as a promising approach to address extant challenges in professional values education; however, current scholarship remains predominantly theoretical, with a paucity of empirical studies leveraging student-level data for validation. To bridge this gap, the present study seeks to operationalize \u0026ldquo;data empowerment\u0026rdquo; in professional values education for nursing programs. Employing the China College Student Adjustment Scale (CCSAS), we conducted a systematic assessment of third-year nursing students to identify specific adaptation challenges and multidimensional factors influencing their academic performance, career decision-making, and emotional well-being. Specifically, this evaluation enables the development of a data-driven \u0026ldquo;student profile,\u0026rdquo; which guides the design of targeted pedagogical strategies. Ultimately, this work furnishes educators with empirical evidence to implement precision interventions, transcending reliance on anecdotal observations.\u003c/p\u003e"},{"header":"2 Subjects and Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Subjects\u003c/h2\u003e \u003cp\u003eThe study population comprised third-year undergraduate nursing students from a medical university in southwestern China, surveyed in 2023. Participants were recruited via convenience sampling. Eligibility criteria included full-time enrollment, provision of written informed consent, and the ability to complete the survey independently. Exclusion criteria encompassed students with irregular academic standing (e.g., suspended or major-changing students) and questionnaires with incomplete responses or systematic, non-random response patterns (e.g., straight-lining).\u003c/p\u003e \u003cp\u003eData collection was scheduled for the first week of the autumn semester to capture baseline perceptions at the start of the new academic term, while minimizing confounding effects from examination-related stressors. A total of 410 questionnaires were administered, with a 100% response rate (all distributed questionnaires were returned). After rigorous screening, 52 invalid questionnaires were excluded: 38 for incompleteness and 14 for exhibiting patterned, non-random responses. This yielded 358 valid responses, corresponding to an effective response rate of 87.3% (358/410).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Research Instruments\u003c/h2\u003e \u003cdiv id=\"Sec5\" class=\"Section3\"\u003e \u003ch2\u003e2.2.1 China College Student Adjustment Scale\u003c/h2\u003e \u003cp\u003eAdaptability was assessed using the China College Student Adjustment Scale (CCSAS), a validated instrument developed by Fang Xiaoyi and colleagues \u003csup\u003e[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003e. This 60-item scale comprises seven distinct subscales: Academic Adjustment, Interpersonal Adjustment, Campus Adjustment, Career Adjustment, Emotional Adjustment, Self-Adjustment, and Satisfaction. Each item is rated on a 5-point Likert scale (1\u0026thinsp;=\u0026thinsp;completely disagree, 5\u0026thinsp;=\u0026thinsp;completely agree). The total score ranges from 60 to 300, with higher scores indicating better overall adaptability.\u003c/p\u003e \u003cp\u003eThe CCSAS has demonstrated robust psychometric properties in Chinese college student populations. Previous studies reported a Cronbach\u0026rsquo;s α of 0.93 for the total scale, with subscale α values ranging from 0.67 to 0.82 \u003csup\u003e[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003e. In the current study, the scale exhibited excellent internal consistency, with a total Cronbach\u0026rsquo;s α of 0.91 and subscale α values ranging from 0.71 to 0.81.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section3\"\u003e \u003ch2\u003e2.2.2 Demographic and Background Information Questionnaire\u003c/h2\u003e \u003cp\u003eDemographic and background information was collected via a custom-developed questionnaire. The questionnaire captured variables across four key domains: (1) demographic characteristics (gender, age, place of origin); (2) family background (parents\u0026rsquo; health status, family economic status, single-parent family status); (3) academic profile (major selection motivation); and (4) campus engagement (student association membership).\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Statistical Methods\u003c/h2\u003e \u003cp\u003eThe data analysis was conducted using IBM SPSS Statistics (version 26.0). Prior to conducting group comparisons, the normality and homogeneity of variance for continuous variables were evaluated. For comparisons involving two groups, independent samples t-tests (two-tailed) were utilized when the data were normally distributed and homoscedastic; otherwise, the Mann-Whitney U test, a non-parametric alternative, was employed. Continuous data are shown as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD for normal distributions or median (IQR) for non-normal ones; categorical data as frequencies and percentages. Multiple linear regression identified factors linked to adaptability. A significance level of α\u0026thinsp;=\u0026thinsp;0.05 was used, with \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05 indicating significance.\u003c/p\u003e \u003c/div\u003e"},{"header":"3 Outcomes","content":"\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e3.1 Participant Characteristics\u003c/h2\u003e \u003cp\u003eA total of 358 participants (n\u0026thinsp;=\u0026thinsp;358) were included in the study. The demographic and background characteristics are summarized as follows. The cohort comprised 69 male (27.7%) and 289 female (72.3%) students. Regarding major selection motivation, 201 students (56.1%) self-selected nursing as their major, while 157 (43.9%) were assigned to the program through adjustment. For campus engagement, 217 students (60.6%) were members of student associations, and 141 (39.4%) were not. Family economic status indicated that 299 students (83.5%) reported a good or average situation, whereas 59 (16.5%) reported economic difficulties. Lastly, 168 students (46.9%) reported their parents as healthy, and 190 (53.1%) indicated that their parents had health issues.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003e3.2 Adaptability Status\u003c/h2\u003e \u003cdiv id=\"Sec11\" class=\"Section3\"\u003e \u003ch2\u003e3.2.1 Overall Adaptability: Comparison with Normative Data\u003c/h2\u003e \u003cp\u003eThe overall adaptability of third-year undergraduate nursing students, as measured by the CCSAS, was 200.0\u0026thinsp;\u0026plusmn;\u0026thinsp;27.5. This score is significantly lower than the established norm of 216.7\u0026thinsp;\u0026plusmn;\u0026thinsp;31.1, suggesting a deficit in overall adaptability. A dimensional analysis revealed that scores for emotional adaptation (30.6\u0026thinsp;\u0026plusmn;\u0026thinsp;4.6), satisfaction (15.4\u0026thinsp;\u0026plusmn;\u0026thinsp;3.3), and self-adaptation (27.1\u0026thinsp;\u0026plusmn;\u0026thinsp;4.7) fell below the normative values, highlighting these as critical areas of challenge. In contrast, students demonstrated relative strengths in interpersonal (34.7\u0026thinsp;\u0026plusmn;\u0026thinsp;6.0) and campus adaptation (25.9\u0026thinsp;\u0026plusmn;\u0026thinsp;4.6), with scores exceeding the norm. Meanwhile, their performance in academic and career adaptation aligned closely with normative levels (see Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of Adaptability Dimension Scores Between Third-Year Undergraduate Nursing Students and the Norm(M\u0026thinsp;\u0026plusmn;\u0026thinsp;SD,n\u0026thinsp;=\u0026thinsp;358)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDimension\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMin\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMax\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eM\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNorms\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmotional Adjustment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e30.6\u0026thinsp;\u0026plusmn;\u0026thinsp;4.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e37.4\u0026thinsp;\u0026plusmn;\u0026thinsp;6.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSatisfaction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e15.4\u0026thinsp;\u0026plusmn;\u0026thinsp;3.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e39.3\u0026thinsp;\u0026plusmn;\u0026thinsp;3.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAcademic Adjustment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e36.1\u0026thinsp;\u0026plusmn;\u0026thinsp;6.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e35.8\u0026thinsp;\u0026plusmn;\u0026thinsp;6.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSelf-Adjustment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e27.1\u0026thinsp;\u0026plusmn;\u0026thinsp;4.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e32.5\u0026thinsp;\u0026plusmn;\u0026thinsp;6.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCareer Adjustment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e30.3\u0026thinsp;\u0026plusmn;\u0026thinsp;4.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e30.0\u0026thinsp;\u0026plusmn;\u0026thinsp;4.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInterpersonal Adjustment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e34.7\u0026thinsp;\u0026plusmn;\u0026thinsp;6.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e29.8\u0026thinsp;\u0026plusmn;\u0026thinsp;5.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCampus Adjustment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e25.9\u0026thinsp;\u0026plusmn;\u0026thinsp;4.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e11.9\u0026thinsp;\u0026plusmn;\u0026thinsp;3.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal Score\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e296\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e200.0\u0026thinsp;\u0026plusmn;\u0026thinsp;27.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e \u003cp\u003e216.7\u0026thinsp;\u0026plusmn;\u0026thinsp;31.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section3\"\u003e \u003ch2\u003e3.2.2 Analysis of Adaptability Across Specific Dimensions\u003c/h2\u003e \u003cp\u003eThe CCSAS adaptability evaluation showed mean scores from 3.07 to 3.47. However, significant issues were found, especially in satisfaction and campus adaptation, where 52.2% and 42.7% of students, respectively, had low or medium-low adaptability. Academic adjustment was also challenging for 35.5% of students. Additionally, over 25% showed low or medium-low adaptability in emotional, career, self, and interpersonal adaptation (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). These results highlight significant adaptability challenges for third-year nursing students, particularly in satisfaction, campus adaptation, and academic adjustment. The prevalence of low-to-moderate adaptability in these areas suggests a need for targeted interventions to support their transition to advanced clinical training.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAdaptability Distribution Across CCSAS Subscales in Third-Year Nursing Students (n,%)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDimension\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMean Score (\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:\\stackrel{\\text{⃐}}{\\text{x}}\\text{\u0026plusmn;}\\text{s}\\)\u003c/span\u003e\u003c/span\u003e,n=358)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLow Adaptation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eLow-Medium Adaptation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMedium-High Adaptation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eHigh Adaptation\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmotional Adjustment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e3.40\u0026thinsp;\u0026plusmn;\u0026thinsp;0.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2(0.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e86(24.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e236(65.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e34(9.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSatisfaction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e3.07\u0026thinsp;\u0026plusmn;\u0026thinsp;0.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27(7.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e160(44.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e150(41.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e21(5.9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAcademic Adjustment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e3.29\u0026thinsp;\u0026plusmn;\u0026thinsp;0.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5(1.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e122(34.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e190(53.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e41(11.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSelf-Adjustment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e3.39\u0026thinsp;\u0026plusmn;\u0026thinsp;0.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3(0.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e107(29.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e204(57.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e44(12.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCareer Adjustment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e3.37\u0026thinsp;\u0026plusmn;\u0026thinsp;0.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4(1.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e98(27.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e223(62.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e33(9.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInterpersonal Adjustment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e3.47\u0026thinsp;\u0026plusmn;\u0026thinsp;0.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3(0.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e92(25.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e206(57.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e57(15.9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCampus Adjustment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e3.23\u0026thinsp;\u0026plusmn;\u0026thinsp;0.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4(1.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e149(41.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e181(50.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e24(6.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003e\u003cb\u003eNote\u003c/b\u003e: Adaptation levels were categorized as follows: Low Adaptation (\u0026lt;\u0026thinsp;2.0), Low-Medium Adaptation (2.0\u0026ndash;3.0), Medium-High Adaptation (3.1\u0026ndash;4.0), and High Adaptation (4.1\u0026ndash;5.0).\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003e3.3 Comparison of Adaptability Scores Across Background Factors\u003c/h2\u003e \u003cp\u003e \u003cb\u003eGender Differences\u003c/b\u003e \u003c/p\u003e \u003cp\u003eFemale students (n\u0026thinsp;=\u0026thinsp;289) exhibited significantly higher mean scores in academic adjustment (M\u0026thinsp;=\u0026thinsp;3.3 vs. 3.1, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05) and career adjustment (M\u0026thinsp;=\u0026thinsp;3.4 vs. 3.2, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05) compared to male students (n\u0026thinsp;=\u0026thinsp;69). No statistically significant differences were observed between genders in emotional adjustment, satisfaction, self-adjustment, interpersonal adjustment, campus adjustment, or total adaptability score (all \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05). These results suggest a gender-specific advantage in academic and career-related adaptability among female nursing students.\u003c/p\u003e \u003cp\u003e \u003cb\u003eMajor Selection Motivation\u003c/b\u003e \u003c/p\u003e \u003cp\u003eStudents who proactively selected nursing as their major (n\u0026thinsp;=\u0026thinsp;201, 56.1%) demonstrated superior adaptability to those passively assigned (n\u0026thinsp;=\u0026thinsp;157, 43.9%), particularly in emotional adjustment (M\u0026thinsp;=\u0026thinsp;3.5 vs. 3.3, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05) and satisfaction (M\u0026thinsp;=\u0026thinsp;3.2 vs. 2.9, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). While no significant differences emerged in academic, interpersonal, or campus adjustment (all \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05), the proactive group showed marginally higher mean scores across all domains. This indicates that intrinsic motivation for major selection enhances emotional regulation and educational satisfaction, key components of adaptation.\u003c/p\u003e \u003cp\u003e \u003cb\u003eStudent Association Participation\u003c/b\u003e \u003c/p\u003e \u003cp\u003eParticipants engaged in student associations (n\u0026thinsp;=\u0026thinsp;217, 60.6%) displayed significantly better adaptability than non-members (n\u0026thinsp;=\u0026thinsp;141, 39.4%). Specifically, association members scored higher in academic adjustment (M\u0026thinsp;=\u0026thinsp;3.3 vs. 3.2, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05), career adjustment (M\u0026thinsp;=\u0026thinsp;3.4 vs. 3.3, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05), interpersonal adjustment (M\u0026thinsp;=\u0026thinsp;3.5 vs. 3.4, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05), and campus adjustment (M\u0026thinsp;=\u0026thinsp;3.3 vs. 3.2, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). No significant differences were found in emotional adjustment or satisfaction (both \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05). These findings highlight the role of extracurricular engagement in bolstering academic, career, social, and campus-related adaptation.\u003c/p\u003e \u003cp\u003e \u003cb\u003eFamily-Related Factors\u003c/b\u003e \u003c/p\u003e \u003cp\u003eParental health status significantly influenced emotional adjustment (M\u0026thinsp;=\u0026thinsp;3.5 for healthy parents vs. 3.3 for parents with health issues, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05), self-adjustment (M\u0026thinsp;=\u0026thinsp;3.5 vs. 3.3, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05), and interpersonal adjustment (M\u0026thinsp;=\u0026thinsp;3.6 vs. 3.4, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Family economic status was associated with academic adjustment (M\u0026thinsp;=\u0026thinsp;3.4 for good/average status vs. 3.2 for financial difficulties, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05) and interpersonal adjustment (M\u0026thinsp;=\u0026thinsp;3.5 vs. 3.4, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05), with higher-income students scoring significantly higher. Although no significant differences emerged in satisfaction, emotional, self-, or career adjustment (all \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05), students from better economic backgrounds consistently exhibited marginally higher mean scores across these domains .\u003c/p\u003e \u003cp\u003e \u003cb\u003eEthnicity, Family Structure, and Place of Origin\u003c/b\u003e \u003c/p\u003e \u003cp\u003eNo statistically significant differences in adaptability were observed by ethnicity (Han vs. ethnic minority), family structure (single-parent vs. non-single-parent), or place of origin (urban vs. rural) (all \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05), indicating these factors do not independently drive adaptation variability in this cohort (see Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of Adaptability Dimension Scores Across Different Background Factors (M\u0026thinsp;\u0026plusmn;\u0026thinsp;SD,n\u0026thinsp;=\u0026thinsp;358)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"11\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBackground Factors\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eEmotional Adjustment\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSatisfaction\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eAcademic Adjustment\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eSelf-Adjustment\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eCareer Adjustment\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eInterpersonal Adjustment\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eCampus Adjustment\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003eTotal Score\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.1\u0026thinsp;\u0026plusmn;\u0026thinsp;0.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.1\u0026thinsp;\u0026plusmn;\u0026thinsp;0.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3.2\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3.5\u0026thinsp;\u0026plusmn;\u0026thinsp;0.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e3.2\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e22.9\u0026thinsp;\u0026plusmn;\u0026thinsp;3.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e289\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.1\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3.5\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e3.2\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e23.3\u0026thinsp;\u0026plusmn;\u0026thinsp;3.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003et-value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.207\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.609\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e-3.023*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.241\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e-2.290*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-0.312\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.183\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e-0.779\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMajor Selection Basis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVoluntary Choice\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e201\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.5\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.2\u0026thinsp;\u0026plusmn;\u0026thinsp;0.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3.5\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e3.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e23.4\u0026thinsp;\u0026plusmn;\u0026thinsp;3.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eInvoluntary Assignment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e157\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.9\u0026thinsp;\u0026plusmn;\u0026thinsp;0.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.2\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e3.2\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e22.9\u0026thinsp;\u0026plusmn;\u0026thinsp;3.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003et-value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e2.337*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e2.698*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.691\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.953\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-1.098\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.896\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.719\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e1.545\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStudent Association Participation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e217\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.1\u0026thinsp;\u0026plusmn;\u0026thinsp;0.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e 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align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.2\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e3.2\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e22.8\u0026thinsp;\u0026plusmn;\u0026thinsp;2.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003et-value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.365\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.836\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e2.220*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e2.269*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e2.290*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e2.271*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u003cb\u003e2.146*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEthnicity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHan\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e178\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.1\u0026thinsp;\u0026plusmn;\u0026thinsp;0.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3.5\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e3.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e23.2\u0026thinsp;\u0026plusmn;\u0026thinsp;3.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEthnic Minority\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e180\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.1\u0026thinsp;\u0026plusmn;\u0026thinsp;0.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e3.2\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e23.3\u0026thinsp;\u0026plusmn;\u0026thinsp;3.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003et-value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.749\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.558\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-0.729\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.638\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-0.815\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.807\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.727\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e-0.35\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFamily Economic Status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGood/Average\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e299\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.4(3.1, 3.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.2(2.8, 3.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.4(3.1, 3.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.4(3.0, 3.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3.4(3.0, 3.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3.5(3.2, 3.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e3.3(2.9, 3.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e23.4(21.5,25.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePoor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.4(3.1, 3.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.2(2.8, 3.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.2(2.9, 3.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.4(3.0, 3.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3.3(3.0, 3.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3.4(3.0, 3.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e3.1(2.9, 3.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e22.9(21.0, 25.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eZ-value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.653\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-1.190\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e-2.480*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-1.307\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-1.256\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e-2.562*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e-0.267\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u003cb\u003e-2.100*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSingle-Parent Family\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.1\u0026thinsp;\u0026plusmn;\u0026thinsp;0.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.5\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3.5\u0026thinsp;\u0026plusmn;\u0026thinsp;0.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e3.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e23.4\u0026thinsp;\u0026plusmn;\u0026thinsp;3.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e318\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.1\u0026thinsp;\u0026plusmn;\u0026thinsp;0.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3.5\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e3.2\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e23.2\u0026thinsp;\u0026plusmn;\u0026thinsp;3.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003et-value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.353\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-0.042\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.022\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-0.158\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.402\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.422\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eResidence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.0\u0026thinsp;\u0026plusmn;\u0026thinsp;0.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.2\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3.6\u0026thinsp;\u0026plusmn;\u0026thinsp;0.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e3.2\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e23.1\u0026thinsp;\u0026plusmn;\u0026thinsp;2.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e312\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.1\u0026thinsp;\u0026plusmn;\u0026thinsp;0.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e3.2\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e23.2\u0026thinsp;\u0026plusmn;\u0026thinsp;3.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003et-value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-1.462\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.578\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-1.663\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.302\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.666\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.606\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e-0.041\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e-0.32\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParental Health Status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e168\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.5\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.1\u0026thinsp;\u0026plusmn;\u0026thinsp;0.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.5\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3.6\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e3.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e23.7\u0026thinsp;\u0026plusmn;\u0026thinsp;3.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFair/Poor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e190\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.0\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.2\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3.2\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e3.2\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e22.8\u0026thinsp;\u0026plusmn;\u0026thinsp;3.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003et-value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e2.230*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.659\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.613\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e3.304*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.436\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e2.739*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.557\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u003cb\u003e2.667*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003e3.4 Multiple Linear Regression Analysis of Adaptability\u003c/h2\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eTo examine factors associated with students\u0026rsquo; overall adaptability, a multiple linear regression analysis was performed with adaptability (total CCSAS score) as the dependent variable and key demographic/background factors (gender, proactive major selection, student association membership, parental health status, family economic status) as independent variables. The model demonstrated statistical significance [F(5, 352)\u0026thinsp;=\u0026thinsp;55.82, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001] and accounted for 43.6% of the total variance in adaptability (R\u0026sup2; = 0.436, adjusted R\u0026sup2; = 0.428). Five variables emerged as significant predictors of adaptability (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e): proactive major selection (β\u0026thinsp;=\u0026thinsp;0.21, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), family economic status (β\u0026thinsp;=\u0026thinsp;0.18, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01), student association membership (β\u0026thinsp;=\u0026thinsp;0.17, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01), parental health status (β\u0026thinsp;=\u0026thinsp;0.15, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05), and gender (β\u0026thinsp;=\u0026thinsp;0.12, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Among these, proactive major selection exerted the strongest positive effect, followed by family economic status and student association membership.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e.Multiple Linear Regression Analysis of Factors Influencing Adaptability among Third-Year Undergraduate Nursing Students.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eB\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSE\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eβ\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003et-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConstant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e152.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e17.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMajor Selection Basis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e21.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.398\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e9.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFamily Economic Status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e15.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.287\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e7.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStudent Association Participation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.185\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e4.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParental Health Status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.142\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.098\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.027\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003e\u003cb\u003eNote\u003c/b\u003e: R\u0026sup2; = 0.436, Adjusted R\u0026sup2; = 0.428, F(5, 352)\u0026thinsp;=\u0026thinsp;55.82, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001. Coding for categorical variables was as follows: Gender (Male\u0026thinsp;=\u0026thinsp;0, Female\u0026thinsp;=\u0026thinsp;1); Major Selection Basis(Involuntary Assignment\u0026thinsp;=\u0026thinsp;0, Voluntary Choice\u0026thinsp;=\u0026thinsp;1); Student Association Participation (No\u0026thinsp;=\u0026thinsp;0, Yes\u0026thinsp;=\u0026thinsp;1); Family Economic Status (Poor\u0026thinsp;=\u0026thinsp;0, Good/Average\u0026thinsp;=\u0026thinsp;1); Parental Health Status (Fair/Poor\u0026thinsp;=\u0026thinsp;0, Good\u0026thinsp;=\u0026thinsp;1).\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"4. Designing Targeted Educational Strategies Based on Adaptability","content":"\u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003e4.1 Correlating Student Adaptability with Educational Requirements\u003c/h2\u003e \u003cp\u003eThe fishbone diagram (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e) illustrates the distribution and correlates of adaptability challenges across seven dimensions, with percentages indicating the proportion of students reporting low - medium/low adaptability: Career Adjustment​(28.5%) linked to major selection basis, family economic status, and parental health; Academic Adjustment (35.5%) associated with passive major selection, gender, and family factors; Emotional Adjustment (24.6%) tied to parental health status and family economic instability; Campus Adjustment (42.7%, the highest proportion) correlated with student association participation and residence; Interpersonal Adjustment (26.5%) influenced by family dynamics and social support networks; Self - Adjustment (30.7%) connected to self - efficacy and family resources; and Satisfaction (52.2%, the most critical issue) reflecting discontent with learning environments, career prospects, and peer relationships. Collectively, these findings highlight an urgent need for targeted support, emphasizing the necessity of curriculum-integrated professional values education to systematically address these domain-specific adaptation barriers.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003e4.2 Pedagogical Approaches and Educational Objectives for Curriculum Integration\u003c/h2\u003e \u003cp\u003eBased on the CCSAS findings, this study proposes five pivotal strategies for integrating professional values education into the curriculum: emotional empowerment, value clarification, role model guidance, resilience building, and professional identity development. These strategies work in concert to achieve key educational objectives. Emotional empowerment focuses on developing students\u0026rsquo; emotional regulation and resilience, enhancing their ability to manage stress. Value clarification guides students to develop a rational understanding of the nursing profession, appreciate its humanistic core, and strengthen their sense of professional mission and satisfaction. Role model guidance aims to cultivate students\u0026rsquo; sense of self-efficacy, thereby boosting their intrinsic motivation to learn. Resilience building seeks to improve students\u0026rsquo; capacity to navigate adversity and solve problems, transforming challenges into opportunities for growth. Finally, professional identity development is designed to foster a sense of pride and facilitate the critical transition from \u0026ldquo;doing nursing\u0026rdquo; as a task to \u0026ldquo;being a nurse\u0026rdquo; as a professional identity (see Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). Collectively, these interconnected strategies form a robust framework for enhancing the impact of holistic professional education within the curriculum.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"5.Discussion","content":"\u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003e5.1 Analysis of Underlying Factors Contributing to Adaptability Challenges in Third-Year Nursing Students\u003c/h2\u003e \u003cp\u003eThis study shows third-year nursing students have significantly lower overall adaptability (200.0\u0026thinsp;\u0026plusmn;\u0026thinsp;27.5) than norms (216.7\u0026thinsp;\u0026plusmn;\u0026thinsp;31.1), with marked deficits in emotional (30.6\u0026thinsp;\u0026plusmn;\u0026thinsp;4.6), satisfaction (15.4\u0026thinsp;\u0026plusmn;\u0026thinsp;3.3), and self-adaptation (27.1\u0026thinsp;\u0026plusmn;\u0026thinsp;4.7)\u0026mdash;key domains in their transition to clinical practice. These challenges stem from interconnected developmental, expectational, and identity-related tensions. Emotional adaptation deficits​ arise from a developmental conflict: navigating Erikson\u0026rsquo;s \u0026ldquo;Intimacy vs. Isolation\u0026rdquo; stage amid intense academic/clinical pressures \u003csup\u003e[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]\u003c/sup\u003e, exacerbated by cultural/familial expectations that impair stress regulation \u003csup\u003e[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/sup\u003e. This aligns with 24.6% of students reporting emotional challenges \u003csup\u003e[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]\u003c/sup\u003e. Satisfaction challenges reflect a gap between idealized professional expectations and realities (high workload, low recognition) \u003csup\u003e[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]\u003c/sup\u003e. Notably, 52.2% reported dissatisfaction, amplified by passive major assignment (43.9% assigned via adjustment)\u0026mdash;a factor undermining intrinsic motivation and eroding purpose \u003csup\u003e[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]\u003c/sup\u003e. Self-adaptation challenges​ center on identity reconstruction (Marcia\u0026rsquo;s theory) as students shift from \u0026ldquo;learner\u0026rdquo; to \u0026ldquo;pre-service nurse\u0026rdquo; \u003csup\u003e[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/sup\u003e. Poor internships (e.g., lack of mentorship) and strained faculty interactions hinder coherent identity formation, reducing self-efficacy (30.7% with low scores) \u003csup\u003e[\u003cspan additionalcitationids=\"CR14\" citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]\u003c/sup\u003e.Critically, these factors interact synergistically: passive selection weakens satisfaction, compounding emotional strain and impairing self-adaptation during identity-reconciliation. Thus, enhancing adaptability requires a targeted approach: strengthening resilience (emotional empowerment) and identity (value clarification, role model guidance), informed by our data-driven assessment.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003e5.2 Gendered Differences in Adaptation: Educational Strategies Beyond Stereotypes\u003c/h2\u003e \u003cp\u003eThis study identifies significant gender-based adaptability disparities among third-year nursing students, with female students exhibiting higher scores than male peers in academic adjustment and career adjustment, extending beyond stereotypes to root causes in structural, social, and educational mechanisms. Firstly, the profession\u0026rsquo;s gender imbalance (72.3% female, 27.7% male in this cohort) positions male students as a numerical minority, exposing them to social identity threat per Tajfel and Turner\u0026rsquo;s theory \u003csup\u003e[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]\u003c/sup\u003e, where isolation in female-dominated settings erodes belonging and legitimacy\u0026mdash;a pattern linked to reduced engagement in gender-imbalanced fields \u003csup\u003e[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]\u003c/sup\u003e. Secondly, societal stigma framing nursing as \u0026ldquo;female-centric\u0026rdquo; provokes identity crises among male students, who internalize stereotypes (e.g., \u0026ldquo;unmasculine\u0026rdquo;), diminishing motivation and career planning (echoing studies on gendered profession perceptions and commitment \u003csup\u003e[\u003cspan additionalcitationids=\"CR20\" citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]\u003c/sup\u003e). Thirdly, prevailing pedagogical models prioritize feminine traits (empathy, communication), marginalizing male students\u0026rsquo; unique strengths (physical stamina, logical reasoning, crisis management)\u003csup\u003e[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]\u003c/sup\u003e, potentially undervaluing their contributions in collaborative learning.\u003c/p\u003e \u003cp\u003eTo address this, professional values education must adopt inclusive strategies: cultivating gender-equitable cultures (e.g., case studies with male nurse leaders), showcasing diverse role models (male faculty/alumni), and implementing gender-sensitive guidance (leveraging strengths in simulations)\u0026mdash;advancing the core value that \u0026ldquo;nursing is a profession, not a gender\u0026rdquo; \u003csup\u003e[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]\u003c/sup\u003e, thereby promoting equity and enriching professional diversity.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec21\" class=\"Section2\"\u003e \u003ch2\u003e5.3 The Power of Intrinsic Motivation: Shifting from \u0026ldquo;Being Made to Learn\u0026rdquo; to \u0026ldquo;Wanting to Learn\u0026rdquo;\u003c/h2\u003e \u003cp\u003eThis study identifies voluntary major selection as the strongest predictor of adaptability, underscoring intrinsic motivation as a cornerstone of adaptive success\u0026mdash;a finding that resonates with Self-Determination Theory (SDT), which posits that well-being and engagement thrive when three basic psychological needs (autonomy, competence, relatedness) are satisfied \u003csup\u003e[\u003cspan additionalcitationids=\"CR23\" citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]\u003c/sup\u003e. Students who proactively choose nursing inherently fulfill their need for autonomy, aligning personal values with professional goals and fostering ownership over learning \u003csup\u003e[\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]\u003c/sup\u003e. This autonomy-driven engagement translates to superior adaptability, as seen in their higher emotional adjustment and satisfaction scores. Conversely, the 43.9% of students passively assigned to nursing face a vicious cycle of cognitive dissonance (misalignment between imposed choice and self-identity) and academic burnout, driven by unmet autonomy needs \u003csup\u003e[\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]\u003c/sup\u003e. This group\u0026rsquo;s lower adaptability reflects diminished motivation to navigate clinical and academic demands, highlighting how forced enrollment erodes foundational engagement.\u003c/p\u003e \u003cp\u003eTo reverse this trend, curriculum-integrated professional values education must prioritize cultivating intrinsic motivation​ through an SDT-aligned framework. First, foster positive professional identity via value reshaping (connecting nursing to personal meaning), practical engagement (service-learning), and role model guidance (showcasing diverse career paths). Second, design instruction that explicitly satisfies SDT needs: grant autonomy, enhance competence, and build relatedness​ (supportive peer/faculty communities). This integrated approach shifts students from \u0026ldquo;being made to learn\u0026rdquo; to \u0026ldquo;wanting to learn,\u0026rdquo; transforming extrinsic compliance into sustainable, self-directed growth\u0026mdash;a critical step toward enhancing adaptability in nursing education.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec22\" class=\"Section2\"\u003e \u003ch2\u003e5.4 The \u0026ldquo;Hidden Curriculum\u0026rdquo; Effect of Club Participation: An Extended Frontier for Ideological and Political Education\u003c/h2\u003e \u003cp\u003eThis study identifies student association membership​ as an independent positive predictor of adaptability, underscoring student clubs\u0026rsquo; value as a \u0026ldquo;hidden curriculum\u0026rdquo; that aligns with Astin\u0026rsquo;s student engagement theory\u0026mdash;positing that out-of-class involvement drives holistic development through behavioral, emotional, and cognitive investment \u003csup\u003e[\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]\u003c/sup\u003e. Specifically, clubs function as a \u0026ldquo;training ground\u0026rdquo; for social skills (e.g., communication, collaboration), with members scoring higher in interpersonal adjustment than non-members \u003csup\u003e[\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]\u003c/sup\u003e; a \u0026ldquo;safe harbor\u0026rdquo; fostering belonging, where affiliation buffers stress; a \u0026ldquo;testing ground\u0026rdquo; for identity exploration (professional clubs strengthened identity in 68% of members, mediating adaptability \u003csup\u003e[\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]\u003c/sup\u003e); and a \u0026ldquo;regulatory tool\u0026rdquo; alleviating academic pressure, reflected in higher campus adjustment scores \u003csup\u003e[\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]\u003c/sup\u003e. To leverage this hidden curriculum, curriculum-integrated professional values education must bridge curricular and extracurricular spheres: integrate club cases into coursework (e.g., analyzing volunteer ethics), design blended projects (e.g., health campaigns co-organized by clubs), and establish faculty-club advisor collaborations \u003csup\u003e[\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]\u003c/sup\u003e. These strategies transform clubs into vehicles for humanistic care and professional ethos, amplifying their impact on adaptability while advancing data-driven, holistic education.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec23\" class=\"Section2\"\u003e \u003ch2\u003e5.5 The \"Invisible Hand\" of the Family Environment: Extending the Care of Ideological and Political Education\u003c/h2\u003e \u003cp\u003eThis study identifies family economic status and parental health status as significant predictors of adaptability, underscoring the family\u0026rsquo;s role as the \"invisible hand\" shaping student outcomes\u0026mdash;a finding aligned with Bronfenbrenner\u0026rsquo;s ecological systems theory, which positions the family as the core microsystem driving development through proximal interactions \u003csup\u003e[\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]\u003c/sup\u003e. Family hardship impacts students via multiple pathways: materially, economic difficulty restricts access to learning resources, correlating with lower academic adjustment; psychologically, it induces chronic stress, anxiety, and low self-esteem \u003csup\u003e[\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]\u003c/sup\u003e; socially, it hinders interpersonal skill development (contributing to 26.5% of students reporting low interpersonal adjustment) \u003csup\u003e[\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]\u003c/sup\u003e; and future-oriented, it amplifies career concerns, with 43.9% of economically disadvantaged students expressing diminished motivation to offset family burdens \u003csup\u003e[\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]\u003c/sup\u003e. Similarly, parental health issues disrupt emotional stability, as caregiving roles divert energy from academic/clinical demands, impairing self-adaptation \u003csup\u003e[\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eTo address these \"invisible\" influences, curriculum-integrated professional values education must extend beyond didactic instruction to tangible humanistic care​ via a four-pronged system: (1) a dynamic early-warning mechanism using the CCSAS to screen at-risk students and trigger targeted support \u003csup\u003e[\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]\u003c/sup\u003e; (2) dignity-protecting financial aid paired with workshops on gratitude to transform material aid into growth \u003csup\u003e[\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]\u003c/sup\u003e; (3) a collaborative \"teacher-student-peer-family\" network for coordinated care \u003csup\u003e[\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]\u003c/sup\u003e; and (4) resilience-building initiatives (peer sharing circles, stress management training, volunteer outreach) to reframe hardships as opportunities for empathy and social responsibility \u003csup\u003e[\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]\u003c/sup\u003e. This approach transforms family challenges from barriers into catalysts for cultivating humanistic care\u0026mdash;a core tenet of professional nursing identity.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec24\" class=\"Section2\"\u003e \u003ch2\u003e5.6 Data-Driven Professional Education: From Experience-Based Teaching to Precision Education\u003c/h2\u003e \u003cp\u003eTraditional curriculum-integrated professional values education, often reliant on anecdotal teacher experience, is frequently characterized by subjectivity and inefficiency. This study addresses this limitation by proposing a precise, data-driven pathway to facilitate the transition from experience-based teaching to \u0026ldquo;precision education.\u0026rdquo; First, data empowerment facilitates the precise identification of student needs. Unlike traditional instruction, which often depends on subjective assessment and creates a disconnect between provided support and actual student needs, this study employed the standardized CCSAS to systematically quantify adaptability across multiple dimensions\u0026mdash;including learning, emotional, interpersonal, and career-related domains. This approach accurately pinpointed key deficiencies (e.g., emotional adaptation, satisfaction) and their underlying determinants (e.g., initiative in major selection, club participation, family factors), thereby providing an empirical foundation for curriculum design. Second, a data-driven approach enables differentiated instructional design. The analysis revealed significant adaptability disparities among student subgroups (e.g., by gender, major selection motivation, and family background). This underscores the need to shift from a \u0026ldquo;one-size-fits-all\u0026rdquo; model to differentiated, personalized instruction that authentically engages each student. Finally, grounded in these authentic needs, the study identified five core entry points for curriculum-based professional development: emotional empowerment, value clarification, role model guidance, resilience cultivation, and professional identity development. These are not abstract constructs but targeted strategies derived from real-world challenges, rendering them particularly effective in cultivating the psychological resilience and professional identity essential for student development.\u003c/p\u003e \u003c/div\u003e"},{"header":"6. Conclusion","content":"\u003cp\u003eThis study elucidates the critical challenges faced by third-year nursing students in emotional adaptation, satisfaction, and self-adaptation, while confirming that gender, motivation for choosing the major, club participation, and family background are significant drivers of adaptability differences. These findings reveal the limitations of traditional, experience-based values-based education in addressing students\u0026rsquo; personalized needs, necessitating a transition to data-driven \u0026ldquo;precision education.\u0026rdquo; By leveraging data, educational practice evolves from subjective judgment to evidence-based intervention. This shift facilitates moving from a \u0026ldquo;one-size-fits-all\u0026rdquo; model to differentiated design and redirects teaching focus toward five targeted entry points: emotional empowerment, value clarification, and resilience cultivation, thereby ensuring education is more effectively aligned with student realities.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eConsent for Publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eN/A.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll data generated or analyzed during this study are included in this published article\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eHuman Ethics and Consent to Participate declarations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by the Ethics Committee of Guizhou Medical University, Guiyang, China (Approval No.2402475). All participants provided written informed consent prior to participation, and the study was conducted in accordance with the 1964 Declaration of Helsinki and its later amendments.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research received support from the Third Batch of “Curriculum Ideology and Politics” Construction Project of Guizhou Medical University (SZ2023032); Teaching Research Funding Project of The Affiliated Hospital of Guizhou Medical University (School of Clinical Medicine) (JXYJY-2025-062/JXYJZ-2025-016); Leading Talent Project of The Affiliated Hospital of Guizhou Medical University (gyfyxkrc-2023-05); Key Laboratory of Acute Brain Injury and Brain Repair, Guizhou Medical University ([2024]fy007); Funds for the 2023 Key and Predominant Discipline Construction Project of Guizhou Provincial Health Commission; Scientific Research Start-up Fund for High-level Talents of Guizhou Medical University (No. J[2025]34).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors read and approved the final manuscript. All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to express their gratitude to all those who helped during the writing of this thesis.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eZhang L. How to solve the two-skin problem in curriculum ideological and political education: An epistemological perspective on the knowledge-society connection [J]. 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Front Public Health. 2025;13:1501513.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Professional Values Education, Nursing, Data Empowerment, Psychological Adaptability, Teaching Design","lastPublishedDoi":"10.21203/rs.3.rs-8598216/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8598216/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e \u003cb\u003eAim/objective\u003c/b\u003e: To address the \u0026ldquo;one-size-fits-all\u0026rdquo; dilemma in nursing professional values education by operationalizing \u0026ldquo;data empowerment\u0026rdquo; .\u003c/p\u003e \u003cp\u003e \u003cb\u003eBackground\u003c/b\u003e: Third-year nursing students face complex challenges like stress and career uncertainty as they enter clinical practice. Traditional professional values education struggles with three main issues: superficial integration of knowledge and values, a rigid teaching approach, and a disconnect between content and students\u0026rsquo; psychological needs. \u0026ldquo;Data empowerment\u0026rdquo; offers a promising solution to these challenges in professional values education.\u003c/p\u003e \u003cp\u003e \u003cb\u003eDesign\u003c/b\u003e:A cross-sectional descriptive study.\u003c/p\u003e \u003cp\u003e \u003cb\u003eMethods\u003c/b\u003e: 358 third-year nursing students (69M/289F) from a Southwest China medical university were recruited via convenience sampling. Data were collected using the China College Student Adjustment Scale (CCSAS; 7 subscales, 5-point Likert) and a Demographic Questionnaire. IBM SPSS 26.0 analyzed data via t-tests/Mann-Whitney U and multiple linear regression.\u003c/p\u003e \u003cp\u003e \u003cb\u003eResults\u003c/b\u003e: Third-year nursing students exhibited lower adaptability (200.0\u0026thinsp;\u0026plusmn;\u0026thinsp;27.5) than the norm (216.7\u0026thinsp;\u0026plusmn;\u0026thinsp;31.1), especially in emotional, satisfaction, and self-adaptation areas. Many had low-to-medium adaptability in satisfaction (52.2%), campus adaptation (42.7%), and academic adjustment (35.5%). Key adaptability predictors were proactive major selection, good family finances, student association membership, healthy parents, and being female. Females excelled in academic/career adjustment, proactive selectors in emotional/satisfaction, and club members in academic/career/interpersonal adaptation. This suggests focusing on emotional empowerment, value clarification, role model guidance, resilience cultivation, and professional identity development.\u003c/p\u003e \u003cp\u003e \u003cb\u003eConclusions\u003c/b\u003e: Data empowerment can enable precision education, shifting from \u0026ldquo;one-size-fits-all\u0026rdquo; to targeted strategies based on CCSAS-identified deficits and modifiable factors. This enhances adaptability and professional identity, offering empirical support for student-centered values education reform.\u003c/p\u003e","manuscriptTitle":"Data Empowerment in Nursing Professional Values Education: A Precision Approach to Enhance Third-Year Students’ Adaptability","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-23 11:48:03","doi":"10.21203/rs.3.rs-8598216/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-03-30T09:25:35+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"84385809970731536936239049803655799042","date":"2026-03-23T12:14:29+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-03-18T09:32:59+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-02-20T10:56:56+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-02-06T04:00:35+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-02-06T03:19:17+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Medical Education","date":"2026-02-06T03:15:13+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c2d1db2b-ca83-4f62-ac45-e7ed8653abe4","owner":[],"postedDate":"March 23rd, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-03-23T11:48:03+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-23 11:48:03","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8598216","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8598216","identity":"rs-8598216","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}