Factors associated with career decision-making difficulties among undergraduate nursing students: a latent profile analysis

Background: Career decision-making difficulties are often associated with negative outcomes, including decreased motivation for learning, weakened professional identity, increased burnout, and a higher risk of turnover. However, most research has concentrated on the overall levels of career decision-making difficulties, overlooking the potential variations among different student subgroups. This gap hinders the creation of targeted intervention strategies. Purpose: This study aimed to identify latent profiles of Career decision-making difficulties among undergraduate nursing students and explore factors associated with these profiles. Design: A cross-sectional study. Methods: A convenience sampling method was employed to recruit 562 undergraduate nursing students from three universities in China. Participants completed validated measures assessing demographics, learning engagement, perceived social support, and career decision-making difficulties. Latent profile analysis identified distinct profiles of career decision-making difficulties, and multinomial logistic regression examined the associated factors. Results: Three distinct career decision-making difficulties profiles emerged: multidimensional decision-making block (58.5%), knowledge-action disconnection (34.0%), and information-driven advantage (7.5%). Perceived social support, learning engagement, and class leadership status were significantly associated with these career decision-making profiles. Conclusion: Nursing students face diverse career decision-making challenges, highlighting the need for tailored institutional support. Students in the "Multidimensional Decision-Making Block" profile may benefit from structured career development courses. For the "Knowledge-Action Disconnection" profile, strengthening career information processing is crucial. Enhancing learning engagement, decision-making skills, and support networks can reduce uncertainty and better prepare students for their professional futures.