Correlation Between Self-Efficacy and Problem-Solving Behavioral Intentions Regarding Near Misses Among Nursing Interns: The Mediating Role of Psychological Safety.

BACKGROUND

A near miss is an error or event that is detected or corrected before reaching or harming the patient. Near-miss events among nursing interns may compromise patient safety and reflect challenges in clinical practice. Self-efficacy and psychological safety are important psychological factors that may influence problem-solving behavioral intentions regarding near misses. However, evidence on the relationship between these variables among nursing interns remains limited. This study aimed to explore the relationship between self-efficacy and problem-solving behavioral intentions regarding near misses and to examine the mediating role of psychological safety.

METHODS

This cross-sectional survey was conducted among 556 nursing interns at the First Affiliated Hospital of Guangdong Pharmaceutical University from January 3, 2026, to March 3, 2026, yielding 532 valid responses. Validated scales were used to assess self-efficacy, problem-solving behavioral intentions regarding near misses, and psychological safety. Data were analyzed using SPSS 26.0 and AMOS 24.0.

RESULTS

The results indicated that nursing interns reported a moderate level of self-efficacy, while their total scores for problem-solving behavioral intentions regarding near misses and for psychological safety were both at a high level. Self-efficacy was positively correlated with both problem-solving behavioral intentions regarding near misses (r = 0.253, p < 0.001) and psychological safety (r = 0.301, p < 0.001), while psychological safety was positively correlated with problem-solving behavioral intentions regarding near misses (r = 0.217, p < 0.001). Mediation analysis indicated that psychological safety statistically accounted for 20.5% of the total association between self-efficacy and problem-solving behavioral intentions regarding near misses.

CONCLUSIONS

Self-efficacy was positively associated with nursing interns' problem-solving behavioral intentions regarding near misses, and psychological safety statistically accounted for part of this association. Scenario-based training, nonpunitive feedback, accessible reporting channels, and timely feedback on corrective actions may support interns in identifying, reporting, and reviewing near misses.