Unveiling the Influence of Nomophobia, Emotional Regulation, Self-Efficacy and Loneliness on Anxiety Among Nursing Students: A Structural Equation Modeling Approach

Nursing students often experience high levels of anxiety compared to students in other disciplines due to academic and clinical demands. Some of the important factors believed to influence psychological well-being are nomophobia, emotional regulation, self-efficacy and loneliness. Therefore, the current study aimed to explore the relationships between nomophobia, emotional regulation, loneliness, self-efficacy and anxiety among nursing students using structural equation modeling (SEM). A cross-sectional study was conducted among 121 nursing students. Data were collected using validated tools, including the Nomophobia Questionnaire (NMP-Q), Emotion Regulation Questionnaire (ERQ), UCLA Loneliness Scale, General Self-Efficacy scale and Generalized Anxiety Disorder (GAD-7) scale. Structural Equation Modeling (SEM) was used to explore the relationship between study variables. The findings revealed that nomophobia and loneliness were positively associated with anxiety, with standardized path coefficients of beta = 0.35 (p < 0.001) and beta = 0.25 (p < 0.001), respectively. Conversely, emotional regulation (beta = -0.20, p < 0.001) and self-efficacy (beta = -0.30, p < 0.001) showed significant protective effects by reducing anxiety. Additionally, emotional regulation negatively influenced nomophobia (beta = -0.21, p < 0.001) and loneliness (beta = -0.15, p < 0.05), highlighting its role in mitigating adverse psychological outcomes. Self-efficacy exhibited a negative but non-significant association with loneliness (beta = -0.09, p = 0.10) and demonstrated a significant negative effect on nomophobia (beta = -0.13, p < 0.05). Nomophobia and loneliness significantly contribute to heightened anxiety levels among nursing students, while emotional regulation and self-efficacy serve as protective factors. Given the high-stress nature of nursing education and clinical practice, interventions aimed at enhancing emotional regulation skills and fostering social support networks could be particularly beneficial in mitigating nomophobia, reducing loneliness, and ultimately lowering anxiety levels. Integrating such strategies into nursing curricula may not only support students' mental well-being but also enhance their academic performance.