Background: Clinical decision-making anxiety impairs nursing students’ relationship-centered care (RCC) delivery, yet the underlying psychological mechanisms remain unclear. Objectives: This study examined the relationship between clinical decision-making anxiety and RCC and also explored the mediating roles of sense of coherence (SOC) and emotional intelligence among nursing students. Methods: A cross-sectional study was conducted from March to May 2024 with 185 nursing students from a 4-year undergraduate program in South Korea. Data were collected using 4 validated instruments: the Korean version of the Nursing Anxiety and Self-Confidence with Clinical Decision-Making Scale, the RCC Scale, the 13-item SOC Scale, and the Wong and Law Emotional Intelligence Scale. Results: Clinical decision-making anxiety negatively affected RCC primarily through indirect pathways. Emotional intelligence significantly mediated this relationship (β = −0.067; 95% Confidence interval CI, −0.122, −0.024), as did the sequential pathway through SOC to emotional intelligence (β = −0.037; 95% CI, −0.065, −0.014). SOC alone did not significantly mediate the relationship, and the direct effect of anxiety on RCC was nonsignificant (β = −0.027, P = .469). The total indirect effect was significant (β = −0.089; 95% CI, −0.147, −0.043). Conclusion: Clinical decision-making anxiety undermines RCC indirectly through emotional intelligence and the sequential SOC → emotional intelligence pathway rather than through direct effects. Educational interventions that reduce anxiety while systematically developing SOC and emotional intelligence may enhance nursing students’ RCC competency and improve patient outcomes.
Chang et al. (2026) studied this question.