{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T06:12:24Z","timestamp":1790143944499,"version":"4.0.1"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Nutrition care for older adults women with gynecologic cancers is an emerging and clinically critical competency domain in nursing education. With the accelerated shift toward online learning, understanding the psychological mechanisms that drive deep learning behaviors in this specialty area is essential for curriculum design and educational quality improvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to examine associations between academic emotions, academic self-efficacy, and deep learning behaviors in undergraduate nursing students participating in an online specialty nursing course, and to evaluate the mediating role of academic self-efficacy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional survey was conducted from September 2023 to January 2024 among third- and fourth-year undergraduate nursing students at three universities located in eastern, central, and western China. Of 540 distributed questionnaires, 487 were returned and 461 valid responses were included. The Academic Emotions Questionnaire for Online Learning (AEQ-OL), Academic Self-Efficacy Scale for Nursing Students (ASES-NS), and Deep Learning Behavior Scale (DLBS) were administered electronically. Descriptive statistics, Pearson correlation analysis, and bootstrap mediation analysis were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 461 valid questionnaires were analyzed (effective response rate 94.7%). Positive academic emotions (mean 3.72\u202f\u00b1\u202f0.61) were positively associated with academic self-efficacy (\n                      <jats:italic>r<\/jats:italic>\n                      =\u202f0.542,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.001) and deep learning behaviors (\n                      <jats:italic>r<\/jats:italic>\n                      =\u202f0.631,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.001). Academic self-efficacy was also positively associated with deep learning behaviors (\n                      <jats:italic>r<\/jats:italic>\n                      =\u202f0.587,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.001). In the positive-emotion model, the indirect effect through academic self-efficacy was significant (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      =\u202f0.322, 95% bootstrap CI: 0.260\u20130.386), accounting for 50.6% of the total effect. In the negative-emotion model, the direct effect became non-significant after inclusion of academic self-efficacy, whereas the indirect effect remained significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Academic emotions were significantly associated with deep learning behaviors in this online nursing education context, and academic self-efficacy showed a significant mediating association. These findings support the educational relevance of emotionally supportive learning environments and strategies that strengthen students\u2019 confidence, while causal and temporal relationships require confirmation in longitudinal or experimental studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1956924","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T05:49:29Z","timestamp":1790142569000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Academic emotions, self-efficacy, and deep learning behaviors in online nursing education: a mediation analysis"],"prefix":"10.3389","volume":"14","author":[{"given":"Huanhuan","family":"Xu","sequence":"first","affiliation":[{"name":"Jiangxi Institute of Technology","place":["Nanchang, Jiangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaowen","family":"Sun","sequence":"additional","affiliation":[{"name":"Jiangxi Institute of Technology","place":["Nanchang, Jiangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Chen","sequence":"additional","affiliation":[{"name":"Jiangxi Institute of Technology","place":["Nanchang, Jiangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaoyao","family":"Xia","sequence":"additional","affiliation":[{"name":"Jiangxi Institute of Technology","place":["Nanchang, Jiangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huihui","family":"Zhan","sequence":"additional","affiliation":[{"name":"Jiangxi Institute of Technology","place":["Nanchang, Jiangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Oncology, The 960th Hospital of the PLA Joint Logistics Support Force","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1097\/SPC.0000000000000630","article-title":"Interventions to improve nutritional status for older patients with cancer\u2014a holistic approach is needed","volume":"17","author":"Liposits","year":"2023","journal-title":"Curr Opin Support Palliat Care"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"2898","DOI":"10.1016\/j.clnu.2021.02.005","article-title":"ESPEN practical guideline: Clinical Nutrition in cancer","volume":"40","author":"Muscaritoli","year":"2021","journal-title":"Clin Nutr"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"105826","DOI":"10.1016\/j.nedt.2023.105826","article-title":"Nutritional knowledge of nursing students: a systematic literature 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