Abstract
BACKGROUND: The growing aging population has led to escalating demands for gerontological nursing, further intensified by the COVID-19 pandemic. While ageism is a recognized barrier to nursing students' career motivation toward gerontological nursing (CMGN), the underlying mechanisms through which it exerts influence remain underexplored. Moreover, empirical research on CMGN and related factors in the post-pandemic context is limited. OBJECTIVE: This study examined the levels and predictors of CMGN among early-stage nursing students in the post-pandemic context and explored how ageism influences CMGN directly and indirectly through a sequential-parallel mediation model. METHODS: A cross-sectional online survey was conducted at a medical university in Jiangxi Province, China. A total of 1,192 completed questionnaires from nursing students (mean age = 18.44; 90.3% female; 85.6% first-year students) across two academic tracks (bachelor's and diploma programs) were included in the analysis. T-tests, ANOVA, regression, and structural equation modeling were used to identify key predictors and mediating pathways. RESULTS: Students reported a moderate overall level of CMGN (M = 64.12, SD = 12.86; range = 20-100). Key predictors of both CMGN subscales-Expectancy and Value-with β > 0.1 and p < 0.01 included empathy, intergenerational contact quality, and learning experiences in gerontological nursing. Ageism was a dimension-specific negative predictor, affecting only the Value subscale (β = -0.212, p < 0.001). Mediation analysis further showed that ageism influenced Value both directly (β = -0.200, p < 0.001) and indirectly (β = -0.124, p < 0.001) through a sequential pathway involving contact quality and Expectancy, as well as a parallel pathway mediated by gratitude. CONCLUSION: The multifaceted negative impact of ageism on CMGN underscores the need for a holistic curriculum strategy. Key recommendations include integrated gerontological nursing education, anti-ageism instruction, interventions to foster gratitude and empathy, and interpersonal communication training tailored to geriatric care.