COVID-19 Preventive Practices Among Nursing Students: Integrating Psychological Distress, Self-Efficacy, and Resilience into the Knowledge–Attitudes–Practices (KAP) Framework

Background: During the recent COVID-19 pandemic, nursing students faced heightened infection risks during clinical practicum while managing significant psychological demands. However, factors predicting the preventive practices of future healthcare professionals remain poorly understood. Methods: This cross-sectional study examined 261 nursing students on COVID-19 knowledge, attitudes, practices, psychological distress, self-efficacy, and resilience during the fourth wave of the COVID-19 pandemic in South Korea. Grounded in the Knowledge–Attitudes–Practice (KAP) framework, hierarchical multiple regression analysis was conducted to identify predictors of preventive practice behaviors. Results: Depressive symptoms (β = 0.27, p = 0.023) and resilience (β = 0.29, p < 0.001) were significantly positive predictors of COVID-19 preventive practice. Conclusions: Resilience emerged as the strongest predictor of COVID-19 preventive practice among nursing students, highlighting the importance of psychological resources in sustaining infection prevention behaviors. Nursing education programs should incorporate resilience-building strategies to strengthen pandemic preparedness and clinical readiness among future healthcare professionals.