Open Access

ARTICLE

State Anxiety and Self-Efficacy across Educational Stages, Including Clinical Practicum, in Japanese Rehabilitation Students: A 3-Year Longitudinal Study

Shota Suzumura^1,2, Hiroaki Sakurai¹, Soichiro Koyama^1,*, Kazuya Takeda¹, Kenta Fujimura¹, Takuma Ii¹, Chikusa Muraoka¹, Tomomi Nakajima¹, Akiko Maeda¹, Shohei Mori¹, Yoshikiyo Kanada¹, Shigeo Tanabe¹
1 Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
2 Department of Rehabilitation Medicine, National Center for Geriatrics and Gerontology, Obu, Japan
* Corresponding Author: Soichiro Koyama. Email:

International Journal of Mental Health Promotion https://doi.org/10.32604/ijmhp.2026.083448

Received 03 April 2026; Accepted 07 August 2026; Published online 27 August 2026

Abstract

Background: Physical and occupational therapy students face academic and clinical stressors, but longitudinal changes in anxiety and its association with self-efficacy remain unclear. This study examined state anxiety across curriculum-based educational stages, including clinical practicum, and its association with self-efficacy in a Japanese cohort. Methods: This 3-year longitudinal observational study included 144 physical and occupational therapy students at one Japanese university. State anxiety (State-Trait Anxiety Inventory–Form JYZ) and General Self-Efficacy Scale (GSES) were assessed at six curriculum-aligned time points. A linear mixed-effects model included Time, gender, within-person GSES deviation, between-person mean GSES, and their interactions with Time as fixed effects and participant ID as a random intercept. Results: Mean state anxiety ranged from 37.5 to 42.8, highest during clinical practicum and lowest after first clinical contact. Time was significantly associated with anxiety (F(5, 206.02) = 5.79, p < 0.001; partial η² = 0.123), and anxiety was lower at first clinical contact than at early enrolment (B = −4.24, 95% CI: −6.30 to −2.19; p < 0.001). Time × within-person GSES (F(5, 260.06) = 3.81, p = 0.002) and Time × between-person mean GSES interactions (F(5, 186.27) = 42.79, p < 0.001) were significant. At early enrolment, higher between-person mean GSES was associated with lower anxiety, whereas within-person GSES deviation was not. During clinical practicum, both within-person and between-person GSES associations were positive; after practicum, the positive association remained only between persons. Conclusions: State anxiety and its associations with self-efficacy varied across curriculum-based stages. Curriculum-aligned monitoring and stage-specific support may be particularly relevant around clinical practicum.

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Keywords

State anxiety; self-efficacy; longitudinal study; rehabilitation students; mental health

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