**1. Introduction**

It is evident that the recommendations to the population for the adoption of safety measures against COVID-19 have failed [1]. Classified as a worldwide pandemic, COVID-19 has affected more than 83 million people worldwide (1,893,502 in Spain) and caused

Alconero-Camarero, A.R.; González-López, J.R.; Antonín-Martín, M.; Borras-Santos, A.; Edo-Gual, M.; Gea-Caballero, V.; Gómez-Urquiza, J.L.;

Meneses-Monroy, A.; et al. COVID-19 Infection among Nursing Students in Spain: The Risk Perception,

Perceived Risk Factors, Coping Style, Preventive Knowledge of the Disease and Sense of Coherence as Psychological Predictor Variables: A Cross Sectional Survey. *Nurs. Rep.* **2022**, *12*, 661–673. https://doi.org/ 10.3390/nursrep12030066

Academic Editors: Richard Gray and Sonia Udod

Received: 29 July 2022 Accepted: 14 September 2022 Published: 16 September 2022

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**Copyright:** © 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/).

more than 1.8 million deaths (50,000 in Spain) [2,3]. Recent research shows that health systems have allocated more resources to hospital and clinical care than to community care [4]. Experts warn that the key is to prevent the onset of the disease and not just treat it when its spread cannot be contained [5]. Hence, community and public health strategies are keys in prevention efforts.

These strategies are in line with the Health Belief Model [6,7] (Rosenstock, 1966, 1976), by which people, in general, present greater illusory optimism and a lower perception of risk, which are well-studied facts in processes such as adherence to treatment or prevention of risky behaviors (drugs, sexual practices, etc.) [8]. Rosenstock's Health Belief Model (HBM) is "a theoretical model concerned with health decision-making. The model attempts to explain the conditions under which a person will engage in individual health behaviors, such as preventative screenings or seeking treatment for a health condition" [6,7]. The model is based on the assumption that people's willingness to change their health behaviors primarily comes from their health perceptions. Individual beliefs about health and health conditions play a role in determining health-related behaviors. The psychological and cognitive processes underlying the Health Belief Models indicate that psychological constructs such as risk perception, coping style and knowledge perception are keys in the adoption of preventive measures against certain communicable diseases [9]. Thus, recent studies on COVID-19 focus on these psychological constructs [10]. Among the health models, one model that stands out in the field of public health and health promotion is the salutogenic model [11], which relates one's approach to stressful situations (such as the COVID-19 pandemic) to the individual's capacity for self-management of such situations [12]. This model develops concepts such as sense of coherence (SOC), which is directly related to the ability to employ cognitive, affective and instrumental strategies to better cope with stress [11].

Studies relating other psychological constructs besides SOC to the risk of acquisition of COVID-19 are unknown. Our study focused on nursing students (NS). Their lack of clinical experience, combined with their knowledge of preventive measures, may be valuable indicators for developing a predictive model relating psychological constructs such as SOC and coping styles to the likelihood of contracting the virus. This study constitutes an important aid in designing health education strategies in two manners: one, to inform the teachers of NS who perform their clinical placements, and two, based on general policies, since young people under 30 years of age seem to have a lower perception of risk in relation to the transmission of COVID-19 [13]. Our hypothesis considers that it is possible to predict the risk of contagion in nursing students, based on knowledge of psychological variables that, according to the literature, can act as mediators in this sense. These variables would have to relate to knowledge and coping strategies in the face of contagion, such as those we have described.

The main objective was to analyze the variables of risk perception, perceived risk factors, coping styles, SOC and knowledge of preventive measures among NS as possible mediating and predictor variables for contracting COVID-19.
