Elif Budak ERTÜRK, Sevcan Avcı IŞIK, Nilgün ÖZBAŞ, Caner İNCEKAŞ
Archives of Health Science and Research - 2026;13(1):1-11
Objective: This study aimed to examine the mediating role of social media awareness of appearance and body image (BI) in accepting plastic surgery among nursing students with multicenter structural equation modeling. Methods: This cross-sectional study was conducted between May 25, 2024, and June 30, 2024, with a total of 379 students at 2 universities (1 public and 1 private) located in metropolitan and rural areas of Türkiye. Data were collected with a sociodemographic questionnaire, Acceptance of Cosmetic Surgery (ACS) Scale, BI Scale, and Appearance-Related Social Media Consciousness (ASMC) Scale and then analyzed. Results: Structural equation modeling revealed that ASMC exerted significant direct effects on the subdimensions of ACS (standardized beta: ACS-Thoughts = -0.623, P < .001; ACS-Social = -0.270, P = .025; ACS-Personal = -0.613, P < .001). Bootstrap mediation analyses demonstrated that ASMC also produced significant indirect effects on ACS through BI (ACS-Thoughts: beta = 1.051, 95% CI [0.585, 1.917], P < .001; ACS-Social: beta = 0.809, 95% CI [0.428, 1.489], P < .001; ACS-Personal: beta = 0.991, 95% CI [0.573, 1.750], P < .001). Appearance-related social media consciousness significantly predicted BI1, BI2, and BI4, whereas BI3 was nonsignificant, indicating that mediation primarily occurred through BI2 and BI4, while the contribution of other BI pathways was negligible. The model demonstrated acceptable fit indices (chi2/df = 2.91; Comparative Fit Index = 0.84; root mean square error of approximation = 0.071; standardized root mean square residual = 0.079), thereby supporting the partial mediation hypothesis. Conclusion: The findings highlight the significant influence of social media awareness on the ACS, partially mediated by BI, suggesting the need for educational interventions addressing media literacy and body perception among nursing students.
