{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T16:57:13Z","timestamp":1792688233619,"version":"4.5.0"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>With the rapid advancement of artificial intelligence (AI), it has exerted a profound influence on the medical field. Currently, AI applications in nursing remain nascent in China. This study aimed to investigate nurses\u2019 attitudes and anxiety levels toward AI in general hospitals in western China, and to analyze the association of these psychological factors with their AI training acceptance and clinical AI tool usage behavior.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A multicenter cross-sectional design was employed. In February 2026, a questionnaire survey was conducted among 620 registered nurses in public general hospitals across western China (Sichuan, Guizhou, and Qinghai provinces). The questionnaire collected data on nurses\u2019 demographic information, whether they had received AI training and whether they had used AI tools in the workplace, as well as their responses to the General Attitudes Toward AI Scale (GAAIS) and the AI Anxiety Scale (AIAS). Participation was voluntary and anonymous. Descriptive statistics, reliability and validity testing, correlation analysis, and structural equation modeling were performed using R software (version 4.5.1).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 603 returned questionnaires (97.3% response rate), 591 were valid. Negative attitudes were significantly associated with lower training acceptance (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u202f=\u202f\u22120.140,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.015) and lower tool usage (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u202f=\u202f\u22120.141,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.003). Positive attitudes and AI anxiety showed no significant associations with either outcome. Older age and longer work experience were associated with higher rates of both outcomes, with work experience showing the strongest association with tool usage. No significant association was found between training acceptance and tool usage after covariate adjustment (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u202f=\u202f0.070,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.356).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Hospital-level resources, older age, and longer work experience were the factors most strongly associated with nurses\u2019 AI training acceptance and AI tool usage, with work experience showing the strongest association with tool usage. Negative attitudes were associated with lower engagement in both outcomes, whereas positive attitudes and anxiety showed no significant independent associations. These findings suggest that institutional support, experience-based peer learning, and targeted reduction of negative perceptions may be key priorities for AI integration in nursing practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1864635","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T05:38:16Z","timestamp":1784007496000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Nurses\u2019 AI training acceptance and tool usage: a structural equation model of individual and hospital-level factors"],"prefix":"10.3389","volume":"14","author":[{"given":"Linli","family":"Guo","sequence":"first","affiliation":[{"name":"Department of Clinical Trial Center, West China Hospital, Sichuan University\/West China School of Nursing, Sichuan University","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qin","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Mental Health Center, National Center for Mental Disorders, West China Hospital, Sichuan University\/West China School of Nursing, Sichuan University","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengjie","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Colorectal Cancer Center, West China Hospital, Sichuan University\/West China School of Nursing, Sichuan University","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siyun","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Mental Health Center, National Center for Mental Disorders, West China Hospital, Sichuan University\/West China School of Nursing, Sichuan University","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Limei","family":"Chen","sequence":"additional","affiliation":[{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Department of Pediatrics Nursing, West China Second University Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaotao","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Clinical Trial Center, West China Hospital, Sichuan University\/West China School of Nursing, Sichuan University","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoxia","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Qinghai Provincial People\u2019s Hospital","place":["Xining, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zuli","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Women and Child Psychiatry, The Second People\u2019s Hospital of Guizhou Province","place":["Guiyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1186\/s12912-024-01887-z","article-title":"Dual mediating effects of anxiety to use and acceptance attitude of artificial intelligence technology on the relationship between nursing students\u2019 perception of and intention to use them: a descriptive study","volume":"23","author":"Cho","year":"2024","journal-title":"BMC Nurs"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"105541","DOI":"10.1016\/j.nedt.2022.105541","article-title":"Nursing students\u2019 intent to use AI-based healthcare technology: path 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anxiety, and self-efficacy on nursing students\u2019 behavioral intentions","volume":"21","author":"Kwak","year":"2022","journal-title":"BMC Nurs"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"107033","DOI":"10.1016\/j.nedt.2026.107033","article-title":"Future nurses\u2019 attitudes and anxiety toward artificial intelligence: a cross-sectional study","volume":"162","author":"Kanat","year":"2026","journal-title":"Nurse Educ Today"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1038\/s44360-025-00016-7","article-title":"The landscape of AI implementation in US hospitals","volume":"1","author":"Hwang","year":"2026","journal-title":"Nature Health"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"e0001026","DOI":"10.1371\/journal.pdig.0001026","article-title":"Eliminating the AI digital divide by building local capacity","volume":"4","author":"Gulamali","year":"2025","journal-title":"PLOS Digit 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Nurs"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"e0319588","DOI":"10.1371\/journal.pone.0319588","article-title":"Artificial intelligence (AI) in nursing administration: challenges and opportunities","volume":"20","author":"Qaladi","year":"2025","journal-title":"PLoS One"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"1109","DOI":"10.1007\/s12553-022-00697-0","article-title":"Integration of artificial intelligence into nursing practice","volume":"12","author":"Abuzaid","year":"2022","journal-title":"Health Technol"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"724","DOI":"10.1186\/s12912-025-03406-0","article-title":"The mediation of trust on artificial intelligence anxiety and continuous adoption of artificial intelligence technology among primacy nurses: a cross-sectional study","volume":"24","author":"Zhou","year":"2025","journal-title":"BMC Nurs"}],"container-title":["Frontiers in Public 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