{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T16:58:21Z","timestamp":1792688301275,"version":"4.5.0"},"reference-count":47,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"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>Background<\/jats:title>\n                    <jats:p>The rapid advancement of artificial intelligence is driving an unprecedented technological transformation in nursing. However, the successful integration of these technologies depends largely on the proficiency and perspectives of registered nurses. Consequently, there is an urgent need to examine the psychological and behavioral responses of this workforce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A multi-center, cross-sectional survey was conducted from March to May 2026. a stratified convenience sampling method was employed to recruit 1,392 registered nurses from tertiary hospitals, secondary hospitals, and community health centers in Chongqing. Data collection instruments included a general demographic questionnaire, the Artificial Intelligence Literacy Scale, the Artificial Intelligence Anxiety Scale, and the General Attitudes Towards Artificial Intelligence Scale. Statistical analyses, including descriptive statistics, Spearman correlation, and multiple linear regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 1,392 registered nurses participated in the study, with a mean age of 34.69\u202f\u00b1\u202f7.13\u202fyears. AI literacy scored 5.27\u202f\u00b1\u202f0.90 (75.29% scoring rate). AI anxiety was moderate (51.29%), with the highest concerns appearing in socio-technical blindness (56.43%) and job replacement (55.14%). Overall, nurses maintained a positive attitude toward AI (74.00%). AI literacy was negatively correlated with anxiety (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f\u22120.338,\n                      <jats:italic>p\u202f&amp;lt;<\/jats:italic>\n                      0.001) and significantly positively correlated with attitude (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f0.551,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), anxiety and attitude were negatively correlated (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f\u22120.541,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Regression analysis indicated that AI literacy was a significant associated factor for both anxiety levels (\n                      <jats:italic>B<\/jats:italic>\n                      \u202f=\u202f-0.453,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001) and attitudes (\n                      <jats:italic>B<\/jats:italic>\n                      \u202f=\u202f0.377,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), explaining 9.9 and 29.4% of the variance, respectively. Additionally, a lower frequency of electronic device use (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.024) and lack of proficiency in device operation (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.033) were associated with higher anxiety levels, whereas male nurses demonstrated more positive attitudes compared to female nurses (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.011).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Nurses demonstrated high AI literacy and positive attitudes; however, anxiety remained prominent. Enhancing AI literacy may alleviate psychological anxiety, with device accessibility and usage patterns also playing critical roles. To facilitate the effective integration of artificial intelligence into clinical practice, administrators should strengthen institutional support mechanisms alongside providing facility resources and conventional education, thereby promoting the full utilization and translation of available resources.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1880523","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T06:00:15Z","timestamp":1786514415000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Artificial intelligence literacy, anxiety, and attitudes among registered nurses across different hospital tiers: a multi-center cross-sectional study"],"prefix":"10.3389","volume":"14","author":[{"given":"Yingqi","family":"Dai","sequence":"first","affiliation":[{"name":"The Second Affiliated Hospital of Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xili","family":"Zhao","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital of Chongqing Medical University","place":["Chongqing, China"]},{"name":"Acute and Critical Care Nursing Innovation and Translation Engineering Research Center of Chongqing Education Commission of China","place":["Chongqing, China"]},{"name":"Chongqing Geriatric Specialized Nursing Clinical Diagnosis and Treatment Center","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Pan","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital of Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaxin","family":"Wei","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital of Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1603","DOI":"10.2147\/JMDH.S459946","article-title":"A systematic review of the application of artificial intelligence in nursing care: where are we, and what\u2019s next?","volume":"17","author":"Ruksakulpiwat","year":"2024","journal-title":"J Multidiscip Healthc"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"104153","DOI":"10.1016\/j.ijnurstu.2021.104153","article-title":"Artificial intelligence -based technologies in nursing: A scoping literature review of the evidence","volume":"127","author":"von Gerich","year":"2022","journal-title":"Int J Nurs Stud"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"689","DOI":"10.1186\/s12909-023-04698-z","article-title":"Revolutionizing healthcare: the role of artificial intelligence in clinical practice","volume":"23","author":"Alowais","year":"2023","journal-title":"BMC Med Educ"},{"key":"ref4","first-page":"3","article-title":"Real-world application, challenges and implication of artificial intelligence in healthcare: an essay","volume":"43","author":"Mudgal","year":"2022","journal-title":"Pan Afr Med J"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"951","DOI":"10.3390\/jpm13060951","article-title":"A review of the role of artificial intelligence in healthcare","volume":"13","author":"Al Kuwaiti","year":"2023","journal-title":"J Pers Med"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1214","DOI":"10.3390\/jpm13081214","article-title":"Advancing patient care: how artificial intelligence is transforming healthcare. Journal of","volume":"13","author":"Poalelungi","year":"2023","journal-title":"Pers Med"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"957","DOI":"10.1111\/jnu.70040","article-title":"Artificial intelligence applications in healthcare: A systematic review of their impact on nursing practice and patient outcomes","volume":"57","author":"Abdelmohsen","year":"2025","journal-title":"J Nurs Scholarsh"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"e188","DOI":"10.7861\/fhj.2021-0095","article-title":"Artificial intelligence in healthcare: transforming the practice of medicine","volume":"8","author":"Bajwa","year":"2021","journal-title":"Future Healthc J"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"104158","DOI":"10.1016\/j.nepr.2024.104158","article-title":"Artificial intelligence (AI) applications in healthcare and considerations for nursing education","volume":"80","author":"Montejo","year":"2024","journal-title":"Nurse Educ Pract"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1016\/j.ijnss.2018.09.013","article-title":"Can nurses remain relevant in a technologically advanced future?","volume":"6","author":"Pepito","year":"2019","journal-title":"Int J Nurs Sci"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1093\/jamia\/ocz192","article-title":"A governance model for the application of AI in health care","volume":"27","author":"Reddy","year":"2020","journal-title":"J Am Med Inform Assoc"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"e2070","DOI":"10.1002\/nop2.2070","article-title":"Advancing nursing practice with artificial intelligence: enhancing preparedness for the future","volume":"11","author":"Rony","year":"2024","journal-title":"Nurs Open"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"e70035","DOI":"10.1111\/inr.70035","article-title":"Acceptance and readiness of critical care nurses to use artificial intelligence: A structural equation modeling approach","volume":"72","author":"Baraka","year":"2025","journal-title":"Int Nurs Rev"},{"key":"ref14","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":"ref15","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1038\/s41539-024-00264-4","article-title":"A systematic review of AI literacy scales","volume":"9","author":"Lintner","year":"2024","journal-title":"NPJ Sci Learn"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1355","DOI":"10.11124\/JBIES-23-00269","article-title":"Digital health education: shaping the next generation of nursing professionals","volume":"21","author":"Cardoso","year":"2023","journal-title":"JBI Evidence Synthesis"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"e16","DOI":"10.1016\/j.pedn.2024.09.012","article-title":"Evaluation of neonatal nurses\u2019 anxiety and readiness levels towards the use of artificial intelligence","volume":"79","author":"\u00dcnal","year":"2024","journal-title":"J Pediatr Nurs"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/jocn.17562","article-title":"Examining the anxiety and preparedness levels of nurses and nurse candidates for artificial intelligence health technologies","volume":"18","author":"Mara\u015f","year":"2024","journal-title":"J Clin Nurs"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"e01269","DOI":"10.1097\/CIN.0000000000001269","article-title":"The relationship between anxiety and readiness levels regarding artificial intelligence in midwives: an intergenerational comparative study. CIN","volume":"43","author":"Yilmaz","year":"2025","journal-title":"Comput Inform Nurs"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1186\/s40359-025-02757-2","article-title":"Mediating effect of AI attitudes and AI literacy on the relationship between career self-efficacy and job-seeking anxiety","volume":"13","author":"Li","year":"2025","journal-title":"BMC Psychol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1353","DOI":"10.1111\/jan.16335","article-title":"Paediatric nurses\u2019 perspectives on artificial intelligence applications: A cross-sectional study of concerns, literacy levels and attitudes","volume":"81","author":"\u00d6z\u00e7evik Suba\u015fi","year":"2025","journal-title":"J Adv Nurs"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"488","DOI":"10.1186\/s12912-024-02143-0","article-title":"The moderating role of ethical awareness in the relationship between nurses\u2019 artificial intelligence perceptions, 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Elm","year":"2007","journal-title":"BMJ"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"e5278","DOI":"10.1136\/bmj.e5278","article-title":"Sample size calculations: should the emperor\u2019s clothes be off the peg or made to measure?","volume":"345","author":"Norman","year":"2012","journal-title":"BMJ"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1324","DOI":"10.1080\/0144929X.2022.2072768","article-title":"Measuring user competence in using artificial intelligence: validity and reliability of artificial intelligence literacy scale","volume":"42","author":"Wang","year":"2023","journal-title":"Behav Inform Technol"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1080\/10494820.2019.1674887","article-title":"Development and validation of an artificial intelligence anxiety scale: an initial application in predicting motivated learning behavior","volume":"30","author":"Wang","year":"2022","journal-title":"Interact Learn 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between artificial intelligence-related attitudes, creative self-efficacy, and clinical reasoning competency among nurses","volume":"24","author":"Atalla","year":"2025","journal-title":"BMC Nurs"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"989","DOI":"10.1186\/s12912-025-03577-w","article-title":"The mediating effects of technology trust and perceived value in the relationship between eHealth literacy and attitude toward the usage of artificial intelligence in nursing: a cross-sectional study","volume":"24","author":"Chen","year":"2025","journal-title":"BMC Nurs"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1186\/s12909-024-05400-7","article-title":"Medical students\u2019 AI literacy and attitudes towards AI: a cross-sectional two-center study using pre-validated assessment instruments","volume":"24","author":"Laupichler","year":"2024","journal-title":"BMC Med 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