Nurses’ attitudes toward artificial intelligence: AI literacy as a predictor and the mediating effect of AI anxiety

This study examines the demographic factors affecting nurses’ attitudes toward artificial intelligence (AI), AI literacy and AI anxiety. Explore the correlations among nurses’ AI literacy, AI anxiety and attitudes toward AI, and determine the internal mechanisms of the correlations among the three. This study investigated 478 nurses working in hospitals in Hunan Province, China. A battery of instruments was used for data collection: a Nurse Information Form for Demographics, and three standardized scales—the Artificial Intelligence Literacy Scale (AILS), the Artificial Intelligence Anxiety Scale (AIAS), and the General Attitudes Towards Artificial Intelligence Scale (GAAIS)—to assess the core constructs of this study. Aided by IBM SPSS Statistics (Version 26.0), the collected data were collated and subjected to statistical analysis. Multivariate analysis was performed to investigate the effects of different social demographic data on the study subjects’ attitudes toward AI, AI literacy and AI anxiety. We also analyzed the correlations among attitudes toward AI, AI literacy and AI anxiety, and conducted multiple linear regression analysis on the variables with statistically significant effects on attitudes toward AI in univariate analysis and correlation analysis, using the Hayes PROCESS 4.1 model in SPSS to explore the mediating effects among these variables. Among the 478 questionnaires collected, 450 were valid, for an effective response rate of 94.14%. The attitudes toward AI, AI literacy, and AI anxiety scores were 55.10 ± 8.25, 63.86 ± 8.91, and 61.95 ± 24.92, respectively. The education, age and professional title of the nurses significantly differed in terms of their attitudes toward AI. Nurse gender is correlated with AI literacy levels. AI anxiety is significantly negatively correlated with AI literacy (r =-0.32, p ≤ 0.001) and attitudes toward AI (r =- 0.42, p ≤ 0.001), whereas AI literacy and attitudes toward AI are significantly positively correlated (r = 0.45, p ≤ 0.001). The percentage of the mediating effect attributable to AI anxiety was 22.22%. In our research, nurses’ attitudes toward AI are closely linked to their AI literacy and AI anxiety, with AI anxiety acting as the underlying mechanism that explains the relationship between these two factors. Nursing administrators should focus on enhancing nurses’ AI literacy while monitoring their emotional states to strengthen their positive attitudes toward AI. To achieve this goal, nursing managers could adopt a dual approach: First, practical AI-related training could be provided to improve nurses’ AI literacy. Second, during this critical phase of digital transformation, individuals regularly assess their psychological well-being and implement supportive measures to alleviate AI anxiety.