Hantavirus preparedness among undergraduate nursing students in the United Arab Emirates: a cross-sectional study of knowledge, risk perception and preventive practice

BACKGROUND: Hantavirus infection is uncommon in many settings but can cause severe pulmonary or renal disease. Nursing students require disease-specific preparedness for exposure-history taking, safe prevention counselling and infection prevention during community and clinical learning. This study examined undergraduate nursing students' knowledge, risk perception and preventive practice toward hantavirus and identified associated factors. METHODS: A descriptive analytical cross-sectional survey was conducted among 236 undergraduate nursing students in one nursing program in Ras Al Khaimah, the United Arab Emirates during the 2025-2026 academic year. Data was collected using the researcher-developed Hantavirus Knowledge, Attitudes and Preventive Practices Questionnaire for Nursing Students (HKAPP-NS). Descriptive statistics, Cronbach's alpha, Pearson correlations and multivariable linear regression with HC3 robust standard errors were used. RESULTS: Knowledge was low among the 236 complete-case respondents (mean 8.13/20, SD 5.84), with 59.0% classified as having poor knowledge. Attitude was moderate (mean 33.34/50, SD 7.78), and overall practice was higher (mean 42.98/64, SD 15.83). Internal consistency was strong across domains (alpha 0.886-0.967). Attitude correlated with overall practice (r = 0.569, p < 0.001), whereas knowledge did not (r = 0.101, p = 0.120). Previous hantavirus teaching, infection prevention and control training and environmental exposure predicted higher knowledge. Attitude was the strongest independent predictor of overall practice. CONCLUSIONS: Students reported comparatively frequent precautionary practice but had important disease-specific knowledge gaps, particularly regarding safe rodent-contamination cleanup, routine vaccine availability, specific antiviral treatment and person-to-person transmission. The finding that attitude, rather than knowledge, independently predicted practice suggests that scenario-based One Health education should combine factual teaching with risk appraisal, self-efficacy building, exposure-history taking and prevention counselling to strengthen future nurses' preparedness for rodent-borne zoonotic infections.