Nursing Students' Global Warming Knowledge and Sustainability Attitudes: The Moderating Role of Eco-Anxiety

Recently, global warming and climate change knowledge and sustainability attitudes have gained prominence in nursing education; however, studies are scarce about how eco-anxiety moderates between these associations. This study explored the moderating role of nursing students' eco-anxiety between global warming knowledge and sustainability attitudes. Utilising a cross-sectional and correlational design, nursing students (n = 561) were recruited via consecutive sampling between November 2024 and February 2025. Three standardised scales were used to collect data. Structural equation modelling was employed for data analyses. The two dimensions of global warming knowledge, knowledge of climate change and global warming (β = 0.14, p = 0.021) and awareness of the environment (β = 0.37, p = 0.003), had a direct, positive influence on sustainability attitudes. Global warming knowledge was positively associated with eco-anxiety (r = 0.18, p = 0.001). Eco-anxiety negatively influenced sustainability attitudes (β = -0.56, p = 0.020). Eco-anxiety significantly moderated the influence of the two dimensions of global warming knowledge, knowledge of climate change and global warming (β = -0.29, p = 0.005) and awareness of the environment (β = 0.93, p = 0.003), on sustainability attitudes. Our findings may guide nursing curriculum policymakers, nursing colleges and educators, and healthcare institutions to integrate global warming, climate change and eco-anxiety in their academic and clinical experiences to better prepare future nurses to care for populations and the environment affected by its negative impacts.