Assessment of knowledge, attitude, anxiety level and perceived mental healthcare needs toward mpox infection among nursing students: A multi-center cross-sectional study

Abstract

Despite the crucial role of nursing students in managing public health crises, their understanding and attitudes towards monkeypox (mpox) remain underexplored. This study aims to assess nursing students' knowledge, attitudes, anxiety levels, and perceived need for mental healthcare support related to mpox across the UAE, Iraq, and Egypt. A cross-sectional survey was conducted with 1,386 nursing students from three universities using non-probability purposive sampling. Participants completed a structured questionnaire covering sociodemographic information, knowledge of mpox, attitudes towards the disease, levels of anxiety, and perceived mental healthcare needs. Knowledge was categorized into poor, fair, and good, attitudes into negative, neutral, and positive, and anxiety into low, moderate, and high levels. Data were analysed for correlations using Pearson's correlation coefficient and statistical tests. We performed multivariate regression analysis to find odd ratios of assessed parameters against several sociodemographic variables. Among the participants, 21.8% demonstrated good knowledge of mpox, while 53.4% had moderate or fair knowledge and 24.8% had poor knowledge. Attitudes were predominantly neutral (44.7%) or negative (36%), and 57.2% reported moderate anxiety. Approximately 33% of students felt a significant need for mental healthcare support. Knowledge correlated positively with attitudes and negatively with anxiety and perceived mental healthcare needs. Attitudes also negatively correlated with perceived mental healthcare needs. The neutral or negative attitudes towards mpox suggest a need for enhanced educational interventions. Addressing these gaps through targeted training programs could improve knowledge, foster positive attitudes, and mitigate anxiety, thereby better preparing future healthcare professionals for emerging health threats. • Significant gaps in mpox knowledge among nursing students, with many showing only moderate to poor understanding, especially notable among students from Egypt. • Nursing students generally have neutral to negative attitudes towards mpox, suggesting a lack of positive engagement and potential impact on disease management. • A notable proportion of nursing students experience moderate anxiety about mpox and perceive a substantial need for mental healthcare support, highlighting the importance of addressing psychological impacts. • Positive correlation between knowledge and attitudes towards mpox, indicating that improving knowledge may lead to more positive attitudes and reduced anxiety. • Significant variations in knowledge, attitudes, and anxiety based on factors such as nationality, educational stage, and exposure to mpox information, emphasizing the need for tailored educational and support programs.