Preparedness of Chinese nurses for emerging infectious diseases: evidence from a nationwide online cross-sectional survey on monkeypox knowledge and attitudes

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Background Emerging infectious diseases (EIDs) continue to pose recurrent challenges to global health systems. Nurses, as frontline healthcare professionals, play a pivotal role in early detection, infection control, and patient management. Mpox (monkeypox) outbreaks provide a real-world stress test for evaluating nurses’ preparedness for EIDs. This study assessed Chinese nurses’ knowledge and attitudes toward Mpox and examined training- and professional-related determinants of preparedness. Methods A national online cross-sectional survey was conducted among nurses in China between January and March 2024 using convenience sampling. The questionnaire covered demographic characteristics, Mpox-related knowledge (27 items), and attitudes (7 items). Descriptive statistics, correlation analyses, and multivariable linear regression were performed. Results A total of 387 valid responses were analyzed. Respondents were recruited from 24 provincial-level administrative regions, although the sample was concentrated in Eastern China. Overall, 81.9% of nurses demonstrated good Mpox-related knowledge, and 97.4% showed positive attitudes. Knowledge scores were positively correlated with attitudes ( p < 0.001). Multivariable analysis revealed that professional title and receipt of Mpox-related workplace training were independently associated with higher knowledge scores (adjusted R 2 = 9.0%). Professional title was also a significant determinant of attitudes (adjusted R 2 = 3.9%). Conclusion Chinese nurses exhibited generally high levels of knowledge and positive attitudes toward Mpox in the post-outbreak period, suggesting a high baseline awareness of EIDs. Workplace training and professional role differentiation appear central to preparedness. These findings highlight the importance of sustained, structured infectious disease education and leadership-oriented training to strengthen nursing preparedness for future EID threats.

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