JMIR Publications

ABSTRACT

Background:

In an increasingly digitalized society, information security has become a major challenge, with frequent data breaches resulting in substantial adverse consequences. Among various types of information, health-related information is particularly sensitive and vulnerable to misuse or compromise. As frontline clinical professionals, nurses have direct and frequent access to both patients and their health information. However, empirical evidence regarding information security behaviors from the perspective of nurses remains limited.

Objective:

To examine the current status of information security behaviors among nurses in the digital information environment.

Methods:

A descriptive cross-sectional study was conducted between September and November 2025. Nurses from 254 healthcare institutions across 29 provinces and seven major geographic regions in mainland China were surveyed. Convenience sampling combined with snowball sampling was used to collect data from 8,210 nurses. The primary measures included demographic characteristics, occupational characteristics, healthcare institution-related characteristics, and information security behaviors. The Information Security Behavior Scale comprised four dimensions: device protection, password management, proactive awareness, and information handling. Data cleaning and statistical analyses were performed using SPSS version 27.0.

Results:

After applying the inclusion and exclusion criteria, 8,041 nurses were included in the final analysis. The mean age of participants was 34.43 ± 7.23 years; 95.05% were female, and 79.21% were clinical nurses. The total score for information security behaviors was 103.85 ± 14.02. Significant differences in total information security behavior scores were observed across groups stratified by gender, age, Professional Experience, nursing professional title, nursing role, China’s Regional Divisions, hospital ownership, hospital level, hospital type, and department type (P < 0.05). After covariate balancing, gender, hospital ownership, China’s Regional Divisions, hospital type, and department type remained independent factors associated with the total information security behavior score among nurses.

Conclusions:

Information security behaviors among nurses in China were at a moderate-to-high level overall. However, specific behavioral domains, particularly certain aspects of device protection and proactive awareness, remained suboptimal. The findings indicate heterogeneous patterns of information security behaviors across hospital types, department type, and nursing roles in China. Future information security policies and training programs at the nursing management level should consider more tailored and context-specific intervention strategies.