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

Background: 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. Methods: 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. Results: 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. Conclusion: 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.