Mediating Effects of Self-efficacy and Perceived Organizational Support Between Risk Perception and Nurses’ Participation Intention in “Internet + Nursing Services”

Mediating Effects of Self-efficacy and Perceived Organizational Support Between Risk Perception and Nurses’ Participation Intention in “Internet + Nursing Services” | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Mediating Effects of Self-efficacy and Perceived Organizational Support Between Risk Perception and Nurses’ Participation Intention in “Internet + Nursing Services” Jiajia Xu, Yue Hu, Shuaishuai Guo, Xinyi Wang, Dan Liu This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7975418/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract Aims To explore the mediating effect of self-efficacy and perceived organizational support on nurses’ risk perception and participation intention in “Internet + nursing services”. Methods A cross-sectional survey was conducted from June to August 2025 using convenience sampling to recruit 624 nurses from five hospitals in Shanxi Province, China. Data were collected using a demographic questionnaire, risk perception outcome assessment scale for nurses in “Internet + nursing services” for the elderly, participation intention of nurses on “Internet + nursing services” scale, the general self-efficacy scale, and the perceived organizational support scale. Descriptive analysis and correlation analysis were performed using SPSS 27.0, and structural equation modeling was constructed with AMOS 24.0 for mediation effect analysis. Results The research results show that the risk perception of nurses in “Internet + nursing services” is negatively correlated with their participation intention. The mediation analysis shows that the mediating effects of nurses’ perceived organizational support and self-efficacy, and their chain mediation effect, accounted for 72.36%, 14.18%, and 13.46% of the total effect, respectively. Conclusion Nurses’ risk perception of “Internet + nursing services” can influence their participation intention in the service through their perceived organizational support and self-efficacy. “Internet + nursing services” risk perception self-efficacy perceived organizational support participation intention Figures Figure 1 Figure 2 Introduction “Internet + nursing services” in China refer to the home care services provided by registered nurses in medical institutions to patients who require home services, relying on internet information technology and adopting the form of “online application, offline service”. Patients make appointments and place orders for services through relevant applications, and nurses bring the necessary supplies to provide home care services according to the agreed time and service content. This service model enables patients to receive professional nursing services without leaving home, effectively alleviating the burden of travel for elderly patients with limited mobility and improving the efficiency of medical resource utilization. As the core participants in “Internet + nursing services”, the willingness of nurses to provide services will directly affect the promotion and application of this service model [1]. However, a survey shows that the willingness of nurses to provide home care services is only 38.44%, which is far lower than the 82.73% willingness of patients to receive home-based services [2]. In existing research on the factors influencing nurses’ participation intention in “Internet + nursing services”, we have found that nurses’ concerns about potential risks during service are one of the key factors affecting their participation [3–6]. 83.4% of nurses expressed concern about the risks associated with home care, believing that “Internet + nursing services” would increase medical risks and disputes [7]. They are unwilling to undertake nursing service projects that involve complex operations and have a high potential risk, and they are cautious and hesitant about participating in such services for a long time, with a low overall participation intention [8]. The risk perception theory indicates that risk perception influences the way individuals engage in risky events and their decision-making [9]. Nurses must address various potential risks during home service, and their behavioral decisions and participation intention often depend on their subjective emotional perception of risks rather than rational assessment of risks [10]. Thus, it can be seen that the level of nurses’ risk perception may directly affect their participation intention. At the same time, whether individuals are willing to make contributions beyond the requirements of their job duties is largely influenced by their perceived organizational support [11]. The assessment of organizational support is frequently applied to stimulate individuals’ sustained participation intention [12] and maintain their enthusiasm for participation [13]. Self-efficacy also serves as an important influencing factor for individual participation intention [14]. The premise of an individual’s behavioral choice is having the self-efficacy to overcome risks and achieve goals. Organizational support also has a positive effect on nurses’ self-efficacy [15]. In summary, risk perception, perceived organizational support, and self-efficacy all have significant influences on individuals’ participation intention. However, existing research has paid little attention to the intrinsic connections and mediating mechanisms among these variables. Therefore, this study takes perceived organizational support and self-efficacy as mediating variables to explore the internal path and mechanism of action of nurses’ risk perception in “Internet + nursing services” on their participation intentions. The aim is to provide a reference basis for relevant management departments to formulate intervention strategies that enhance nurses’ participation intention and promote the sustainable development of “Internet + nursing services”. Risk Perception and Participation Intention Risk perception is an individual’s subjective cognition of potential risks and is a key predictor of behavior maintenance and change [16]. The Theory of Planned Behavior indicates that behavioral intention is a direct precursor to actual behavior [17], reflecting the degree of an individual’s willingness to engage in a specific behavior. The transactional theory of stress and coping proposed by Lazarus and Folkman [18] emphasizes that it is not the event itself but the individual’s primary appraisal of potential risks and benefits, along with the secondary appraisal of their own coping abilities and resources, that determines stress-coping behaviors. When an event is perceived as risky but individuals believe they can effectively cope with it, they are more likely to accept the challenge and adopt corresponding proactive coping strategies [19]. However, if the perceived risk exceeds an individual’s perceived control, they tend to choose risk-avoidant behaviors such as evasion or withdrawal [20]. Safety is a fundamental prerequisite for ensuring the quality of nursing care, and nurses’ risk perception regarding the nursing service process may influence their participation intention. Therefore, it is reasonable to hypothesize that nurses’ risk perception of “Internet + nursing services” is closely related to their participation intentions. Risk Perception, Perceived Organizational Support, and Participation Intention Perceived organizational support refers to employees’ subjective psychological feeling about whether the work organization values their contributions and cares about their well-being [21]. Individuals in organizations with a high security atmosphere often have a higher sense of perceived organizational support. However, in high-risk situations, employees’ demand for organizational support increases significantly, and their perception of such support becomes more sensitive. High-risk perception can trigger employees to re-evaluate the resources and support available from the organization. This increase in demand may lower their evaluation of the perceived quality of organizational support [22]. Therefore, risk perception is likely to influence nurses’ perceived organizational support. Furthermore, perceived organizational support can directly affect employees’ willingness to respond to risk events. Perceived organizational support can meet the emotional needs of nurses, thereby enhancing their confidence in dealing with risks. Consequently, it is plausible that risk perception among nurses engaged in “Internet + nursing services” influences their participation intention through the mediating role of perceived organizational support. Risk Perception, Self-efficacy, and Participation Intention Self-efficacy refers to an individual’s belief in their capability to attain certain goals within a particular domain. It serves as an intrinsic motivator for behavioral change, and its level directly influences an individual’s choice of actions and persistence of their behaviors [23]. The Risk Perception Attitude (RPA) framework [24] posits that individual behavior is influenced by risk perception, efficacy beliefs, and the interplay between the two. Risk perception may trigger emotional responses that subsequently affect an individual’s self-efficacy and participation intention. Research indicates that individuals with high self-efficacy demonstrate greater confidence in handling complex and resource-demanding tasks [25]. Risk perception is closely related to self-efficacy, and high self-efficacy will further enhance an individual’s positive behavior. Based on this, we propose the following hypothesis: self-efficacy mediates the relationship between nurses’ risk perception of “Internet + nursing services” and their participation intention. Perceived Organizational Support and Self-efficacy An individual’s self-efficacy is not only derived from intrinsic beliefs but is also closely linked to the level of external support. It can influence individual behavior through its mediating role or other chain mediation pathways [26]. Challenging work processes may deplete employees’ psychological energy resources. Consequently, when resources are insufficient to cope with complex tasks, individuals tend to reduce effort or withdraw from work to conserve their remaining resources [27]. According to the Job Demands-Resources (JD-R) theory model, the value of job resources becomes particularly salient when the job demands are high, and external resources can effectively relieve the job pressure of individuals and promote their job performance [28]. The home environment, as a unique workplace, places higher demands on the various capabilities of home nurses. In such contexts, organizational support, as an external resource, can supplement psychological resources like self-efficacy, thereby mitigating resource depletion. Multiple studies have indicated a positive correlation between perceived organizational support and self-efficacy [29,30]. A high level of perceived organizational support has been shown to predict greater self-efficacy [31]. Providing multi-faceted organizational support can help individuals enhance their confidence in coping with difficulties. Therefore, we propose that risk perception may enhance nurses’ self-efficacy by increasing their perceived organizational support, ultimately boosting their participation intention in “Internet + nursing services”. Current Study Previous research on the relationship between risk perception and participation intention has primarily focused on areas such as consumer behavioral intentions and health information-seeking behaviors, with few studies examining this relationship from the perspective of service providers. This study aims to investigate the association between nurses’ risk perception and their participation intention regarding “Internet + nursing services”, and to elucidate the mediating roles of perceived organizational support and self-efficacy within this pathway. Based on the existing literature, we propose the following hypotheses, and the hypothesized model is presented in Fig. 1 : Hypothesis 1 Nurses’ risk perception negatively predicts their participation intention in “Internet + nursing services”; Hypothesis 2 Perceived organizational support plays a mediating role between nurses’ risk perception and their participation intention; Hypothesis 3 Self-efficacy plays a mediating role between nurses’ risk perception and their participation intention; Hypothesis 4 Perceived organizational support and self-efficacy exhibit a chain mediating effect between nurses’ risk perception and their participation intention. Methods Design This study employed a cross-sectional design and utilized convenience sampling to investigate the relationships among self-efficacy, perceived organizational support, risk perception, and participation intention of nurses participating in “Internet + nursing services” from five medical institutions in Shanxi Province. This study was conducted in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) criteria. Participants This study was conducted from June to August 2025, using a combination of online and offline methods to survey nurses from multiple medical institutions in Shanxi Province. In structural equation modeling, the sample size is 10 to 15 times the number of variables [32]. With 23 variables in this study and considering a 20% questionnaire loss rate, the final sample size should be between 276 and 414 cases. Inclusion criteria: (1) In-service nurses who have obtained nursing professional qualification certificates; (2) Work experience of more than 2 years; (3) The medical institution where nurses work carries out “Internet + nursing services”; (4) Informed consent and voluntary agreement to participate in the study. Exclusion criteria: (1) Those who were not on duty during the investigation period due to reasons such as vacation or going out; (2) Intern and logistics nurse. Instruments Demographic characteristics Self-designed by the researchers, including demographic characteristics (age, gender, professional title, position, specialist nurse, years of working, hospital level, department, educational level). Risk Perception Outcome Assessment Scale for Nurses in “Internet + Nursing Services” for the Elderly The risk factor and risk perception outcome assessment scale for nurses in “Internet + nursing services” for the elderly [33] was previously developed by the research team. This scale consists of two subscales, namely nurses’ risk factors and risk perception outcomes. This study utilized the second part, the nurses’ risk perception outcome section, which included 14 items across three dimensions: physiological risk (items 1–6), practice risk (items 7–11), and economic risk (items 12–14). A 5-point Likert scale was employed for scoring each item, ranging from “almost none” (1 point) to “extremely high” (5 points). The total score ranges from 14 to 70, with a higher score indicating a greater level of risk perception. In this study, the Cronbach’s α coefficient of the scale was 0.936. Participation Intention of Nurses on “Internet + Nursing Service” Scale This scale was developed by Li Suyuan et al. [34]. It consists of three subscales: the participating behavioral attitude subscale (5 items), the subjective behavioral norms subscale (5 items), and the perceived behavioral control subscale (7 items), totaling 17 items. Items 10, 14, and 15 are reverse-scored. The scale encompasses eight dimensions: values (2 items), economic perspective (1 item), development perspective (2 items), work (3 items), family (2 items), self-perception (2 items), environmental perception (3 items), and technological perception (2 items). Each item is rated on a 5-point Likert scale, ranging from “strongly disagree” (1 point) to “strongly agree” (5 points). In this study, the Cronbach’s α coefficient of the scale was 0.913, and the Cronbach’s α coefficients of the three subscales were 0.801, 0.850, and 0.805, respectively. General Self-Efficacy Scale The general self-efficacy scale was originally developed by Jerusalem and Schwarzer. In this study, the Chinese version of the General Self-Efficacy Scale, translated and revised by scholars such as Wang Caikang [35], was selected. This scale comprises 10 items, each rated on a 4-point Likert scale ranging from “completely incorrect” (1 point) to “completely correct” (4 points). In this study, the Cronbach’s α coefficient of the scale was 0.918. Perceived Organizational Support Scale This scale was developed by Chen Zhixia and later revised by Zuo Hongmei [36]. This scale included two dimensions: affective support (items 1–10) and instrumental support (items 11–13). Each item is scored using a 5-point Likert scale, ranging from “strongly disagree” to “strongly agree”, with scores of 1 to 5 points, respectively. The total score ranges from 13 to 65 points, with a higher score indicating a stronger perception of organizational support among nurses. The Cronbach’s α coefficient of the scale in this study was 0.945. Data Collection and Quality Control This research questionnaire collection was conducted through a combination of electronic and paper-based questionnaires. The electronic questionnaire was conducted through the ‘Wenjuanxing’ online platform ( https://www.wjx.cn ), and a QR code was created for data collection. The questionnaire was voluntarily completed by nurses, with informed consent obtained before the formal data collection. All questions in the questionnaire were marked as required. Participants could choose to exit the survey at any time, and each IP account was only allowed to submit once. To ensure data quality, the electronic questionnaires were manually checked. Questionnaires with a completion time of less than 120 seconds or those with the same sequence number selected for all questions were considered invalid. The paper questionnaires were distributed on-site by the researchers. The researchers explained the relevant content of the study to the nurses to obtain informed consent. After collection, the questionnaires were promptly checked to ensure the completeness of the responses. A total of 658 questionnaires were distributed, 624 were valid, with an effective response rate of 94.83%. Statistical methods Statistical analysis was performed using SPSS 27.0 and AMOS 24.0 software. Common method bias was assessed using Harman’s single-factor test. Due to the large sample size, key variables in this study were treated as approximately normally distributed continuous variables. Measurement data were presented as mean and standard deviation, and analyzed using t-tests or F-tests. Pearson correlation analysis was conducted to examine the relationships among demographic characteristics, risk perception, self-efficacy, perceived organizational support, and participation intention. The structural equation model was constructed using Amos 24.0 to analyze the pathway and mediating effects. The Bootstrap method with 5000 resamples was used to test the significance of the mediating effects. A 95% confidence interval not including zero indicated a significant mediating effect. Differences were deemed statistically significant at p < 0.05. Result Univariate Analysis of Nurses’ General Information and Participation Intention Scores The results showed that there were statistically significant differences in the nurses’ participation intention in “Internet + nursing services” in terms of their professional titles, positions, and whether they were specialized nurses ( p < 0.05). (see Table 1 ). Table 1 Univariate analysis of general information of nurses and the score of participation intention in “Internet + nursing services” Variables N (%) Score(M ± SD) F/t P Age 0.081 0.970 ≤ 30 203(32.5%) 56.43 ± 8.10 31–40 334(53.5%) 56.63 ± 8.57 41–50 78(12.5%) 56.94 ± 8.69 ≥ 51 9(1.4%) 57.67 ± 14.76 Gender 0.540 0.589 Male 25(4.0%) 57.52 ± 8.65 Female 599(96.0%) 56.58 ± 8.52 Professional title 3.406 0.017 Nurse 80(12.8%) 55.80 ± 7.72 Senior nurse 194(31.1%) 55.71 ± 7.90 Nurse-in-charge 328(52.6%) 57.05 ± 8.90 Associate chief nurse and above 22(3.5%) 61.18 ± 9.45 position -2.512 0.012 Nurse 595(95.4%) 56.43 ± 8.41 Head nurse 29(4.6%) 60.48 ± 9.98 Specialist nurse 2.950 0.003 Yes 171(27.4%) 58.25 ± 7.88 No 453(72.6%) 56.00 ± 8.68 Years of working 1.995 0.114 ≤ 5 164(26.3%) 56.15 ± 7.77 6–10 141(22.6%) 56.03 ± 8.36 11–20 289(46.3%) 56.82 ± 8.91 ≥ 21 30(4.8%) 59.97 ± 8.95 Hospital level 1.793 0.077 Tertiary hospital 564(90.4%) 56.78 ± 8.66 Secondary hospital 60(9.6%) 55.05 ± 6.94 Department 2.116 0.097 Internal medicine 312(50.0%) 56.06 ± 8.76 Surgery 209(33.5%) 56.53 ± 7.94 Emergency 19(3.0%) 58.53 ± 7.14 Others 84(13.5%) 58.48 ± 9.11 Education level 1.144 0.328 Below College 21(3.4%) 55.19 ± 7.55 Bachelor 563(90.2%) 56.58 ± 8.70 Master and above 40(6.4%) 57.83 ± 6.03 The Scores of Nurses’ Risk Perception, Participation Intention, Self-efficacy, and Perceived Organizational Support in “Internet + Nursing Services” The total scores of nurses’ risk perception, participation intention, self-efficacy, and perceived organizational support in “Internet + nursing services”, as well as the scores of each dimension, are detailed in Table 2 . Table 2 The scores of nurses’ risk perception, participation intention, self-efficacy, and perceived organizational support in “Internet + nursing services” (n = 624) Variables Items Scoring range Average total score (M ± SD) Average Score of per item (M ± SD) risk perception 14 14 ~ 70 39.74 ± 9.97 2.84 ± 0.71 physiological risk 6 6 ~ 30 15.84 ± 4.69 2.64 ± 0.78 practice risk 5 5 ~ 25 15.77 ± 3.90 3.15 ± 0.78 economic risk 3 3 ~ 15 8.14 ± 2.42 2.71 ± 0.81 participation intention 17 17 ~ 85 56.62 ± 8.52 3.33 ± 0.50 participating behavioral attitude 5 5 ~ 25 18.04 ± 2.99 3.61 ± 0.60 values 2 2 ~ 10 7.75 ± 1.26 3.88 ± 0.63 economic perspective 1 1 ~ 5 3.45 ± 0.82 3.45 ± 0.82 development perspective 2 2 ~ 10 6.84 ± 1.54 3.42 ± 0.77 subjective behavioral norms 5 5 ~ 25 16.71 ± 3.33 3.34 ± 0.67 work 3 3 ~ 15 10.56 ± 2.40 3.52 ± 0.80 family 2 2 ~ 10 6.15 ± 1.23 3.08 ± 0.62 perceived behavioral control 7 7 ~ 35 21.86 ± 3.35 3.12 ± 0.48 self-perception 2 2 ~ 10 6.38 ± 1.20 3.19 ± 0.60 environmental perception 3 3 ~ 15 8.65 ± 1.59 2.88 ± 0.53 technological perception 2 2 ~ 10 6.83 ± 1.19 3.42 ± 0.60 self-efficacy 10 10 ~ 40 25.79 ± 5.65 2.58 ± 0.57 perceived organizational support 13 13 ~ 65 44.80 ± 8.10 3.45 ± 0.62 affective support 10 10 ~ 50 33.39 ± 6.53 3.34 ± 0.65 instrumental support 3 3 ~ 15 11.42 ± 1.93 3.81 ± 0.64 Correlation Analysis of Nurses’ Risk Perception, Participation Intention, Self-efficacy, and Perceived Organizational Support in “Internet + Nursing Services” The Pearson correlation analysis results indicated that nurses’ risk perception of “Internet + nursing services” was negatively correlated with participation intention (r=-0.287, P < 0.001), negatively correlated with self-efficacy (r=-0.270, P < 0.001), and negatively correlated with perceived organizational support (r=-0.284, P < 0.001). Participation intention was positively correlated with self-efficacy (r = 0.556, P < 0.001) and positively correlated with perceived organizational support (r = 0.656, P < 0.001). Self-efficacy was positively correlated with perceived organizational support (r = 0.481, P < 0.001), see Table 3 . Table 3 The correlation among nurses’ risk perception, participation intention, self-efficacy, and perceived organizational support in “Internet + nursing services” Variables 1 2 3 4 1. risk perception 1.000 2. participation intention -0.287** 1.000 3. self-efficacy -0.270** 0.556** 1.000 4. perceived organizational support -0.284** 0.656** 0.481** 1.000 Note:**means p <0.001 Analysis of the Mediating Effect of Self-efficacy and Perceived Organizational Support between Nurses’ Risk Perception and Participation Intention in “Internet + Nursing Services” Common Method Bias The results of Harman’s single-factor test showed that there were eight factors with eigenvalues greater than 1, and the variance explained by the first common factor was 30.617%, below the 40% threshold. Thus, this study did not exhibit serious common method bias [37]. Mediation Analysis The chain mediating effect model was constructed using Amos 24.0. In order to effectively control measurement errors, variables with statistical significance in the univariate analysis, such as professional title, position, and specialist nurse, were taken as control variables. Taking nurses’ risk perception as the independent variable, participation intention as the dependent variable, and self-efficacy and perceived organizational support as the mediating variables, the established model is shown in Fig. 2 . Note PHY: Physiological risk; PRA: Practice risk; ECO: Economic risk; AFF: Affective support; INS: Instrumental support After modifying the initial model using modification indices, it was found that the effect of nurses’ risk perception of participating in “Internet + nursing services” on their participation intention was not significant ( P = 0.229). After removing this path, the modified model demonstrated a good fit, as shown in Table 4 . The deviation-corrected Bootstrap method was used for repeated sampling 5,000 times to test whether the mediating effect was statistically significant. The confidence interval was set at 95%, and the results are shown in Table 5 . The model shows that the effect value of risk perception → participation intention is -0.046, with a 95% CI (-0.122 to 0.030) containing 0, indicating that the direct effect is not significant. The effect value of risk perception → perceived organizational support → participation intention was − 0.199, and the 95% CI (-0.258 to -0.146) did not include 0, indicating that the mediating effect of perceived organizational support was valid. The effect size of risk perception → self-efficacy → participation intention was − 0.039, and the 95% CI (-0.066 to -0.018) did not include 0, indicating that the mediating effect of self-efficacy was established. The effect size of risk perception → perceived organizational support → self-efficacy → participation intention was − 0.037, and the 95% CI (-0.056 to -0.024) did not include 0, indicating that the model of perceived organizational support and self-efficacy as a chain mediator holds true. In summary, nurses’ level of risk perception regarding “Internet + nursing services” can influence their b participation intention through three pathways: the mediating role of perceived organizational support, the mediating role of self-efficacy, and the chain mediating role of perceived organizational support and self-efficacy. Table 4 Model fit indicators Fitness index c 2 /df RMSEA CFI GFI AGFI IFI NFI Standard for judging 2.552 0.050 0.968 0.954 0.929 0.969 0.949 Metric <3 0.9 >0.9 >0.9 >0.9 >0.9 Note: c 2 /df = chi-square to degrees of freedom, RMSEA = root mean square error of approximation, CFI = comparative fit index, GFI = goodness-of-fit index, AGFI = adjusted goodness-of-fit index, IFI = incremental fit index, NFI = normed fit index. Table 5 Bootstrap analysis to test the mediating effect of self-efficacy and perceived organizational Support between nurses’ risk perception and participation intention in “Internet + nursing services” Model path Standardized path factor SE Bootstrap 95%CI Effect ratio (%) Low High Direct effect -0.046 0.039 -0.122 0.030 - Total indirect effect -0.275** 0.033 -0.340 -0.211 100.00 Path 1 -0.199** 0.029 -0.258 -0.146 72.36 Path 2 -0.039** 0.012 -0.066 -0.018 14.18 Path 3 -0.037** 0.008 -0.056 -0.024 13.46 Note: Path 1: Risk perception → Perceived organizational support → Participation intention;Path 2༚Risk perception → Self-efficacy →Participation intention༛Path 3༚Risk perception → Perceived organizational support → Self-efficacy → Participation intention. ** P <0.001. Discussion The Current Status of Nurses’ Participation Intention to Participate in “Internet + Nursing Services” The research results show that nurses’ participation intention to participate in “Internet + nursing services” is at a medium-high level (3.33 ± 0.50), indicating that nurses generally have a relatively positive attitude towards participating in this service, which is similar to the previous research results [38]. Among them, the total score of nurses’ participation behavioral attitude (3.61 ± 0.60) was relatively the highest, indicating that nurses recognize the professional value and social significance of this service model and largely approve of its potential benefits. In contrast, the score for perceived behavioral control was relatively low (3.12 ± 0.48), which might be one of the key factors restricting nurses’ participation intention. When nursing services are transferred from the standardized hospital setting to the home environment, the lack of team support and security guarantees significantly increases nurses’ sense of insecurity [39]. However, the current policy support and guarantee mechanisms are not clear, which makes nurses lack confidence in providing safe and high-quality nursing services. Secondly, the lack of targeted technical training, policy promotion, and reward mechanisms has led some nurses to have insufficient cognition of “Internet + nursing services”, further weakening their sense of behavioral control over the completion of such services. Individual willingness is determined by individual attitude and self-perception. Nurses’ positive attitude towards “Internet + nursing services” implies their recognition of the value of this service model, which to a certain extent can increase individual participation intention [40]. However, its deficiencies in aspects such as risk control, policy support, and technical training have also led to nurses’ low self-perception of behavioral control in participating in services and a significant reduction in participation intention. It is suggested that relevant departments should enhance the policy promotion and publicity of the “Internet + nursing services” model to deepen nurses’ value recognition and foster a more positive attitude. At the same time, strengthen the training of nurses’ relevant skills in participating in services to comprehensively enhance their core service capabilities, promote the construction of supporting guarantee systems, and further enhance the willingness of nurses to participate while ensuring safety and quality. In this study, we found that nurses’ participation intention vary significantly in terms of professional title, position, and whether they are specialized nurses. The higher the participation intention score of “Internet + nursing services” among senior professional titles, management positions, and specialist nurses, the consistent with the results of several previous studies [38,41]. This might be due to the fact that this group of nurses has significant advantages in the accumulation of clinical service experience, the mastery of professional skills, and the emergency response to complex situations, which enables them to have higher service efficiency in providing “Internet + nursing services”. This suggests that it is necessary to fully mobilize the enthusiasm of nurses with senior professional titles, nursing managers, and specialized nurses to participate, give full play to their exemplary and leading role, and encourage nurses with lower service willingness to participate the service. Correlation Analysis of Nurses’ Risk Perception, Participation Intention, Self-efficacy, and Perceived Organizational Support in “Internet + Nursing Services” This study found that nurses’ risk perception of “Internet + nursing services” is negatively correlated with their participation intention, which is consistent with the results of multiple studies [42]. Risk perception constitutes the basis of an individual’s psychological tendency when responding to risks, usually manifested as risk denial or response exaggeration [43]. High-risk perception increases fear, stimulates the establishment of psychological defense mechanisms, and leads individuals to adopt negative behaviors to avoid risks [44]. The higher nurses’ perception of potential physiological, practice, economic, and other multiple risks in “Internet + nursing services”, the stronger the resulting anxiety and fear may be, thereby weakening their confidence in participating in the services and ultimately reducing their willingness and initiative to engage in them. Self-efficacy is positively correlated with participation intention. Psychologist Bandura pointed out that the key determinant of an individual’s behavior is not their actual ability level, but their subjective perception of their own capabilities, that is, self-efficacy [22]. The higher the perceived organizational support, the higher the nurses’ participation intention. Perceived organizational support influences an individual’s work attitudes and behaviors. According to social exchange theory, the behavior between individuals and organizations is reciprocal. If nurses perceive organizational support, they will increase their commitment to work in accordance with the principle of reciprocity [45], thereby improving the quality of nursing services. Therefore, when nurses feel strong support from their institutions, their participation intention in the services significantly increases. In conclusion, in order to enhance nurses’ participation intention, relevant departments must attach great importance to it and take effective measures. By improving relevant laws and regulations, perfecting the safety guarantee system, and strengthening the training of visiting nurses, thereby enhancing their ability to correctly identify and effectively avoid risks, and promoting the sustainable development of “Internet + nursing services”. Analysis of the Mediating Effect of Self-efficacy and Perceived Organizational Support between Nurses’ Risk Perception and Participation Intention in “Internet + Nursing Services” The Direct Predictive Effect of Risk Perception on Participation Intention is Not Significant The results of this study indicate that the direct effect of nurses’ risk perception of “Internet + nursing services” on participation intention has not reached a significant level, which may be due to the differences in nurses’ cognition of this service model. A higher level of risk perception reflects that nurses have a stronger ability to identify and assess potential risks. At the same time, they may also have a more comprehensive understanding of risk mitigation and response mechanisms. Therefore, some nurses may still have a strong willingness to serve even if they perceive a relatively high risk. Furthermore, this also indicates that the decision-making on nurses’ participation intention is rational, and they will not simply adopt risk-avoidance strategies due to the existence of risks. The risks in the process of “Internet + nursing services” objectively exist and cannot be eliminated. An excessively high level of risk perception may weaken nurses’ confidence in participating in services, trigger avoidance psychology, and even lead nurses to avoid risks by refusing to participate in service [46]. Conversely, if the risk perception is too low, medical staff may ignore the risk due to the mentality of taking chances, thereby causing errors [47]. At the same time, a lack of prevention can also affect the effective response to risk events. A reasonable perception of risks is a manifestation of nurses’ risk awareness, which helps to prompt nurses to proactively take positive risk prevention measures to reduce the probability of potential risk events. Therefore, it is suggested that the management department should, on the one hand, strengthen safety management during the service process, and on the other hand, apply reasonable risk communication strategies to guide nurses to form accurate risk cognition and judgment on “Internet + nursing services” through reasonable information transmission, to be able to make rational behavioral decisions. Perceived Organizational Support Mediates the Relationship between Risk Perception and Participation Intention Research shows that perceived organizational support has a 72.36% mediating effect between risk perception and participation intention, verifying Hypothesis 2 . This reflects the significant mediating role of perceived organizational support in this regard. Risk perception has a negative impact on perceived organizational support. High levels of risk perception are correlated with lower levels of perceived organizational support, indicating that nurses have a greater need for organizational support in high-risk scenarios, and their sense of organizational support may decrease. Secondly, the sense of organizational support, as a key resource for coping with risk pressure, positively influences participation intention. A higher sense of organizational support among employees indicates that they believe the organization can provide the necessary resources and guarantees to help them deal with the risks and challenges they may face at work, thereby reducing the negative impact of risk perception and enhancing their willingness to engage in necessary risky behaviors [48]. “Internet + nursing services” are not part of the daily nursing duties and usually require caregivers to invest additional time and energy to provide home care. The special service environment brings many challenges and concerns to nurses. Against this backdrop, perceived organizational support is a powerful external driver influencing nurses’ behavioral choices, significantly and positively affecting their participation intention. The more substantial the support provided by healthcare institutions, the stronger the nurses’ intention to engage in these services. Organizational support is an important source of employees’ sense of security and courage to act. If an organization can provide a comprehensive support system that includes security guarantees, skills training, reward support, it can greatly enhance their participation intention. Self-efficacy has a Mediating Effect Between Risk Perception and Participation Intention The results of the mediating effect analysis show that the indirect effect of self-efficacy is -0.039, accounting for 14.18% of the total effect. Self-efficacy is an individual’s comprehensive evaluation of whether they can perform a specific task [49]. People with a higher sense of self-efficacy are more likely to believe that they have sufficient ability and confidence to deal with challenges. Previous studies have confirmed the negative correlation between self-efficacy and risk perception [50], suggesting that an individual’s high self-efficacy weakens the negative impact of risk and has a positive expectation of the outcome of events, thus resulting in a lower risk perception. The results of this study show that high-risk perception may reduce an individual’s self-efficacy and further lower participation intention. High-difficulty tasks can suppress an individual’s sense of self-efficacy and reduce the possibility of their participation in the tasks [51]. High-risk perception will make individuals pay more attention to the possible risks that may occur during the service process and the expected consequences of failure. Excessive focus on the negative impacts of risk events can increase negative emotions, causing individuals to make negative and irrational evaluations, thereby weakening their self-efficacy and participation intention. To enhance nurses’ participation intention in “Internet + nursing services”, hospital management departments should strengthen systematic training for nurses on home care services, improve their operational skills and emergency handling capabilities, and thereby enhance their self-efficacy. The Chain Mediating Role of Perceived Organizational Support and Self-efficacy between Risk Perception and Participation Intention We found that organizational support perception and self-efficacy play a complete mediating role between risk perception and participation intention, with a chain mediating effect of 13.46%. When employees feel supported by the organization, this sense of security will significantly enhance their efficacy in dealing with risks and thereby increase their participation intention. It is worth noting that the chain-mediated pathway of “perceived organizational support → self-efficacy” serves as a crucial bridge between nurses’ risk perception of “Internet + nursing services” and their participation intention. It indicates the shaping effect of the organizational environment on an individual’s psychological state. Organizational support can not only directly enhance an individual’s participate intention but also indirectly strengthen their self-efficacy. This suggests that we should fully recognize the promotion of perceived organizational support on self-efficacy, strengthen the organizational construction of medical institutions, enhance the sense of organizational support of nurses, further enhance their self-efficacy in coping with risks, and ultimately enhance nurses’ participation intention in “Internet + nursing services”. Implications for Nursing Management Enhancing nurses’ participation intention is the primary prerequisite for promoting the continuous development of “Internet + nursing services”. From the perspectives of the external environment and individual psychology, the research has revealed the chain mediating effect of nurses’ perceived organizational support and self-efficacy between risk perception and participation intention. This indicates that strengthening organizational support and enhancing nurses’ self-efficacy should be regarded as the overall intervention goals to increase nurses’ participation intention. First of all, the relevant administrative departments should focus on building a more complete safety management system for “Internet + nursing services”, and enhance the safety and quality of services from aspects such as establishing and improving the relevant legal guarantee system, optimizing the operation process norms and risk emergency plans for home services, and standardizing the access standards and qualification reviews for online nurses. Secondly, it is necessary to provide sufficient resources and information support, establish a fair performance assessment and reward mechanism, and build a solid organizational support system to enhance the psychological capital of nurses and increase their participation intention. Thirdly, the self-efficacy of nurses should be effectively enhanced through systematic skills training, home scenario simulation training, positive value promotion and dynamic feedback mechanisms. Through organizational construction and cultural cultivation, long-term intervention measures can be formed to enhance the intrinsic motivation and service efficiency of nurses, thus promoting the sustainable development of “Internet + nursing services”. Limitations Due to limited time and energy, this study was only investigated in one province. The sample size was limited and lacks representativeness, and the applicability of the research conclusions is somewhat limited. Future studies could carry out large-scale surveys. This study is a cross-sectional study and has certain limitations in verifying causality. Future studies could adopt longitudinal research designs or carry out interventional studies on relevant factors to further verify the research results. In addition, this study mainly focuses on the participation intention of nurses. Although behavioral intention is an important predictor of actual behavioral choices, the two are not entirely equivalent. Future research could introduce more variables to further study the internal mechanism of the transformation of behavioral intention into actual behavior, and explore key factors to effectively promote nurses’ participation in “Internet + nursing services”. Conclusion The results of this study show that perceived organizational support and self-efficacy play a chain mediating role between nurses’ risk perception of “Internet + nursing service” and their participation intention. Relevant departments should fully recognize the important role of perceived organizational support and self-efficacy in promoting nurses’ participation intention in “Internet + nursing services”, develop targeted intervention strategies, enhance nurses’ willingness to serve, and promote the sustainable development of “Internet + nursing services” for the elderly. Declarations Ethics approval and consent to participate This study was approved by the Ethics Committee of Shanxi Bethune Hospital on June 10, 2025 (Ethical approval number: YXLL-2025-155). Before the investigation, all nurses were informed of the research objectives, methods, and significance, and their informed consent was obtained. This study strictly adheres to the ethical standards of the Declaration of Helsinki. Consent for publication Not applicable. Competing interests The authors declare no conflicts of interest. Funding Special Research Project for High-Quality Development of the Health Industry in Shanxi Province (Project Number: DJKZXKT2023269); Science Foundation of Shanxi Bethune Hospital (Project Number: 2022YJ01). Author Contribution JX and YH was responsible for the research design and the writing of the first draft of the manuscript. JX optimized the research and supervised the study. The data collation and analysis were carried out by YH and SG. Data collection and organization were handled by XW and DL. JX and YH are co-first authors, who contributed equally to this study. All authors reviewed and commented on the manuscript and approved the current version. Acknowledgements We sincerely thank all the nurses who participated in this study. Data Availability The data that support the findings of this study are available from the corresponding author upon reasonable request. References Liu W, Li Y, Zhu H, Li K, Deng H, Cai X. Meta-synthesis of the experience of nurses with “Internet Nursing Service” in China. Int J Nurs Sci.2025;12(3):233-240. doi:10.1016/j.ijnss.2025.04.012 Xie F., Lin F., & Gan T. Status quo of patients and nurses' attitude and willingness of "Internet + nursing services". Chinese Journal of Modern Nursing. 2020;26(17):2251-2255. doi:10.3760/cma.j.cn115682-20191009-03617 Yu H, Xu S, Chen Y, Li Y, Yang Q. 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Nurses’ intention to stay: The impact of perceived organizational support, job control and job satisfaction. Journal of Advanced Nursing. 2020;76(5):1141-1150. doi:10.1111/jan.14305 Behrens LL, Boltz M, Kolanowski A, et al. Pervasive Risk Avoidance: Nursing Staff Perceptions of Risk in Person-Centered Care Delivery. Gerontologist. 2020;60(8):1424-1435. doi:10.1093/geront/gnaa099 Trevino P, Green A, Middaugh D, Heo S, Beverly C, Deshpande J. Nursing perception of risk in common nursing practice situations. Journal of Healthcare Risk Management. 2018;37(3):19-28. doi:10.1002/jhrm.21283 Hong Y, Zhao J, Yu J, Wang H, "Quality of life and emergency preparedness of MHO staff: role of psychological capital and perceived organizational support". J Health Organ Manag.2022;36(7):875-891. doi:10.1108/JHOM-05-2022-0130 Ersan N, Fişekçioğlu E, Dölekoğlu S, Oktay İ, İlgüy D. Perceived sources and levels of stress, general self-efficacy and coping strategies in clinical dental students. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7975418","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":556431682,"identity":"7a25667c-6da7-49b1-b84c-d1ba38d629bb","order_by":0,"name":"Jiajia 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services provided by registered nurses in medical institutions to patients who require home services, relying on internet information technology and adopting the form of \u0026ldquo;online application, offline service\u0026rdquo;. Patients make appointments and place orders for services through relevant applications, and nurses bring the necessary supplies to provide home care services according to the agreed time and service content. This service model enables patients to receive professional nursing services without leaving home, effectively alleviating the burden of travel for elderly patients with limited mobility and improving the efficiency of medical resource utilization. As the core participants in \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo;, the willingness of nurses to provide services will directly affect the promotion and application of this service model [1]. However, a survey shows that the willingness of nurses to provide home care services is only 38.44%, which is far lower than the 82.73% willingness of patients to receive home-based services [2]. In existing research on the factors influencing nurses\u0026rsquo; participation intention in \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo;, we have found that nurses\u0026rsquo; concerns about potential risks during service are one of the key factors affecting their participation [3\u0026ndash;6]. 83.4% of nurses expressed concern about the risks associated with home care, believing that \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo; would increase medical risks and disputes [7]. They are unwilling to undertake nursing service projects that involve complex operations and have a high potential risk, and they are cautious and hesitant about participating in such services for a long time, with a low overall participation intention [8].\u003c/p\u003e\u003cp\u003eThe risk perception theory indicates that risk perception influences the way individuals engage in risky events and their decision-making [9]. Nurses must address various potential risks during home service, and their behavioral decisions and participation intention often depend on their subjective emotional perception of risks rather than rational assessment of risks [10]. Thus, it can be seen that the level of nurses\u0026rsquo; risk perception may directly affect their participation intention. At the same time, whether individuals are willing to make contributions beyond the requirements of their job duties is largely influenced by their perceived organizational support [11]. The assessment of organizational support is frequently applied to stimulate individuals\u0026rsquo; sustained participation intention [12] and maintain their enthusiasm for participation [13]. Self-efficacy also serves as an important influencing factor for individual participation intention [14]. The premise of an individual\u0026rsquo;s behavioral choice is having the self-efficacy to overcome risks and achieve goals. Organizational support also has a positive effect on nurses\u0026rsquo; self-efficacy [15]. In summary, risk perception, perceived organizational support, and self-efficacy all have significant influences on individuals\u0026rsquo; participation intention. However, existing research has paid little attention to the intrinsic connections and mediating mechanisms among these variables. Therefore, this study takes perceived organizational support and self-efficacy as mediating variables to explore the internal path and mechanism of action of nurses\u0026rsquo; risk perception in \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo; on their participation intentions. The aim is to provide a reference basis for relevant management departments to formulate intervention strategies that enhance nurses\u0026rsquo; participation intention and promote the sustainable development of \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo;.\u003c/p\u003e\n\u003ch3\u003eRisk Perception and Participation Intention\u003c/h3\u003e\n\u003cp\u003eRisk perception is an individual\u0026rsquo;s subjective cognition of potential risks and is a key predictor of behavior maintenance and change [16]. The Theory of Planned Behavior indicates that behavioral intention is a direct precursor to actual behavior [17], reflecting the degree of an individual\u0026rsquo;s willingness to engage in a specific behavior. The transactional theory of stress and coping proposed by Lazarus and Folkman [18] emphasizes that it is not the event itself but the individual\u0026rsquo;s primary appraisal of potential risks and benefits, along with the secondary appraisal of their own coping abilities and resources, that determines stress-coping behaviors. When an event is perceived as risky but individuals believe they can effectively cope with it, they are more likely to accept the challenge and adopt corresponding proactive coping strategies [19]. However, if the perceived risk exceeds an individual\u0026rsquo;s perceived control, they tend to choose risk-avoidant behaviors such as evasion or withdrawal [20]. Safety is a fundamental prerequisite for ensuring the quality of nursing care, and nurses\u0026rsquo; risk perception regarding the nursing service process may influence their participation intention. Therefore, it is reasonable to hypothesize that nurses\u0026rsquo; risk perception of \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo; is closely related to their participation intentions.\u003c/p\u003e\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eRisk Perception, Perceived Organizational Support, and Participation Intention\u003c/h2\u003e\u003cp\u003ePerceived organizational support refers to employees\u0026rsquo; subjective psychological feeling about whether the work organization values their contributions and cares about their well-being [21]. Individuals in organizations with a high security atmosphere often have a higher sense of perceived organizational support. However, in high-risk situations, employees\u0026rsquo; demand for organizational support increases significantly, and their perception of such support becomes more sensitive. High-risk perception can trigger employees to re-evaluate the resources and support available from the organization. This increase in demand may lower their evaluation of the perceived quality of organizational support [22]. Therefore, risk perception is likely to influence nurses\u0026rsquo; perceived organizational support. Furthermore, perceived organizational support can directly affect employees\u0026rsquo; willingness to respond to risk events. Perceived organizational support can meet the emotional needs of nurses, thereby enhancing their confidence in dealing with risks. Consequently, it is plausible that risk perception among nurses engaged in \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo; influences their participation intention through the mediating role of perceived organizational support.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eRisk Perception, Self-efficacy, and Participation Intention\u003c/h3\u003e\n\u003cp\u003eSelf-efficacy refers to an individual\u0026rsquo;s belief in their capability to attain certain goals within a particular domain. It serves as an intrinsic motivator for behavioral change, and its level directly influences an individual\u0026rsquo;s choice of actions and persistence of their behaviors [23]. The Risk Perception Attitude (RPA) framework [24] posits that individual behavior is influenced by risk perception, efficacy beliefs, and the interplay between the two. Risk perception may trigger emotional responses that subsequently affect an individual\u0026rsquo;s self-efficacy and participation intention. Research indicates that individuals with high self-efficacy demonstrate greater confidence in handling complex and resource-demanding tasks [25]. Risk perception is closely related to self-efficacy, and high self-efficacy will further enhance an individual\u0026rsquo;s positive behavior. Based on this, we propose the following hypothesis: self-efficacy mediates the relationship between nurses\u0026rsquo; risk perception of \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo; and their participation intention.\u003c/p\u003e\n\u003ch3\u003ePerceived Organizational Support and Self-efficacy\u003c/h3\u003e\n\u003cp\u003eAn individual\u0026rsquo;s self-efficacy is not only derived from intrinsic beliefs but is also closely linked to the level of external support. It can influence individual behavior through its mediating role or other chain mediation pathways [26]. Challenging work processes may deplete employees\u0026rsquo; psychological energy resources. Consequently, when resources are insufficient to cope with complex tasks, individuals tend to reduce effort or withdraw from work to conserve their remaining resources [27]. According to the Job Demands-Resources (JD-R) theory model, the value of job resources becomes particularly salient when the job demands are high, and external resources can effectively relieve the job pressure of individuals and promote their job performance [28]. The home environment, as a unique workplace, places higher demands on the various capabilities of home nurses. In such contexts, organizational support, as an external resource, can supplement psychological resources like self-efficacy, thereby mitigating resource depletion. Multiple studies have indicated a positive correlation between perceived organizational support and self-efficacy [29,30]. A high level of perceived organizational support has been shown to predict greater self-efficacy [31]. Providing multi-faceted organizational support can help individuals enhance their confidence in coping with difficulties. Therefore, we propose that risk perception may enhance nurses\u0026rsquo; self-efficacy by increasing their perceived organizational support, ultimately boosting their participation intention in \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo;.\u003c/p\u003e\n\u003ch3\u003eCurrent Study\u003c/h3\u003e\n\u003cp\u003ePrevious research on the relationship between risk perception and participation intention has primarily focused on areas such as consumer behavioral intentions and health information-seeking behaviors, with few studies examining this relationship from the perspective of service providers. This study aims to investigate the association between nurses\u0026rsquo; risk perception and their participation intention regarding \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo;, and to elucidate the mediating roles of perceived organizational support and self-efficacy within this pathway. Based on the existing literature, we propose the following hypotheses, and the hypothesized model is presented in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e:\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eHypothesis 1\u003c/strong\u003e\u003cp\u003eNurses\u0026rsquo; risk perception negatively predicts their participation intention in \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo;;\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eHypothesis 2\u003c/strong\u003e\u003cp\u003ePerceived organizational support plays a mediating role between nurses\u0026rsquo; risk perception and their participation intention;\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eHypothesis 3\u003c/strong\u003e\u003cp\u003eSelf-efficacy plays a mediating role between nurses\u0026rsquo; risk perception and their participation intention;\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eHypothesis 4\u003c/strong\u003e\u003cp\u003ePerceived organizational support and self-efficacy exhibit a chain mediating effect between nurses\u0026rsquo; risk perception and their participation intention.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003eDesign\u003c/h2\u003e\u003cp\u003eThis study employed a cross-sectional design and utilized convenience sampling to investigate the relationships among self-efficacy, perceived organizational support, risk perception, and participation intention of nurses participating in \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo; from five medical institutions in Shanxi Province. This study was conducted in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) criteria.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eParticipants\u003c/h3\u003e\n\u003cp\u003eThis study was conducted from June to August 2025, using a combination of online and offline methods to survey nurses from multiple medical institutions in Shanxi Province. In structural equation modeling, the sample size is 10 to 15 times the number of variables [32]. With 23 variables in this study and considering a 20% questionnaire loss rate, the final sample size should be between 276 and 414 cases.\u003c/p\u003e\u003cp\u003eInclusion criteria: (1) In-service nurses who have obtained nursing professional qualification certificates; (2) Work experience of more than 2 years; (3) The medical institution where nurses work carries out \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo;; (4) Informed consent and voluntary agreement to participate in the study.\u003c/p\u003e\u003cp\u003eExclusion criteria: (1) Those who were not on duty during the investigation period due to reasons such as vacation or going out; (2) Intern and logistics nurse.\u003c/p\u003e\n\u003ch3\u003eInstruments\u003c/h3\u003e\n\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003eDemographic characteristics\u003c/h2\u003e\u003cp\u003eSelf-designed by the researchers, including demographic characteristics (age, gender, professional title, position, specialist nurse, years of working, hospital level, department, educational level).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003eRisk Perception Outcome Assessment Scale for Nurses in \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;Nursing Services\u0026rdquo; for the Elderly\u003c/h2\u003e\u003cp\u003eThe risk factor and risk perception outcome assessment scale for nurses in \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo; for the elderly [33] was previously developed by the research team. This scale consists of two subscales, namely nurses\u0026rsquo; risk factors and risk perception outcomes. This study utilized the second part, the nurses\u0026rsquo; risk perception outcome section, which included 14 items across three dimensions: physiological risk (items 1\u0026ndash;6), practice risk (items 7\u0026ndash;11), and economic risk (items 12\u0026ndash;14). A 5-point Likert scale was employed for scoring each item, ranging from \u0026ldquo;almost none\u0026rdquo; (1 point) to \u0026ldquo;extremely high\u0026rdquo; (5 points). The total score ranges from 14 to 70, with a higher score indicating a greater level of risk perception. In this study, the Cronbach\u0026rsquo;s α coefficient of the scale was 0.936.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\u003ch2\u003eParticipation Intention of Nurses on \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;Nursing Service\u0026rdquo; Scale\u003c/h2\u003e\u003cp\u003eThis scale was developed by Li Suyuan et al. [34]. It consists of three subscales: the participating behavioral attitude subscale (5 items), the subjective behavioral norms subscale (5 items), and the perceived behavioral control subscale (7 items), totaling 17 items. Items 10, 14, and 15 are reverse-scored. The scale encompasses eight dimensions: values (2 items), economic perspective (1 item), development perspective (2 items), work (3 items), family (2 items), self-perception (2 items), environmental perception (3 items), and technological perception (2 items). Each item is rated on a 5-point Likert scale, ranging from \u0026ldquo;strongly disagree\u0026rdquo; (1 point) to \u0026ldquo;strongly agree\u0026rdquo; (5 points). In this study, the Cronbach\u0026rsquo;s α coefficient of the scale was 0.913, and the Cronbach\u0026rsquo;s α coefficients of the three subscales were 0.801, 0.850, and 0.805, respectively.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e\u003ch2\u003eGeneral Self-Efficacy Scale\u003c/h2\u003e\u003cp\u003eThe general self-efficacy scale was originally developed by Jerusalem and Schwarzer. In this study, the Chinese version of the General Self-Efficacy Scale, translated and revised by scholars such as Wang Caikang [35], was selected. This scale comprises 10 items, each rated on a 4-point Likert scale ranging from \u0026ldquo;completely incorrect\u0026rdquo; (1 point) to \u0026ldquo;completely correct\u0026rdquo; (4 points). In this study, the Cronbach\u0026rsquo;s α coefficient of the scale was 0.918.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec15\" class=\"Section2\"\u003e\u003ch2\u003ePerceived Organizational Support Scale\u003c/h2\u003e\u003cp\u003eThis scale was developed by Chen Zhixia and later revised by Zuo Hongmei [36]. This scale included two dimensions: affective support (items 1\u0026ndash;10) and instrumental support (items 11\u0026ndash;13). Each item is scored using a 5-point Likert scale, ranging from \u0026ldquo;strongly disagree\u0026rdquo; to \u0026ldquo;strongly agree\u0026rdquo;, with scores of 1 to 5 points, respectively. The total score ranges from 13 to 65 points, with a higher score indicating a stronger perception of organizational support among nurses. The Cronbach\u0026rsquo;s α coefficient of the scale in this study was 0.945.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec16\" class=\"Section2\"\u003e\u003ch2\u003eData Collection and Quality Control\u003c/h2\u003e\u003cp\u003eThis research questionnaire collection was conducted through a combination of electronic and paper-based questionnaires. The electronic questionnaire was conducted through the \u0026lsquo;Wenjuanxing\u0026rsquo; online platform (\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.wjx.cn\u003c/span\u003e\u003cspan address=\"https://www.wjx.cn\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e), and a QR code was created for data collection. The questionnaire was voluntarily completed by nurses, with informed consent obtained before the formal data collection. All questions in the questionnaire were marked as required. Participants could choose to exit the survey at any time, and each IP account was only allowed to submit once. To ensure data quality, the electronic questionnaires were manually checked. Questionnaires with a completion time of less than 120 seconds or those with the same sequence number selected for all questions were considered invalid. The paper questionnaires were distributed on-site by the researchers. The researchers explained the relevant content of the study to the nurses to obtain informed consent. After collection, the questionnaires were promptly checked to ensure the completeness of the responses. A total of 658 questionnaires were distributed, 624 were valid, with an effective response rate of 94.83%.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec17\" class=\"Section2\"\u003e\u003ch2\u003eStatistical methods\u003c/h2\u003e\u003cp\u003eStatistical analysis was performed using SPSS 27.0 and AMOS 24.0 software. Common method bias was assessed using Harman\u0026rsquo;s single-factor test. Due to the large sample size, key variables in this study were treated as approximately normally distributed continuous variables. Measurement data were presented as mean and standard deviation, and analyzed using t-tests or F-tests. Pearson correlation analysis was conducted to examine the relationships among demographic characteristics, risk perception, self-efficacy, perceived organizational support, and participation intention. The structural equation model was constructed using Amos 24.0 to analyze the pathway and mediating effects. The Bootstrap method with 5000 resamples was used to test the significance of the mediating effects. A 95% confidence interval not including zero indicated a significant mediating effect. Differences were deemed statistically significant at \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec18\" class=\"Section2\"\u003e\u003ch2\u003eResult\u003c/h2\u003e\u003cdiv id=\"Sec19\" class=\"Section3\"\u003e\u003ch2\u003eUnivariate Analysis of Nurses\u0026rsquo; General Information and Participation Intention Scores\u003c/h2\u003e\u003cp\u003eThe results showed that there were statistically significant differences in the nurses\u0026rsquo; participation intention in \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo; in terms of their professional titles, positions, and whether they were specialized nurses (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). (see Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eUnivariate analysis of general information of nurses and the score of participation intention in \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo;\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eN (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eScore(M\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eF/t\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.081\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.970\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026le;\u0026thinsp;30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e203(32.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e56.43\u0026thinsp;\u0026plusmn;\u0026thinsp;8.10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e31\u0026ndash;40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e334(53.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e56.63\u0026thinsp;\u0026plusmn;\u0026thinsp;8.57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e41\u0026ndash;50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e78(12.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e56.94\u0026thinsp;\u0026plusmn;\u0026thinsp;8.69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e9(1.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e57.67\u0026thinsp;\u0026plusmn;\u0026thinsp;14.76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.540\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.589\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e25(4.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e57.52\u0026thinsp;\u0026plusmn;\u0026thinsp;8.65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e599(96.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e56.58\u0026thinsp;\u0026plusmn;\u0026thinsp;8.52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eProfessional title\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e3.406\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.017\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNurse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e80(12.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e55.80\u0026thinsp;\u0026plusmn;\u0026thinsp;7.72\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSenior nurse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e194(31.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e55.71\u0026thinsp;\u0026plusmn;\u0026thinsp;7.90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNurse-in-charge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e328(52.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e57.05\u0026thinsp;\u0026plusmn;\u0026thinsp;8.90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAssociate chief nurse and above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e22(3.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e61.18\u0026thinsp;\u0026plusmn;\u0026thinsp;9.45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eposition\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e-2.512\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.012\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNurse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e595(95.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e56.43\u0026thinsp;\u0026plusmn;\u0026thinsp;8.41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHead nurse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e29(4.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e60.48\u0026thinsp;\u0026plusmn;\u0026thinsp;9.98\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSpecialist nurse\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2.950\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.003\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e171(27.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e58.25\u0026thinsp;\u0026plusmn;\u0026thinsp;7.88\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e453(72.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e56.00\u0026thinsp;\u0026plusmn;\u0026thinsp;8.68\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eYears of working\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.995\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.114\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026le;\u0026thinsp;5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e164(26.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e56.15\u0026thinsp;\u0026plusmn;\u0026thinsp;7.77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e6\u0026ndash;10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e141(22.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e56.03\u0026thinsp;\u0026plusmn;\u0026thinsp;8.36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e11\u0026ndash;20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e289(46.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e56.82\u0026thinsp;\u0026plusmn;\u0026thinsp;8.91\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e30(4.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e59.97\u0026thinsp;\u0026plusmn;\u0026thinsp;8.95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eHospital level\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.793\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.077\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTertiary hospital\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e564(90.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e56.78\u0026thinsp;\u0026plusmn;\u0026thinsp;8.66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSecondary hospital\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e60(9.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e55.05\u0026thinsp;\u0026plusmn;\u0026thinsp;6.94\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDepartment\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2.116\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.097\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eInternal medicine\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e312(50.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e56.06\u0026thinsp;\u0026plusmn;\u0026thinsp;8.76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSurgery\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e209(33.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e56.53\u0026thinsp;\u0026plusmn;\u0026thinsp;7.94\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEmergency\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e19(3.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e58.53\u0026thinsp;\u0026plusmn;\u0026thinsp;7.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOthers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e84(13.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e58.48\u0026thinsp;\u0026plusmn;\u0026thinsp;9.11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEducation level\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.144\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.328\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBelow College\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e21(3.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e55.19\u0026thinsp;\u0026plusmn;\u0026thinsp;7.55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBachelor\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e563(90.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e56.58\u0026thinsp;\u0026plusmn;\u0026thinsp;8.70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMaster and above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e40(6.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e57.83\u0026thinsp;\u0026plusmn;\u0026thinsp;6.03\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eThe Scores of Nurses\u0026rsquo; Risk Perception, Participation Intention, Self-efficacy, and Perceived Organizational Support in \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;Nursing Services\u0026rdquo;\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe total scores of nurses\u0026rsquo; risk perception, participation intention, self-efficacy, and perceived organizational support in \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo;, as well as the scores of each dimension, are detailed in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eThe scores of nurses\u0026rsquo; risk perception, participation intention, self-efficacy, and perceived organizational support in \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo; (n\u0026thinsp;=\u0026thinsp;624)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eItems\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eScoring range\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eAverage total score\u003c/p\u003e\u003cp\u003e(M\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eAverage Score of per item\u003c/p\u003e\u003cp\u003e(M\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003erisk perception\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e14\u0026thinsp;~\u0026thinsp;70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e39.74\u0026thinsp;\u0026plusmn;\u0026thinsp;9.97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e2.84\u0026thinsp;\u0026plusmn;\u0026thinsp;0.71\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ephysiological risk\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6\u0026thinsp;~\u0026thinsp;30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e15.84\u0026thinsp;\u0026plusmn;\u0026thinsp;4.69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e2.64\u0026thinsp;\u0026plusmn;\u0026thinsp;0.78\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003epractice risk\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5\u0026thinsp;~\u0026thinsp;25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e15.77\u0026thinsp;\u0026plusmn;\u0026thinsp;3.90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e3.15\u0026thinsp;\u0026plusmn;\u0026thinsp;0.78\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eeconomic risk\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3\u0026thinsp;~\u0026thinsp;15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e8.14\u0026thinsp;\u0026plusmn;\u0026thinsp;2.42\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e2.71\u0026thinsp;\u0026plusmn;\u0026thinsp;0.81\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eparticipation intention\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e17\u0026thinsp;~\u0026thinsp;85\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e56.62\u0026thinsp;\u0026plusmn;\u0026thinsp;8.52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e3.33\u0026thinsp;\u0026plusmn;\u0026thinsp;0.50\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eparticipating behavioral attitude\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5\u0026thinsp;~\u0026thinsp;25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e18.04\u0026thinsp;\u0026plusmn;\u0026thinsp;2.99\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e3.61\u0026thinsp;\u0026plusmn;\u0026thinsp;0.60\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003evalues\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2\u0026thinsp;~\u0026thinsp;10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e7.75\u0026thinsp;\u0026plusmn;\u0026thinsp;1.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e3.88\u0026thinsp;\u0026plusmn;\u0026thinsp;0.63\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eeconomic perspective\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1\u0026thinsp;~\u0026thinsp;5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e3.45\u0026thinsp;\u0026plusmn;\u0026thinsp;0.82\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e3.45\u0026thinsp;\u0026plusmn;\u0026thinsp;0.82\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003edevelopment perspective\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2\u0026thinsp;~\u0026thinsp;10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e6.84\u0026thinsp;\u0026plusmn;\u0026thinsp;1.54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e3.42\u0026thinsp;\u0026plusmn;\u0026thinsp;0.77\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003esubjective behavioral norms\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5\u0026thinsp;~\u0026thinsp;25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e16.71\u0026thinsp;\u0026plusmn;\u0026thinsp;3.33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e3.34\u0026thinsp;\u0026plusmn;\u0026thinsp;0.67\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ework\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3\u0026thinsp;~\u0026thinsp;15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e10.56\u0026thinsp;\u0026plusmn;\u0026thinsp;2.40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e3.52\u0026thinsp;\u0026plusmn;\u0026thinsp;0.80\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003efamily\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2\u0026thinsp;~\u0026thinsp;10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e6.15\u0026thinsp;\u0026plusmn;\u0026thinsp;1.23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e3.08\u0026thinsp;\u0026plusmn;\u0026thinsp;0.62\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eperceived behavioral control\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7\u0026thinsp;~\u0026thinsp;35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e21.86\u0026thinsp;\u0026plusmn;\u0026thinsp;3.35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e3.12\u0026thinsp;\u0026plusmn;\u0026thinsp;0.48\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eself-perception\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2\u0026thinsp;~\u0026thinsp;10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e6.38\u0026thinsp;\u0026plusmn;\u0026thinsp;1.20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e3.19\u0026thinsp;\u0026plusmn;\u0026thinsp;0.60\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eenvironmental perception\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3\u0026thinsp;~\u0026thinsp;15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e8.65\u0026thinsp;\u0026plusmn;\u0026thinsp;1.59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e2.88\u0026thinsp;\u0026plusmn;\u0026thinsp;0.53\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003etechnological perception\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2\u0026thinsp;~\u0026thinsp;10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e6.83\u0026thinsp;\u0026plusmn;\u0026thinsp;1.19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e3.42\u0026thinsp;\u0026plusmn;\u0026thinsp;0.60\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eself-efficacy\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10\u0026thinsp;~\u0026thinsp;40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e25.79\u0026thinsp;\u0026plusmn;\u0026thinsp;5.65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e2.58\u0026thinsp;\u0026plusmn;\u0026thinsp;0.57\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eperceived organizational support\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e13\u0026thinsp;~\u0026thinsp;65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e44.80\u0026thinsp;\u0026plusmn;\u0026thinsp;8.10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e3.45\u0026thinsp;\u0026plusmn;\u0026thinsp;0.62\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eaffective support\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10\u0026thinsp;~\u0026thinsp;50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e33.39\u0026thinsp;\u0026plusmn;\u0026thinsp;6.53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e3.34\u0026thinsp;\u0026plusmn;\u0026thinsp;0.65\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003einstrumental support\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3\u0026thinsp;~\u0026thinsp;15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e11.42\u0026thinsp;\u0026plusmn;\u0026thinsp;1.93\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c5\"\u003e\u003cp\u003e3.81\u0026thinsp;\u0026plusmn;\u0026thinsp;0.64\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eCorrelation Analysis of Nurses\u0026rsquo; Risk Perception, Participation Intention, Self-efficacy, and Perceived Organizational Support in \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;Nursing Services\u0026rdquo;\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe Pearson correlation analysis results indicated that nurses\u0026rsquo; risk perception of \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo; was negatively correlated with participation intention (r=-0.287, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), negatively correlated with self-efficacy (r=-0.270, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and negatively correlated with perceived organizational support (r=-0.284, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Participation intention was positively correlated with self-efficacy (r\u0026thinsp;=\u0026thinsp;0.556, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and positively correlated with perceived organizational support (r\u0026thinsp;=\u0026thinsp;0.656, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Self-efficacy was positively correlated with perceived organizational support (r\u0026thinsp;=\u0026thinsp;0.481, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), see Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eThe correlation among nurses\u0026rsquo; risk perception, participation intention, self-efficacy, and perceived organizational support in \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo;\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1. risk perception\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2. participation intention\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-0.287**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3. self-efficacy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-0.270**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.556**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e4. perceived organizational support\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-0.284**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.656**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.481**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003eNote:**means \u003cem\u003ep\u003c/em\u003e\u0026lt;0.001\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eAnalysis of the Mediating Effect of Self-efficacy and Perceived Organizational Support between Nurses\u0026rsquo; Risk Perception and Participation Intention in \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;Nursing Services\u0026rdquo;\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv id=\"Sec20\" class=\"Section2\"\u003e\u003ch2\u003eCommon Method Bias\u003c/h2\u003e\u003cp\u003eThe results of Harman\u0026rsquo;s single-factor test showed that there were eight factors with eigenvalues greater than 1, and the variance explained by the first common factor was 30.617%, below the 40% threshold. Thus, this study did not exhibit serious common method bias [37].\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec21\" class=\"Section2\"\u003e\u003ch2\u003eMediation Analysis\u003c/h2\u003e\u003cp\u003eThe chain mediating effect model was constructed using Amos 24.0. In order to effectively control measurement errors, variables with statistical significance in the univariate analysis, such as professional title, position, and specialist nurse, were taken as control variables. Taking nurses\u0026rsquo; risk perception as the independent variable, participation intention as the dependent variable, and self-efficacy and perceived organizational support as the mediating variables, the established model is shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eNote\u003c/strong\u003e\u003cp\u003ePHY: Physiological risk; PRA: Practice risk; ECO: Economic risk; AFF: Affective support; INS: Instrumental support\u003c/p\u003e\u003c/p\u003e\u003cp\u003eAfter modifying the initial model using modification indices, it was found that the effect of nurses\u0026rsquo; risk perception of participating in \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo; on their participation intention was not significant (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.229). After removing this path, the modified model demonstrated a good fit, as shown in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e. The deviation-corrected Bootstrap method was used for repeated sampling 5,000 times to test whether the mediating effect was statistically significant. The confidence interval was set at 95%, and the results are shown in Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e. The model shows that the effect value of risk perception \u0026rarr; participation intention is -0.046, with a 95% CI (-0.122 to 0.030) containing 0, indicating that the direct effect is not significant. The effect value of risk perception \u0026rarr; perceived organizational support \u0026rarr; participation intention was \u0026minus;\u0026thinsp;0.199, and the 95% CI (-0.258 to -0.146) did not include 0, indicating that the mediating effect of perceived organizational support was valid. The effect size of risk perception \u0026rarr; self-efficacy \u0026rarr; participation intention was \u0026minus;\u0026thinsp;0.039, and the 95% CI (-0.066 to -0.018) did not include 0, indicating that the mediating effect of self-efficacy was established. The effect size of risk perception \u0026rarr; perceived organizational support \u0026rarr; self-efficacy \u0026rarr; participation intention was \u0026minus;\u0026thinsp;0.037, and the 95% CI (-0.056 to -0.024) did not include 0, indicating that the model of perceived organizational support and self-efficacy as a chain mediator holds true. In summary, nurses\u0026rsquo; level of risk perception regarding \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo; can influence their b participation intention through three pathways: the mediating role of perceived organizational support, the mediating role of self-efficacy, and the chain mediating role of perceived organizational support and self-efficacy.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eModel fit indicators\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"8\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFitness index\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003ec\u003csup\u003e2\u003c/sup\u003e/df\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eRMSEA\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eCFI\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eGFI\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eAGFI\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eIFI\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003eNFI\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eStandard for judging\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2.552\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.050\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.968\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.954\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.929\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.969\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0.949\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMetric\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026lt;3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e\u0026lt;0.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e\u0026gt;0.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026gt;0.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e\u0026gt;0.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e\u0026gt;0.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e\u0026gt;0.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"8\"\u003eNote: c\u003csup\u003e2\u003c/sup\u003e/df\u0026thinsp;=\u0026thinsp;chi-square to degrees of freedom, RMSEA\u0026thinsp;=\u0026thinsp;root mean square error of approximation, CFI\u0026thinsp;=\u0026thinsp;comparative fit index, GFI\u0026thinsp;=\u0026thinsp;goodness-of-fit index, AGFI\u0026thinsp;=\u0026thinsp;adjusted goodness-of-fit index, IFI\u0026thinsp;=\u0026thinsp;incremental fit index, NFI\u0026thinsp;=\u0026thinsp;normed fit index.\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eBootstrap analysis to test the mediating effect of self-efficacy and perceived organizational Support between nurses\u0026rsquo; risk perception and participation intention in \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo;\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eModel path\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eStandardized path factor\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eSE\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003eBootstrap 95%CI\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eEffect ratio (%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eLow\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eHigh\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDirect effect\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-0.046\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.039\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e-0.122\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.030\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal indirect effect\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-0.275**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.033\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e-0.340\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e-0.211\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e100.00\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePath 1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-0.199**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.029\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e-0.258\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e-0.146\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e72.36\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePath 2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-0.039**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.012\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e-0.066\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e-0.018\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e14.18\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePath 3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-0.037**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.008\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e-0.056\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e-0.024\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e13.46\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"6\"\u003eNote: Path 1: Risk perception \u0026rarr; Perceived organizational support \u0026rarr; Participation intention;Path 2༚Risk perception \u0026rarr; Self-efficacy \u0026rarr;Participation intention༛Path 3༚Risk perception \u0026rarr; Perceived organizational support \u0026rarr; Self-efficacy \u0026rarr; Participation intention. **\u003cem\u003eP\u003c/em\u003e\u0026lt;0.001.\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e"},{"header":"Discussion","content":"\u003cdiv id=\"Sec23\" class=\"Section2\"\u003e\u003ch2\u003eThe Current Status of Nurses\u0026rsquo; Participation Intention to Participate in \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;Nursing Services\u0026rdquo;\u003c/h2\u003e\u003cp\u003eThe research results show that nurses\u0026rsquo; participation intention to participate in \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo; is at a medium-high level (3.33\u0026thinsp;\u0026plusmn;\u0026thinsp;0.50), indicating that nurses generally have a relatively positive attitude towards participating in this service, which is similar to the previous research results [38]. Among them, the total score of nurses\u0026rsquo; participation behavioral attitude (3.61\u0026thinsp;\u0026plusmn;\u0026thinsp;0.60) was relatively the highest, indicating that nurses recognize the professional value and social significance of this service model and largely approve of its potential benefits. In contrast, the score for perceived behavioral control was relatively low (3.12\u0026thinsp;\u0026plusmn;\u0026thinsp;0.48), which might be one of the key factors restricting nurses\u0026rsquo; participation intention. When nursing services are transferred from the standardized hospital setting to the home environment, the lack of team support and security guarantees significantly increases nurses\u0026rsquo; sense of insecurity [39]. However, the current policy support and guarantee mechanisms are not clear, which makes nurses lack confidence in providing safe and high-quality nursing services. Secondly, the lack of targeted technical training, policy promotion, and reward mechanisms has led some nurses to have insufficient cognition of \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo;, further weakening their sense of behavioral control over the completion of such services. Individual willingness is determined by individual attitude and self-perception. Nurses\u0026rsquo; positive attitude towards \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo; implies their recognition of the value of this service model, which to a certain extent can increase individual participation intention [40]. However, its deficiencies in aspects such as risk control, policy support, and technical training have also led to nurses\u0026rsquo; low self-perception of behavioral control in participating in services and a significant reduction in participation intention. It is suggested that relevant departments should enhance the policy promotion and publicity of the \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo; model to deepen nurses\u0026rsquo; value recognition and foster a more positive attitude. At the same time, strengthen the training of nurses\u0026rsquo; relevant skills in participating in services to comprehensively enhance their core service capabilities, promote the construction of supporting guarantee systems, and further enhance the willingness of nurses to participate while ensuring safety and quality.\u003c/p\u003e\u003cp\u003eIn this study, we found that nurses\u0026rsquo; participation intention vary significantly in terms of professional title, position, and whether they are specialized nurses. The higher the participation intention score of \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo; among senior professional titles, management positions, and specialist nurses, the consistent with the results of several previous studies [38,41]. This might be due to the fact that this group of nurses has significant advantages in the accumulation of clinical service experience, the mastery of professional skills, and the emergency response to complex situations, which enables them to have higher service efficiency in providing \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo;. This suggests that it is necessary to fully mobilize the enthusiasm of nurses with senior professional titles, nursing managers, and specialized nurses to participate, give full play to their exemplary and leading role, and encourage nurses with lower service willingness to participate the service.\u003c/p\u003e\u003cp\u003e\u003cb\u003eCorrelation Analysis of Nurses\u0026rsquo; Risk Perception, Participation Intention, Self-efficacy, and Perceived Organizational Support in \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;Nursing Services\u0026rdquo;\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis study found that nurses\u0026rsquo; risk perception of \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo; is negatively correlated with their participation intention, which is consistent with the results of multiple studies [42]. Risk perception constitutes the basis of an individual\u0026rsquo;s psychological tendency when responding to risks, usually manifested as risk denial or response exaggeration [43]. High-risk perception increases fear, stimulates the establishment of psychological defense mechanisms, and leads individuals to adopt negative behaviors to avoid risks [44]. The higher nurses\u0026rsquo; perception of potential physiological, practice, economic, and other multiple risks in \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo;, the stronger the resulting anxiety and fear may be, thereby weakening their confidence in participating in the services and ultimately reducing their willingness and initiative to engage in them. Self-efficacy is positively correlated with participation intention. Psychologist Bandura pointed out that the key determinant of an individual\u0026rsquo;s behavior is not their actual ability level, but their subjective perception of their own capabilities, that is, self-efficacy [22]. The higher the perceived organizational support, the higher the nurses\u0026rsquo; participation intention. Perceived organizational support influences an individual\u0026rsquo;s work attitudes and behaviors. According to social exchange theory, the behavior between individuals and organizations is reciprocal. If nurses perceive organizational support, they will increase their commitment to work in accordance with the principle of reciprocity [45], thereby improving the quality of nursing services. Therefore, when nurses feel strong support from their institutions, their participation intention in the services significantly increases. In conclusion, in order to enhance nurses\u0026rsquo; participation intention, relevant departments must attach great importance to it and take effective measures. By improving relevant laws and regulations, perfecting the safety guarantee system, and strengthening the training of visiting nurses, thereby enhancing their ability to correctly identify and effectively avoid risks, and promoting the sustainable development of \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo;.\u003c/p\u003e\u003cp\u003e\u003cb\u003eAnalysis of the Mediating Effect of Self-efficacy and Perceived Organizational Support between Nurses\u0026rsquo; Risk Perception and Participation Intention in \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;Nursing Services\u0026rdquo;\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec24\" class=\"Section2\"\u003e\u003ch2\u003eThe Direct Predictive Effect of Risk Perception on Participation Intention is Not Significant\u003c/h2\u003e\u003cp\u003eThe results of this study indicate that the direct effect of nurses\u0026rsquo; risk perception of \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo; on participation intention has not reached a significant level, which may be due to the differences in nurses\u0026rsquo; cognition of this service model. A higher level of risk perception reflects that nurses have a stronger ability to identify and assess potential risks. At the same time, they may also have a more comprehensive understanding of risk mitigation and response mechanisms. Therefore, some nurses may still have a strong willingness to serve even if they perceive a relatively high risk. Furthermore, this also indicates that the decision-making on nurses\u0026rsquo; participation intention is rational, and they will not simply adopt risk-avoidance strategies due to the existence of risks. The risks in the process of \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo; objectively exist and cannot be eliminated. An excessively high level of risk perception may weaken nurses\u0026rsquo; confidence in participating in services, trigger avoidance psychology, and even lead nurses to avoid risks by refusing to participate in service [46]. Conversely, if the risk perception is too low, medical staff may ignore the risk due to the mentality of taking chances, thereby causing errors [47]. At the same time, a lack of prevention can also affect the effective response to risk events. A reasonable perception of risks is a manifestation of nurses\u0026rsquo; risk awareness, which helps to prompt nurses to proactively take positive risk prevention measures to reduce the probability of potential risk events. Therefore, it is suggested that the management department should, on the one hand, strengthen safety management during the service process, and on the other hand, apply reasonable risk communication strategies to guide nurses to form accurate risk cognition and judgment on \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo; through reasonable information transmission, to be able to make rational behavioral decisions.\u003c/p\u003e\u003cdiv id=\"Sec25\" class=\"Section3\"\u003e\u003ch2\u003ePerceived Organizational Support Mediates the Relationship between Risk Perception and Participation Intention\u003c/h2\u003e\u003cp\u003eResearch shows that perceived organizational support has a 72.36% mediating effect between risk perception and participation intention, verifying Hypothesis \u003cspan refid=\"FPar2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. This reflects the significant mediating role of perceived organizational support in this regard. Risk perception has a negative impact on perceived organizational support. High levels of risk perception are correlated with lower levels of perceived organizational support, indicating that nurses have a greater need for organizational support in high-risk scenarios, and their sense of organizational support may decrease. Secondly, the sense of organizational support, as a key resource for coping with risk pressure, positively influences participation intention. A higher sense of organizational support among employees indicates that they believe the organization can provide the necessary resources and guarantees to help them deal with the risks and challenges they may face at work, thereby reducing the negative impact of risk perception and enhancing their willingness to engage in necessary risky behaviors [48]. \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo; are not part of the daily nursing duties and usually require caregivers to invest additional time and energy to provide home care. The special service environment brings many challenges and concerns to nurses. Against this backdrop, perceived organizational support is a powerful external driver influencing nurses\u0026rsquo; behavioral choices, significantly and positively affecting their participation intention. The more substantial the support provided by healthcare institutions, the stronger the nurses\u0026rsquo; intention to engage in these services. Organizational support is an important source of employees\u0026rsquo; sense of security and courage to act. If an organization can provide a comprehensive support system that includes security guarantees, skills training, reward support, it can greatly enhance their participation intention.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec26\" class=\"Section3\"\u003e\u003ch2\u003eSelf-efficacy has a Mediating Effect Between Risk Perception and Participation Intention\u003c/h2\u003e\u003cp\u003eThe results of the mediating effect analysis show that the indirect effect of self-efficacy is -0.039, accounting for 14.18% of the total effect. Self-efficacy is an individual\u0026rsquo;s comprehensive evaluation of whether they can perform a specific task [49]. People with a higher sense of self-efficacy are more likely to believe that they have sufficient ability and confidence to deal with challenges. Previous studies have confirmed the negative correlation between self-efficacy and risk perception [50], suggesting that an individual\u0026rsquo;s high self-efficacy weakens the negative impact of risk and has a positive expectation of the outcome of events, thus resulting in a lower risk perception. The results of this study show that high-risk perception may reduce an individual\u0026rsquo;s self-efficacy and further lower participation intention. High-difficulty tasks can suppress an individual\u0026rsquo;s sense of self-efficacy and reduce the possibility of their participation in the tasks [51]. High-risk perception will make individuals pay more attention to the possible risks that may occur during the service process and the expected consequences of failure. Excessive focus on the negative impacts of risk events can increase negative emotions, causing individuals to make negative and irrational evaluations, thereby weakening their self-efficacy and participation intention. To enhance nurses\u0026rsquo; participation intention in \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo;, hospital management departments should strengthen systematic training for nurses on home care services, improve their operational skills and emergency handling capabilities, and thereby enhance their self-efficacy.\u003c/p\u003e\u003cp\u003e\u003cb\u003eThe Chain Mediating Role of Perceived Organizational Support and Self-efficacy between Risk Perception and Participation Intention\u003c/b\u003e\u003c/p\u003e\u003cp\u003eWe found that organizational support perception and self-efficacy play a complete mediating role between risk perception and participation intention, with a chain mediating effect of 13.46%. When employees feel supported by the organization, this sense of security will significantly enhance their efficacy in dealing with risks and thereby increase their participation intention. It is worth noting that the chain-mediated pathway of \u0026ldquo;perceived organizational support \u0026rarr; self-efficacy\u0026rdquo; serves as a crucial bridge between nurses\u0026rsquo; risk perception of \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo; and their participation intention. It indicates the shaping effect of the organizational environment on an individual\u0026rsquo;s psychological state. Organizational support can not only directly enhance an individual\u0026rsquo;s participate intention but also indirectly strengthen their self-efficacy. This suggests that we should fully recognize the promotion of perceived organizational support on self-efficacy, strengthen the organizational construction of medical institutions, enhance the sense of organizational support of nurses, further enhance their self-efficacy in coping with risks, and ultimately enhance nurses\u0026rsquo; participation intention in \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo;.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec27\" class=\"Section3\"\u003e\u003ch2\u003eImplications for Nursing Management\u003c/h2\u003e\u003cp\u003eEnhancing nurses\u0026rsquo; participation intention is the primary prerequisite for promoting the continuous development of \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo;. From the perspectives of the external environment and individual psychology, the research has revealed the chain mediating effect of nurses\u0026rsquo; perceived organizational support and self-efficacy between risk perception and participation intention. This indicates that strengthening organizational support and enhancing nurses\u0026rsquo; self-efficacy should be regarded as the overall intervention goals to increase nurses\u0026rsquo; participation intention. First of all, the relevant administrative departments should focus on building a more complete safety management system for \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo;, and enhance the safety and quality of services from aspects such as establishing and improving the relevant legal guarantee system, optimizing the operation process norms and risk emergency plans for home services, and standardizing the access standards and qualification reviews for online nurses. Secondly, it is necessary to provide sufficient resources and information support, establish a fair performance assessment and reward mechanism, and build a solid organizational support system to enhance the psychological capital of nurses and increase their participation intention. Thirdly, the self-efficacy of nurses should be effectively enhanced through systematic skills training, home scenario simulation training, positive value promotion and dynamic feedback mechanisms. Through organizational construction and cultural cultivation, long-term intervention measures can be formed to enhance the intrinsic motivation and service efficiency of nurses, thus promoting the sustainable development of \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo;.\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv id=\"Sec28\" class=\"Section2\"\u003e\u003ch2\u003eLimitations\u003c/h2\u003e\u003cp\u003eDue to limited time and energy, this study was only investigated in one province. The sample size was limited and lacks representativeness, and the applicability of the research conclusions is somewhat limited. Future studies could carry out large-scale surveys. This study is a cross-sectional study and has certain limitations in verifying causality. Future studies could adopt longitudinal research designs or carry out interventional studies on relevant factors to further verify the research results. In addition, this study mainly focuses on the participation intention of nurses. Although behavioral intention is an important predictor of actual behavioral choices, the two are not entirely equivalent. Future research could introduce more variables to further study the internal mechanism of the transformation of behavioral intention into actual behavior, and explore key factors to effectively promote nurses\u0026rsquo; participation in \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo;.\u003c/p\u003e\u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe results of this study show that perceived organizational support and self-efficacy play a chain mediating role between nurses\u0026rsquo; risk perception of \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing service\u0026rdquo; and their participation intention. Relevant departments should fully recognize the important role of perceived organizational support and self-efficacy in promoting nurses\u0026rsquo; participation intention in \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo;, develop targeted intervention strategies, enhance nurses\u0026rsquo; willingness to serve, and promote the sustainable development of \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo; for the elderly.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003ch2\u003eEthics approval and consent to participate\u003c/h2\u003e\u003cp\u003e This study was approved by the Ethics Committee of Shanxi Bethune Hospital on June 10, 2025 (Ethical approval number: YXLL-2025-155). Before the investigation, all nurses were informed of the research objectives, methods, and significance, and their informed consent was obtained. This study strictly adheres to the ethical standards of the Declaration of Helsinki.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003cp\u003eNot applicable.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003cp\u003eThe authors declare no conflicts of interest.\u003c/p\u003e\u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e\u003cp\u003eSpecial Research Project for High-Quality Development of the Health Industry in Shanxi Province (Project Number: DJKZXKT2023269); Science Foundation of Shanxi Bethune Hospital (Project Number: 2022YJ01).\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eJX and YH was responsible for the research design and the writing of the first draft of the manuscript. JX optimized the research and supervised the study. The data collation and analysis were carried out by YH and SG. Data collection and organization were handled by XW and DL. JX and YH are co-first authors, who contributed equally to this study. All authors reviewed and commented on the manuscript and approved the current version.\u003c/p\u003e\u003ch2\u003eAcknowledgements\u003c/h2\u003e\u003cp\u003eWe sincerely thank all the nurses who participated in this study.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe data that support the findings of this study are available from the corresponding author upon reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eLiu W, Li Y, Zhu H, Li K, Deng H, Cai X. Meta-synthesis of the experience of nurses with \u0026ldquo;Internet Nursing Service\u0026rdquo; in China. Int J Nurs Sci.2025;12(3):233-240. doi:10.1016/j.ijnss.2025.04.012\u003c/li\u003e\n\u003cli\u003eXie F., Lin F., \u0026amp; Gan T. 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Perceived self-efficacy and its effect on online learning acceptance and student satisfaction. Journal of Service Science and Management, 2011;4(03), 243. doi: 10.4236/jssm.2011.43029\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"“Internet + nursing services”, risk perception, self-efficacy, perceived organizational support, participation intention","lastPublishedDoi":"10.21203/rs.3.rs-7975418/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7975418/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eAims\u003c/h2\u003e\u003cp\u003eTo explore the mediating effect of self-efficacy and perceived organizational support on nurses\u0026rsquo; risk perception and participation intention in \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo;.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eA cross-sectional survey was conducted from June to August 2025 using convenience sampling to recruit 624 nurses from five hospitals in Shanxi Province, China. Data were collected using a demographic questionnaire, risk perception outcome assessment scale for nurses in \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo; for the elderly, participation intention of nurses on \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo; scale, the general self-efficacy scale, and the perceived organizational support scale. Descriptive analysis and correlation analysis were performed using SPSS 27.0, and structural equation modeling was constructed with AMOS 24.0 for mediation effect analysis.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eThe research results show that the risk perception of nurses in \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo; is negatively correlated with their participation intention. The mediation analysis shows that the mediating effects of nurses\u0026rsquo; perceived organizational support and self-efficacy, and their chain mediation effect, accounted for 72.36%, 14.18%, and 13.46% of the total effect, respectively.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eNurses\u0026rsquo; risk perception of \u0026ldquo;Internet\u0026thinsp;+\u0026thinsp;nursing services\u0026rdquo; can influence their participation intention in the service through their perceived organizational support and self-efficacy.\u003c/p\u003e","manuscriptTitle":"Mediating Effects of Self-efficacy and Perceived Organizational Support Between Risk Perception and Nurses’ Participation Intention in “Internet + Nursing Services”","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-10 20:13:30","doi":"10.21203/rs.3.rs-7975418/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-04-30T18:11:29+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"130409559179025755114464518326586590431","date":"2025-12-12T16:08:52+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-12-05T10:53:31+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-11-04T10:38:38+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-11-03T12:50:37+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-11-03T12:48:31+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Nursing","date":"2025-10-29T04:18:47+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"7892121f-8243-4aba-901b-aa956078066e","owner":[],"postedDate":"December 10th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-12-10T20:13:30+00:00","versionOfRecord":[],"versionCreatedAt":"2025-12-10 20:13:30","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7975418","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7975418","identity":"rs-7975418","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}