Green Culture, Nurses’ Climate Change Skepticism, and Eco‐Capability in Hospitals: A Cross‐Sectional Study

AIM: To examine how green organizational culture and nurses' climate change skepticism influence hospitals' eco-capability, and whether climate skepticism moderates this relationship. BACKGROUND: Hospitals contribute significantly to environmental degradation, highlighting the importance of eco-capability in achieving sustainable healthcare. Nurses play a central role in implementing environmental practices; however, their engagement may be hindered by skeptical beliefs about climate change. METHODS: A cross-sectional survey was conducted among 564 nurses from five hospitals in Egypt. Validated Arabic versions of the Eco-Capability in Healthcare Scale, the Green Organizational Culture Scale, and the Climate Change Skepticism Questionnaire were used. Multiple regression and moderation analyses were applied to test study hypotheses. RESULTS: Green culture was positively associated with eco-capability, while climate change skepticism had a strong negative effect. Skepticism also moderated the culture-capability link. Eco-capability was highest among nurses with low skepticism and lowest among those with high skepticism. Participation in climate training and involvement in initiatives independently predicted higher eco-capability. DISCUSSION: The findings show that eco-capability depends on the alignment between organizational culture and nurses' beliefs. A supportive green culture encourages sustainable practice, but its influence is reduced when nurses hold skeptical views about climate change. Educational exposure and participation in environmental activities appear to strengthen engagement and help counter belief-based barriers. CONCLUSION: Eco-capability can be enhanced when hospitals strengthen green culture and reduce climate skepticism among nurses. IMPLICATIONS FOR NURSING: Integrating sustainability and climate content into nursing education and professional development can reduce skepticism and promote environmentally responsible practice. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Policymakers should integrate eco-capability benchmarks into accreditation standards, link sustainability indicators to nurse performance appraisal, and allocate resources for participatory initiatives that actively engage nurses.