The Mediating Role of Climate Change Anxiety in the Effect of Nurses’ Environmental Behaviors on Their Carbon Footprint Awareness

Background: Climate change and related environmental issues are among the major global threats affecting health systems. While nurses’ eco-friendly behaviors are critical for reducing the environmental impact of health care services, the psychological mechanisms through which these behaviors influence carbon footprint awareness have not been sufficiently explained. Objective: The aim of this study is to examine the effect of nurses’ eco-friendly behaviors on carbon footprint awareness and to assess the mediating role of climate change anxiety in this relationship. Methods: The study was conducted using a cross-sectional and analytical design. The sample consisted of 386 nurses selected through convenience sampling based on voluntary participation from among nurses working in secondary and tertiary healthcare facilities in Turkey. Results: It was determined that environmentally friendly behavior significantly and positively predicted carbon footprint awareness (B = 0.542, p < 0.001) and climate change anxiety (B = 0.602, p < 0.001). In addition, climate change anxiety was found to have a significant positive effect on carbon footprint awareness (B = 0.458, p < 0.001). Bootstrap analysis showed that climate change anxiety played a significant partial mediating role in the effect of eco-friendly behavior on carbon footprint awareness (indirect effect = 0.176, 95% CI = 0.165–0.369). Conclusions: Nurses’ eco-friendly behaviors increase carbon footprint awareness both directly and through climate change anxiety. The findings highlight the importance of practices that support eco-friendly behaviors and educational programs that strengthen climate change awareness in the development of sustainable health services. © 2026 by the authors.