Digital literacy, psychological resilience, and work stress among nurses: the moderating role of ward environment.

Introduction: Nurses' work stress remains a persistent global challenge, with the digital transformation of healthcare adding new complexities to their roles. Aims: This study aimed to explore the relationships among nurses' digital literacy, psychological resilience, and work stress, and to investigate the moderating role of the ward environment in these mediation and moderation relationships. Design/methods: A cross-sectional study was conducted from June to July 2025 using anonymous online questionnaires completed by 302 active clinical nurses from Western China. Descriptive statistics, correlation analyses, and structural equation modeling (SEM) were performed. The PROCESS macro was employed to examine the hypothesized moderated mediation effects. Results: Nurses working in intensive care units (ICUs) and emergency rooms (ERs) reported significantly higher levels of work stress compared to those in general wards. The statistical indirect association between digital literacy and work stress through psychological resilience was fully mediated. A key finding was the significant moderating role of the ward environment. In the ER setting, digital literacy was directly associated with lower work stress ( Conclusion: This study demonstrates that the ward environment plays a critical role in shaping how digital literacy and psychological resilience relate to nurses' work stress. The findings suggest that to address work stress effectively, hospitals may consider implementing ward-specific strategies. Based on the observed associations, combining digital tool training with resilience-building initiatives could be beneficial in ERs. In ICUs, the findings point to the need for systemic interventions beyond individual-level resilience to address the high occupational demands.