Climate Change Awareness, Motivation, and Concerns Among Nurses at a Private and a Public Hospital in Karachi, Pakistan: A Comparative Cross-Sectional Study

Background Climate change poses significant and growing threats to human health, particularly in low- and middle-income countries that face limited adaptive capacity. Nurses play a critical role in addressing climate-related health challenges through patient care, health education, and advocacy. However, evidence regarding nurses’ awareness, motivation, and concerns related to climate change remains limited in Pakistan. This study aimed to assess and compare climate change awareness, motivation, and concerns among nurses working in public and private hospitals in Karachi, Pakistan, and to examine the influence of demographic factors on these constructs. Methods A comparative cross-sectional study was conducted among 340 registered nurses from one public (n = 131) and one private (n = 209) tertiary-level hospital in Karachi. Data was collected using the Climate, Health, and Nursing Tool (CHANT) through an online self-administered questionnaire. Data was analyzed using SPSS version 22. Descriptive statistics summarized participant characteristics and construct scores. As the data were not normally distributed, non-parametric tests were applied. The Mann–Whitney U test and the Kruskal–Wallis H test were used for group comparisons, while Spearman’s rank-order correlation assessed associations between demographic variables and study constructs. Results Statistically significant differences were observed between public and private hospital nurses in awareness and experience, with higher scores reported among nurses working in the private hospital (p < 0.05). No significant differences were found between the two groups for motivation, concern, or behavior. Female nurses demonstrated significantly higher levels of awareness and concern, whereas male nurses reported higher engagement in climate-related behaviors. Educational level was not significantly associated with any study variable. Weak but significant negative correlations were identified between age, clinical experience, and concern, indicating lower concern among older and more experienced nurses. Conclusion The findings reveal a clear knowledge gap among nurses, characterized by moderate awareness but strong motivation to engage in climate-related action. Institutional context, gender, and professional experience influence nurses’ engagement with climate-health issues. Integrating climate-health content into nursing education, strengthening institutional support, and providing targeted training opportunities may enhance nurses’ contribution to climate-resilient healthcare systems in Pakistan.