Better Attitudes toward Cybersecurity and Greater Self-Control Predict Lower Risky Online Behaviors among Nurses

Abstract

Objective

The current study examined the moderating effect of self-control on the relationship between attitudes toward cybersecurity and risky online behaviors among direct care nurses.

Methods

A cross-sectional study collected data from 260 direct care nurses in Saudi Arabia using a self-reported questionnaire. Hierarchical multiple regression analysis and simple slope analysis examined the moderation effect of self-control on the relationship between attitudes toward cybersecurity and risky online behaviors.

Results

We found that a better attitude toward cybersecurity and greater self-control predicted lower risky online behaviors. Simple slope tests revealed a significant negative association between attitude toward cybersecurity and risky online behaviors at low levels of self-control, but this association disappears at high levels of self-control, meaning that high levels of self-control have a protective/moderating effect on the relationship between attitude toward cybersecurity and risky online behaviors.

Conclusion

Self-control moderates the effect of attitudes on online practices. The negative attitudes' influence on risky online behaviors is stronger when self-control is low. On the other hand, at high levels of self-control, individuals may engage in safer practices regardless of their attitudes.

Keywords

cybersecurity attitude - cybersecurity training - electronic health record - electronic medical record - health care data - risky cybersecurity behaviors - self-control - moderation effect

Protection of Human and Animal Subjects

The study was performed in accordance with the Declaration of Helsinki. Informed consent was obtained from participants.

Publication History

Received: 21 February 2025

Accepted: 10 September 2025

Article published online:
08 October 2025

• References

• 1 Sardi A, Rizzi A, Sorano E, Guerrieri A. Sustainability-12–07002–V2.Pdf. Sustainability. Published online 2020; 1-16
• 2 Widup S. et al. Verizon: Data breach investigations report 2020. Comput Fraud Secur 2020; 2020: 4
• 3 Yeng PK, Yang B, Snekkenes EA. Framework for Healthcare Security Practice Analysis, Modeling and Incentivization. Paper presented at: 2019 IEEE International Conference on Big Data (Big Data), Los Angeles, CA; 2019; :pp. 3242-3251
• 4 IBM. Cost of a Data Breach Report 2024. Accessed July 10, 2025 at: https://www.ibm.com/security/data-breach
• 5 Kwon J, Johnson ME. The impact of ransomware attacks on hospital operations and patient outcomes. Health Serv Res 2021; 56 (02) 305-312
• 6 Martin G, Martin P, Hankin C, Darzi A, Kinross J. Cybersecurity and healthcare: how safe are we?. BMJ 2017; 358: j3179
• 7 Dart M, Ahmed M. Evaluating staff attitudes, intentions, and behaviors related to cyber security in large Australian health care environments: Mixed methods study. JMIR Hum Factors 2023; 10 (01) e48220
• 8 Kennison SM, Chan-Tin E. Taking risks with cybersecurity: Using knowledge and personal characteristics to predict self-reported cybersecurity behaviors. Front Psychol 2020; 11: 546546
• 9 Thomas K, Li F, Zand A. et al. Data Breaches, Phishing, or Malware? Understanding the risks of stolen credentials. Paper presented at: Proceedings of the 2017 ACM SIGSAC Conference on Computer and Communications Security; 2017 :pp. 1421-1434
• 10 Mikuletič S, Vrhovec S, Skela-Savič B, Žvanut B. Security and privacy oriented information security culture (ISC): Explaining unauthorized access to healthcare data by nursing employees. Comput Secur 2024; 136: 103489
• 11 World Health Organization. Global strategy on digital health 2020–2025. 2020 . Accessed September 16, 2025 at: https://www.who.int/publications/i/item/9789240020924
• 12 National Institute of Standards and Technology. Framework for Improving Critical Infrastructure Cybersecurity. 2018 . Accessed September 16, 2025 at: https://nvlpubs.nist.gov/nistpubs/cswp/nist.cswp.04162018.pdf
• 13 Alhuwail D, Al-Jafar E, Abdulsalam Y, AlDuaij S. Information security awareness and behaviors of health care professionals at public health care facilities. Appl Clin Inform 2021; 12 (04) 924-932
• 14 Shrestha A, Graham DM, Dumaru P, Paudel R, Searle KA, Al-Ameen MN. Understanding the behavior, challenges, and privacy risks in digital technology use by nursing professionals. Proc ACM on Hum Comput Interact 2022; 6 (CSCW): 343
• 15 Yeng PK, Fauzi MA, Yang B. A comprehensive assessment of human factors in cyber security compliance toward enhancing the security practice of healthcare staff in paperless hospitals. Information 2022; 13 (07) 335
• 16 de Ridder DTD, Lensvelt-Mulders G, Finkenauer C, Stok FM, Baumeister RF. Taking stock of self-control: a meta-analysis of how trait self-control relates to a wide range of behaviors. Pers Soc Psychol Rev 2012; 16 (01) 76-99
• 17 Li CK, Holt TJ, Bossler AM, May DC. Examining the mediating effects of social learning on the low self-control—Cyberbullying relationship in a youth sample. Deviant Behav 2016; 37 (02) 126-138
• 18 Hu Q, West R, Smarandescu L. The role of self-control in information security violations: Insights from a cognitive neuroscience perspective. J Manage Inf Syst 2015; 31 (04) 6-48
• 19 Tiemeijer WL. Self-Control: Individual Differences and What They Mean for Personal Responsibility and Public Policy. Cambridge University Press; 2022
• 20 Bandura A. Social cognitive theory of self-regulation. Organ Behav Hum Decis Process 1991; 50: 248-287
• 21 Kahneman D. Thinking, Fast and Slow. NY: Allen Lane and Penguin Books; 2011
• 22 Mwim EN, Mtsweni J, Chimbo B. Factors associated with cybersecurity culture: A quantitative study of public e-health hospitals in South Africa. IFIP Adv Inf Commun Technol 2023; 674: 129-142
• 23 Kessler SR, Pindek S, Kleinman G, Andel SA, Spector PE. Information security climate and the assessment of information security risk among healthcare employees. Health Informatics J 2020; 26 (01) 461-473
• 24 Ali RF, Dominic PDD, Ali SEA, Rehman M, Sohail A. Information security behavior and information security policy compliance: A systematic literature review for identifying the transformation process from noncompliance to compliance. Appl Sci 2021; 11 (08) 3383
• 25 Nodeland B. The effects of self-control on the cyber victim-offender overlap. Int J Cybersec Intell Cybercrime 2020; 3 (02) 4-24
• 26 Hadlington L. Human factors in cybersecurity; examining the link between Internet addiction, impulsivity, attitudes towards cybersecurity, and risky cybersecurity behaviours. Heliyon 2017; 3 (07) e00346
• 27 Tangney JP, Baumeister RF, Boone AL. High self-control predicts good adjustment, less pathology, better grades, and interpersonal success. J Pers 2004; 72 (02) 271-324
• 28 Kang P, Kang J, Monsen KA. Nurse information security policy compliance, information competence, and information security attitudes predict information security behavior. Comput Inform Nurs 2023; 41 (08) 595-602
• 29 Ifinedo P. Effects of security knowledge, self-control, and countermeasures on cybersecurity behaviors. J Comput Inf Syst 2023; 63 (02) 380-396
• 30 Whitten T, Cale J, Brewer R, Logos K, Holt TJ, Goldsmith A. Exploring the role of self-control across distinct patterns of cyber-deviance in emerging adolescence. Int J Offender Ther Comp Criminol 2024 :306624 × 231220011
• 31 Hennessy EA, Johnson BT, Acabchuk RL, McCloskey K, Stewart-James J. Self-regulation mechanisms in health behavior change: a systematic meta-review of meta-analyses, 2006-2017. Health Psychol Rev 2020; 14 (01) 6-42
• 32 Anti E, Vartiainen T. Explanations of insider deviant behavior in information security: A systematic literature review. Comm Assoc Inform Syst 2024; 55 (01) 4
• 33 Neufeld D. Computer crime motives: Do we have it right?. Sociol Compass 2023; 17 (04) e13077
• 34 Moustafa AA, Bello A, Maurushat A. The role of user behaviour in improving cyber security management. Front Psychol 2021; 12: 561011
• 35 Maalem Lahcen RA, Caulkins B, Mohapatra R, Kumar M. Review and insight on the behavioral aspects of cybersecurity. Cybersecurity (Singap) 2020; 3: 1-18
• 36 Adler NJ, Redding SG, Doktor R. From the Atlantic to the Pacific century: Cross-cultural management reviewed. J Manage 1986; 12 (02) 295-318
• 37 Al Haj W, Othman E. Exploring factors contributing to risky online behaviors among registered nurses. Inf Comput Secur 2025
• 38 Alhasan IY. Human Factors in Cybersecurity: A Cross-Cultural Study on Trust [dissertation]. Purdue University Graduate School; 2023
• 39 Prümmer J, van Steen T, van den Berg B. A systematic review of current cybersecurity training methods. Comput Secur 2024; 136: 103585
• 40 Blanchard EE, Feldman SS, White ML, Allen R, Phillips T, Brown MR. Design and implementation of tabletop cybersecurity simulation for health informatics graduate students. Appl Clin Inform 2024; 15 (05) 921-927
• 41 Tran TM, Beuran R, Hasegawa S. Gamification-based cybersecurity awareness course for self-regulated learning. Int J Inf Educ Technol 2023; 13 (04) 724-730
• 42 Jóhannsdóttir LG. Ensuring Patient Safety through Digital Health Technologies [dissertation]. Berlin, Germany: Freie Universität; 2025
• 43 Azam Z, Islam MM, Huda MN. Comparative analysis of intrusion detection systems and machine learning-based model analysis through decision tree. IEEE Access 2023; 11: 80348-80391
• 44 Savage MW, Jones SE, Reno JE, Veil S. A case study: Targeting the stop.Think. Connect. Cybersecurity campaign to university campuses. In: Oxford Research Encyclopedia of Communication. Oxford University Press; 2017