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This study evaluates the current status and influencing factors and maps the pathway to knowledge sharing behavior among surgical nurses using the COM-B model, focusing on internal and external determinants. A cross-sectional design sampled 174 hospitals across 31 provinces, with questionnaires analyzed via univariate and correlation analyses and structural equation modeling.","International Journal of Nursing Studies Advances 10 (2026) 100464  \nContents lists available at ScienceDirect  \nInternational Journal of Nursing Studies Advances  \njournal [homepage:](homepage: www.sciencedirect.com/journal/international)[ www.sciencedirect.com/journal/international](homepage: www.sciencedirect.com/journal/international)journal-of-nursing-studies-advances  \nInnovative motivation as a pathway from evidence-based nursing competence and nurse-physician collaboration to knowledge sharing behavior among surgical nurses : A structural equation modeling study based on the COM-B model  \nYanan Lenga,1, Meixian Lib,1, Xiaodi Zhang b, Haiwei Fub, Ying Wu a,2,**, Zonghua Wang b,2,*   \na Department of Hepatobiliary Surgery, Southwest Hospital, the first affiliated Hospital to Army Medical University, Chongqing, China b Department of Clinical Nursing, School of Nursing, Army Medical University, Chongqing, China  \nA R T I C L E I N F O  \nKeywords:  \nKnowledge sharing behavior Evidence-based nursing competence Innovation self-efficacy  \nNurses  \nA B S T R A C T  \nBackground: With the development of evidence-based medicine, a large amount of high-quality evidence is constantly generated, but surgical nurses are still weak in terms of the knowledge sharing behavior. Organizational and individual factors will determine how surgical nurses share knowledge. However, few cross-sectional studies had based on the Capabilities, Opportunities, Motivations, Behavior (COM-B) model to explore the influence paths of individual internal and external factors on the knowledge sharing behavior of surgical nurses.  \nObjective: This paper aims to evaluate (1) the current status and factors influencing on knowledge sharing behavior and (2) the pathways to knowledge sharing behavior of surgical nurses based on COM-B model.  \nDesign: Cross-sectional study.  \nSetting(s): 174 public hospitals in 31 provinces and municipalities of China.  \nMethods: A cross-sectional study was conducted in the surgery department in China from May to June 2023. Convenience sampling and questionnaires were used to facilitate sampling and data collection. A total of 1388 surgical nurses were included in the study. The data was processed using univariate analysis and correlation analysis, the central hypotheses were tested using a structural equation model (SEM).  \nResults: Of the participants, the knowledge sharing behavior score was 54.98 ± 13.33, and compared with the average score, it was at a moderately low level. There was a positive correlation between the level of knowledge sharing behavior and each variable (p \u003C 0.001). The knowledge sharing behavior was significantly positively correlated with evidence-based nursing  \nUpon acceptance of your manuscript we may publish your X handle along with your other contact information. Please provide us with your handle if you wish for this to be included.  \n* Corresponding author at: Department of Clinical Nursing, School of Nursing, Army Medical University, Shapingba District, Gaotanyan Street 30, Chongqing, 400038, China.  \n** Corresponding author at: Department of Hepatobiliary Surgery, Southwest Hospital, the first affiliated Hospital to Army Medical University, Chongqing, 400038 China.  \n[E-mail addresses:](E-mail addresses: wuying@tmmu.edu.cn)[ wuying@tmmu.edu.cn](E-mail addresses: wuying@tmmu.edu.cn) (Y. Wu), [zonghua910@tmmu.edu.cn](zonghua910@tmmu.edu.cn) (Z. Wang).  \n1 Yanan Leng and Meixian Li contributed equally to the manuscript.  \n2 Zonghua Wang and Ying Wu contributed equally to the manuscript.  \n[https://doi.org/10.1016/j.ijnsa.2025.100464](https://doi.org/10.1016/j.ijnsa.2025.100464)  \nReceived 9 June 2025; Received in revised form 1 December 2025; Accepted 3 December 2025 Available online 4 December 2025  \n2666-142X/© 2025 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC license ([http://creativecommons.org/licenses/by-nc/4.0/](http://creativecommons.org/licenses/by","cbCaikyGWEIsLtIt","https://ap.wps.com/l/cbCaikyGWEIsLtIt","pdf",1060500,3,13,"English","en",105,"# Abstract\n## Background\n## Objective\n## Design\n## Setting(s)\n## Methods\n## Results\n## Conclusions\n# What is already known\n# What this paper adds\n# 1. Introduction","[{\"question\":\"What problem does the study address regarding surgical nurses?\",\"answer\":\"Surgical nurses remain weak in knowledge sharing behavior despite advances in evidence-based medicine. The study targets organizational and individual factors that shape how nurses share knowledge.\"},{\"question\":\"How does the study analyze the factors affecting knowledge sharing behavior?\",\"answer\":\"It uses the COM-B model to explore influence paths of individual internal and external factors. Data are analyzed with univariate and correlation methods and tested with a structural equation model (SEM).\"},{\"question\":\"What are the key findings about relationships among competence, collaboration, and knowledge sharing?\",\"answer\":\"Knowledge sharing behavior is moderately low and positively correlated with the examined variables. Evidence-based nursing competence and nurse-physician collaboration can directly affect knowledge sharing behavior, and innovative self-efficacy partially mediates between competence/collaboration and knowledge sharing.\"}]","Innovative motivation as a pathway from evidence-based nursing competence and nurse-physician collaboration to knowledge sharing behavior among surgical nurses - A structural equation modeling study based on the COM-B model | PDF",1790718718,33,{"code":4,"msg":83,"data":84},"ok",{"site_id":76,"language":75,"slug":85,"title":65,"keywords":86,"description":66,"schema_data":87,"social_meta":140,"head_meta":142,"extra_data":144,"updated_unix":145},"innovative-motivation-as-a-pathway-from-evidence-based-nursing-competence-and-nurse-physician-collaboration-to-knowledge-sharing-behavior-among-surgical-nurses-a-structural-equation-modeling-study-based-on-the-com-b-model","",{"@graph":88,"@context":139},[89,102,122],{"@type":90,"itemListElement":91},"BreadcrumbList",[92,96,98,100],{"item":93,"name":94,"@type":95,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":97,"name":9,"@type":95,"position":14},"https://docshare.wps.com/document/",{"item":99,"name":40,"@type":95,"position":72},"https://docshare.wps.com/document/research-report/",{"item":101,"name":65,"@type":95,"position":19},"https://docshare.wps.com/document/innovative-motivation-as-a-pathway-from-evidence-based-nursing-competence-and-nurse-physician-collaboration-to-knowledge-sharing-behavior-among-surgical-nurses-a-structural-equation-modeling-study-based-on-the-com-b-model/447084/",{"url":101,"name":65,"@type":103,"image":104,"author":109,"headline":65,"publisher":111,"fileFormat":114,"inLanguage":75,"description":66,"dateModified":115,"datePublished":116,"encodingFormat":114,"isAccessibleForFree":117,"interactionStatistic":118},"DigitalDocument",{"url":105,"@type":106,"width":107,"height":108},"https://docshare.wps.com/thumbnails/innovative-motivation-as-a-pathway-from-evidence-based-nursing-competence-and-nurse-physician-collaboration-to-knowledge-sharing-behavior-among-surgical-nurses-a-structural-equation-modeling-study-based-on-the-com-b-model/447084.png","ImageObject",300,407,{"name":63,"@type":110},"Person",{"url":93,"name":112,"@type":113},"DocShare","Organization","application/pdf","2026-10-02","2026-09-29",true,{"@type":119,"interactionType":120,"userInteractionCount":72},"InteractionCounter",{"@type":121},"ViewAction",{"@type":123,"mainEntity":124},"FAQPage",[125,131,135],{"name":126,"@type":127,"acceptedAnswer":128},"What problem does the study address regarding surgical nurses?","Question",{"text":129,"@type":130},"Surgical nurses remain weak in knowledge sharing behavior despite advances in evidence-based medicine. The study targets organizational and individual factors that shape how nurses share knowledge.","Answer",{"name":132,"@type":127,"acceptedAnswer":133},"How does the study analyze the factors affecting knowledge sharing behavior?",{"text":134,"@type":130},"It uses the COM-B model to explore influence paths of individual internal and external factors. Data are analyzed with univariate and correlation methods and tested with a structural equation model (SEM).",{"name":136,"@type":127,"acceptedAnswer":137},"What are the key findings about relationships among competence, collaboration, and knowledge sharing?",{"text":138,"@type":130},"Knowledge sharing behavior is moderately low and positively correlated with the examined variables. 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