Background: Nurses' perceptions of corporate social responsibility (CSR) in Iranian hospitals remain underexplored, particularly where formal CSR education is limited for academic nurses. Nurses' understanding of CSR-as conceptualized by Carroll's pyramid encompassing economic, legal, ethical, and philanthropic responsibilities-is crucial as they translate organizational commitments into patient care quality and safety. This study examined nurses’ perceptions of CSR and the associated factors.
Methods: This cross-sectional study was conducted in 2025 among 309 nurses from 12 hospitals affiliated with Golestan University of Medical Sciences, Iran. Participants were selected using stratified proportional sampling by hospital size with convenience sampling within strata. Organizational-level CSR was assessed using Carroll's CSR questionnaire (20 items; Cronbach's α=0.89; four dimensions; 5-point Likert scale, score range: 20-100). Associations between CSR scores and demographic factors (Age, gender, marital status, education, and ethnicity) and occupational factors (Work experience, clinical unit, and job title) were analyzed using SPSS version 26.0. Group differences were examined using one-way ANOVA, and multiple linear regression was used to identify factors independently associated with total CSR scores.
Results: The mean total CSR score was 72.39 ± 13.22 (Economic: 17.32 ± 3.67; legal: 18.68 ± 3.56; ethical: 18.35 ± 3.74; philanthropic: 18.04 ± 4.37). Significant associations were found with marital status (p=0.024, higher in single nurses), clinical unit (p=0.006, lowest in orthopedic, highest in dialysis/management units), and a weak negative correlation with age (r= -0.132, p=0.020) and work experience (r=-0.116, p=0.041). Multiple linear regression showed that marital status was independently associated with CSR scores (β = 0.120, p = 0.032). Compared with nurses in internal–surgical units, those working in orthopedic (β = -0.223, p < 0.001), emergency (β = -0.135, p = 0.040), and neonatal units (β = -0.113, p = 0.037) had significantly lower CSR scores. The model explained 12.1% of variance (adjusted R² = 0.121)
Conclusion: Nurses in hospitals demonstrated generally positive perceptions of corporate social responsibility. These perceptions were influenced more strongly by workplace factors-particularly the type of clinical unit-than by personal demographic characteristics. Improving organizational conditions and promoting ethical leadership may further enhance CSR awareness, professional performance, and the quality of patient care.
