This study aimed to investigate the relationship between proactive personality and career-related decision-making self-efficacy, with generative artificial intelligence acceptance serving as a mediating factor. Additionally, the study examined the moderating effect of innovation competencies on this mediation pathway, utilizing a moderated mediation framework. The study included 501 university students from Guangdong Province, China, who completed validated measures of proactive personality, career-related decision-making self-efficacy, generative artificial intelligence acceptance, and innovation competencies. Data analysis was conducted using SPSS (Version 26) and the PROCESS macro to evaluate mediation, moderation, and moderated mediation effects. Moreover, confirmatory factor analysis was performed using Amos (Version 28.0) to assess the validity of the measurement models. The results indicate that proactive personality exerts an indirect effect on career-related decision-making self-efficacy via generative artificial intelligence acceptance. The strength of this indirect effect was moderated by innovation competencies, indicating that the relationship is stronger at higher levels of innovation competencies. These findings contribute to a more nuanced understanding of the relationship between proactive personality and career-related decision-making self-efficacy, particularly within the context of technological adaptability.

Background/Objectives: Spiritual care is core to holistic patient care, yet a persistent implementation gap exists in Chinese hospitals. This study examines the association between spiritual leadership and nurses’ spiritual care behavior, with career calling as mediator and empathy as moderator. Methods: A cross-sectional design was adopted. Data were collected from 323 frontline nurses in 10 public hospitals across five provinces in China from June to September 2025 using validated Likert scales. Analyses included confirmatory factor analysis, hierarchical regression, and a second-stage moderated mediation model with 5000 bootstrap resamples using SPSS 26.0 and Mplus 8.3. Results: Spiritual leadership was positively associated with both nurses’ spiritual care behavior and career calling. Career calling partially mediated the relationship between spiritual leadership and nurses’ spiritual care behavior. Furthermore, empathy significantly strengthened the positive association between career calling and spiritual care behavior, and amplified the indirect effect of spiritual leadership on nurses’ spiritual care behavior via career calling. Conclusions: Spiritual leadership, career calling, and empathy are key factors associated with nurses’ spiritual care delivery. Targeted interventions for these factors can bridge the spiritual care implementation gap and enhance holistic patient care.