Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, 501 Smyth Road, Critical Care Wing 1401, Ottawa, ON, K1H 8L6, Canada.
Department of Innovation in Medical Education (DIME), University of Ottawa, Faculty of Medicine, Ottawa, ON, Canada.
Can J Anaesth. 2017 Jun;64(6):581-596. doi: 10.1007/s12630-017-0845-9. Epub 2017 Feb 16.
Inadvertent perioperative hypothermia (IPH) is associated with a range of adverse outcomes. Safe and effective warming techniques exist to prevent IPH; however, IPH remains common. This study aimed to identify factors that anesthesiologists perceive may influence temperature management during the perioperative period.
After Research Ethics Board approval, semi-structured interviews were conducted with staff anesthesiologists at a Canadian academic hospital. An interview guide based on the Theoretical Domains Framework (TDF) was used to capture 14 theoretical domains that may influence temperature management. The interview transcripts were coded using direct content analysis to generate specific beliefs and to identify relevant TDF domains perceived to influence temperature management behaviour.
Data saturation was achieved after 15 interviews. The following nine theoretical domains were identified as relevant to designing an intervention for practices in perioperative temperature management: knowledge, beliefs about capabilities, beliefs about consequences, reinforcement, memory/attention/decision-making, environmental context and resources, social/professional role/identity, social influences, and behavioural regulation. Potential target areas to improve temperature management practices include interventions that address information needs about individual temperature management behaviour as well as patient outcome (feedback), increasing awareness of possible temperature management strategies and guidelines, and a range of equipment and surgical team dynamics that influence temperature management.
This study identified several potential target areas for future interventions from nine of the TDF behavioural domains that anesthesiologists perceive to drive their temperature management practices. Future interventions that aim to close the evidence-practice gap in perioperative temperature management may include these targets.
术中意外低体温（IPH）与一系列不良后果相关。存在安全有效的保暖技术来预防 IPH；然而，IPH 仍然很常见。本研究旨在确定麻醉师认为可能影响围手术期体温管理的因素。
在获得研究伦理委员会批准后，对加拿大一家学术医院的麻醉科工作人员进行了半结构化访谈。访谈指南基于理论领域框架（TDF），以捕获可能影响体温管理的 14 个理论领域。使用直接内容分析对访谈记录进行编码，以生成特定的信念，并确定被认为影响体温管理行为的相关 TDF 领域。
在 15 次访谈后达到了数据饱和。确定了以下九个与围手术期体温管理实践的干预设计相关的理论领域：知识、对能力的信念、对后果的信念、强化、记忆/注意力/决策、环境背景和资源、社会/职业角色/身份、社会影响和行为调节。可能改善体温管理实践的目标领域包括干预措施，以满足有关个体体温管理行为以及患者结局（反馈）的信息需求，提高对可能的体温管理策略和指南的认识，以及一系列影响体温管理的设备和手术团队动态。
本研究从麻醉师认为驱动其体温管理实践的九个 TDF 行为领域中确定了几个未来干预的潜在目标领域。旨在缩小围手术期体温管理中证据与实践差距的未来干预措施可能包括这些目标。
