Yang Lei, Tang Wenjuan, Du Qingqing, Liu Yingmin, Wang Zhen, Yang Xia
Department of Orthopedics, Shanghai Childrens' Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Department of Nursing, Shanghai Childrens' Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
BMC Pediatr. 2025 Aug 8;25(1):616. doi: 10.1186/s12887-025-05920-1.
Inadvertent perioperative hypothermia (IPH) is a clinical phenomenon in which patient's core body temperature is below 36℃ due to non-medical purposes during the perioperative period. Children are more s usceptible to hypothermia due to their significantly higher surface area-to-body weight ratio compared to adults, the immaturity of their thermoregulatory centers, and the thinness of their subcutaneous fat insulation layer. Perioperative nursing is an essential component of the multiprofessional management of surgical patients. Since nurses are the primary caregivers and monitors of patients during perioperative process, a better understanding of nurses' knowledge, attitudes and behaviors regarding IPH prevention is critical to improving patient outcomes. Consequently, a multicenter cross-sectional study was carried out to investigate the current situation of anesthesia and operating room nurses in China, as well as the prevention of inadvertent perioperative hypothermia and its influencing factors.
In this study, 292 nurses from 7 children's specialized hospitals in 4 provinces (Hunan, Anhui, Zhejiang, and Shanghai) in the southern, northern, and central regions of mainland China participated in two-stage purposive and convenience mixed sample technique. General demographic information questionnaire, the knowledge, attitudes, and behaviors questionnaire, and the self-efficacy scale were used for data collection. Descriptive analysis, univariate analysis, correlation analysis, and multiple linear regression analysis were used for data analysis.
The results indicated that mean (SD) score of knowledge, attitudes, and behaviors scales were 15.59 (3.28), 47.02 (8.05), and 52.48 (6.35), respectively. Results of multiple linear regression analysis showed that educational level (t = 2.278, P < 0.05), No. of IPH training (t = 3.408, P < 0.01) and whether there was a perioperative insulation process (t=-3.091, P < 0.01) were risk factors for knowledge; No. of IPH training (t = 3.175 P < 0.01) was risk factor for attitudes; No. of IPH training (t = 2.476, P < 0.05), whether there was a perioperative insulation process (t=-6.612, P < 0.01) and self-efficacy (t = 2.851, P < 0.01) were risk factors for behaviors. Correlation analysis displayed self-efficacy was positively related to knowledge (r = 0.137, P < 0.05), attitudes (r = 0.115, P < 0.05), and behaviors (r = 0.258, P < 0.01); knowledge was also positively correlated with attitudes (r = 0.262, P < 0.01) and behaviors (r = 0.322, P < 0.01); attitudes were positively related to behaviors (r = 0.153, P < 0.01).
To improve knowledge, attitudes, and behaviors of IPH prevention among operating room nurses and anesthesia nurses in children's specialized hospitals, nursing managers should increase the frequency of IPH training and develop standardized perioperative insulation process. Nurses should also enhance their theoretical knowledge learning, improve educational level and self-efficacy.
围手术期意外低温（IPH）是一种临床现象，指患者在围手术期由于非医疗目的导致核心体温低于36℃。儿童由于其体表面积与体重之比显著高于成人、体温调节中枢不成熟以及皮下脂肪绝缘层较薄，更容易发生低温。围手术期护理是手术患者多专业管理的重要组成部分。由于护士是围手术期患者的主要照顾者和监测者，更好地了解护士关于预防IPH的知识、态度和行为对于改善患者预后至关重要。因此，开展了一项多中心横断面研究，以调查中国麻醉和手术室护士的现状，以及围手术期意外低温的预防及其影响因素。
本研究采用两阶段目的抽样与便利抽样相结合的混合抽样技术，选取了中国大陆南部、北部和中部4个省份（湖南、安徽、浙江和上海）7家儿童专科医院的292名护士。采用一般人口学信息问卷、知识、态度和行为问卷以及自我效能量表进行数据收集。数据分析采用描述性分析、单因素分析、相关性分析和多元线性回归分析。
结果表明，知识、态度和行为量表的平均（标准差）得分分别为15.59（3.28）、47.02（8.05）和52.48（6.35）。多元线性回归分析结果显示，教育程度（t = 2.278，P < 0.05）、IPH培训次数（t = 3.408，P < 0.01）和是否有围手术期保温措施（t = -3.091，P < 0.01）是知识的危险因素；IPH培训次数（t = 3.175，P < 0.01）是态度的危险因素；IPH培训次数（t = 2.476，P < 0.05）、是否有围手术期保温措施（t = -6.612，P < 0.01）和自我效能感（t = 2.851，P < 0.01）是行为的危险因素。相关性分析显示，自我效能感与知识（r = 0.137，P < 0.05）、态度（r = 0.115，P < 0.05）和行为（r = 0.258，P < 0.01）呈正相关；知识与态度（r = 0.262，P < 0.01）和行为（r = 0.322，P < 0.01）也呈正相关；态度与行为（r = 0.153，P < 0.01）呈正相关。
为提高儿童专科医院手术室护士和麻醉护士预防IPH的知识、态度和行为，护理管理者应增加IPH培训频率，制定标准化的围手术期保温措施。护士还应加强理论知识学习，提高教育程度和自我效能感。
