A qualitative study on influencing factors of operating room nurses’ preventive behaviors against hypothermia during cesarean section

doi:10.3761/j.issn.0254-1769.2025.10.006

Abstract

Abstract:

Objective To gain an in-depth understanding of influencing factors on the preventive behaviors of operating room nurses regarding hypothermia during cesarean sections，and to provide references for promoting the prevention of hypothermia during cesarean sections. Methods A descriptive qualitative research approach was adopted，based on the theoretical framework of the Precede-Proceed Model to develop an interview outline. Semi-structured interviews were conducted with 12 operating room nurses，and the interview data were analyzed using directed content analysis. Results The influencing factors were categorized into 3 main themes and 8 sub-themes.①Predisposing factors：insufficient theoretical knowledge，low risk awareness among healthcare providers.②Enabling factors：rational allocation of equipment/resources，proficient operational skills，targeted and effective training programs，and standardized preventive procedures.③Reinforcing factors：the need to enhance team cooperation，the need to improve the regulatory mechanism. Conclusion Nursing managers should strengthen education and training to enhance nurses’ awareness and skill levels in preventing hypothermia，improve equipment resources and build an information-based assessment and decision support system to promote the implementation of hypothermia prevention behaviors. Additionally，facilitating team collaboration and utilizing information construction to collect and analyze quality indicators can strengthen quality management and promote continuous improvement in the quality of hypothermia prevention during cesarean sections

Key words: Cesarean Section, Hypothermia, Operating Room Nurse, Precede-Proceed Model, Qualitative Research

摘要：

目的探讨手术室护士对剖宫产术中低体温预防行为的影响因素，为促进剖宫产术中低体温的预防提供参考。方法采用描述性质性研究，基于格林模式的理论框架制订访谈提纲，对12名手术室护士进行半结构式访谈，采用定向内容分析法进行资料分析。结果将影响因素归纳为3个主题和8个亚主题。①倾向因素：理论知识欠缺、风险意识淡薄。②促成因素：合理配置设备资源、掌握良好的操作技能、开展针对性的教育培训、制订标准化预防流程。③强化因素：团队协作有待加强、监管机制有待健全。结论护理管理者应加强教育培训来提升手术室护士剖宫产术中低体温预防的认知和技能水平，完善设备资源和构建信息化评估与决策支持系统来促进低体温预防行为的落实；促进团队协作并通过信息化建设完成质量指标的收集与分析来强化质量管理，推动剖宫产术中低体温预防质量持续改进。

关键词: 剖宫产, 低体温, 手术室护士, 格林模式, 质性研究

FENG Linjia, HAN Xiaoyun, ZHANG Chenghuan, ZHANG Qingqing. A qualitative study on influencing factors of operating room nurses’ preventive behaviors against hypothermia during cesarean section[J]. Chinese Journal of Nursing, 2025, 60(10): 1190-1195.

冯霖佳, 韩小云, 张成欢, 张庆庆. 剖宫产术中护士低体温预防行为影响因素的质性研究[J]. 中华护理杂志, 2025, 60(10): 1190-1195.

Figures/Tables 2

References 18

[1]	普鹰, 张莹, 汤佳骏, 等. 腹腔镜手术患者术中低体温预测模型的构建及应用[J]. 中华护理杂志, 2019, 54(9):1308-1312. DOI
	Pu Y, Zhang Y, Tang JJ, et al. Establishment and validation of a risk prediction model for intraoperative hypothermia in patients undergoing laparoscopic surgery[J]. Chin J Nurs, 2019, 54(9):1308-1312. DOI
[2]	Thorburn PT, Monteiro R, Chakladar A, et al. Maternal temperature in emergency Caesarean section(MATES):an observational multicentre study[J]. Int J Obstet Anesth, 2021, 46:10296.
[3]	Jun JH, Chung MH, Jun IJ, et al. Efficacy of forced-air warming and warmed intravenous fluid for prevention of hypothermia and shivering during Caesarean delivery under spinal anaesthesia:a randomised controlled trial[J]. Eur J Anaesthesiol, 2019, 36(6):442-448.
[4]	Babiker Mohamed MA, Abdelwahab Abdelkarim WA, Salih Aabdeen MA, et al. Evidence-based clinical practice guidelines for the management of perioperative hypothermia:systematic review,critical appraisal,and quality assessment with the AGREE Ⅱ instrument[J]. Ann Med Surg, 2022, 79:103887.
[5]	Zhuo Q, Xu JB, Zhang J, et al. Effect of active and passive warming on preventing hypothermia and shivering during cesarean delivery:a systematic review and meta-analysis of randomized controlled trials[J]. BMC Pregnancy Childbirth, 2022, 22(1):720.
[6]	章明阳, 常后婵, 梁爱群, 等. 广东省85所医院手术室围手术期低体温管理的现状调查[J]. 中华护理杂志, 2020, 55(7):1039-1044. DOI
	Zhang MY, Chang HC, Liang AQ, et al. Investigation on the status of perioperative hypothermia management in 85 hospital operating rooms in Guangdong Province[J]. Chin J Nurs, 2020, 55(7):1039-1044. DOI
[7]	Aluri S, Wrench IJ. Enhanced recovery from obstetric surgery:a U.K. survey of practice[J]. Int J Obstet Anesth, 2014, 23(2):157-160. DOI PMID
[8]	Crosby R, Noar SM. What is a planning model? An introduction to PRECEDE-PROCEED[J]. J Public Health Dent, 2011, 71(Suppl 1):S7-S15.
[9]	Kim J, Jang J, Kim B, et al. Effect of the PRECEDE-PROCEED model on health programs:a systematic review and meta-analysis[J]. Syst Rev, 2022, 11(1):21.
[10]	朱丹玲, 周云仙. 护理文献中质性内容分析法的应用误区探讨[J]. 护理学杂志, 2018, 33(21):97-99.
	Zhu DL, Zhou YX. Methodology errors in qualitative content analysis in papers published in nursing journals[J]. J Nurs Sci, 2018, 33(21):97-99.
[11]	邢雪燕, 高志峰, 涂淑敏, 等. 手术室护士与麻醉护士围术期低体温防护知信行的调查研究[J]. 重庆医学, 2022, 52(8):1225-1229.
	Xing XY, Gao ZF, Tu SM, et al. Investigation on knowledge,attitude and practice of perioperative hypothermia prevention in operating room nurses and anesthesia nurses[J]. Chongqing Med, 2022, 52(8):1225-1229.
[12]	刘敏, 黄瑶, 杨悦来, 等. 基于临床实践指南的围术期低体温护理核心培训课程的建立[J]. 上海口腔医学, 2018, 27(5):501-503.
	Liu M, Huang Y, Yang YL, et al. Establishment of a core curriculum of inadvertent perioperative hypothermia nursing based on clinical practice guidelines[J]. Shanghai J Stomatol, 2018, 27(5):501-503.
[13]	李丽, 刘惠, 邵丽. PBL联合情境模拟教学对改善术中低体温护理的效果[J]. 上海护理, 2019, 19(1):57-60.
	Li L, Liu H, Shao L. Effect of PBL combined with situational simulation teaching on improving intraoperative hypothermia nursing[J]. Shanghai Nurs, 2019, 19(1):57-60.
[14]	谭彩姬, 陈丽红, 肖玉兰. 护士长授权赋能教育联合情景模拟教学法在术中低体温干预护理中的应用[J]. 齐鲁护理杂志, 2021, 27(8):119-121.
	Tan CJ, Chen LH, Xiao YL. Application of empowerment education of head nurses combined with scenario simulation teaching method in intraoperative hypothermia intervention nursing[J]. J Qilu Nurs, 2021, 27(8):119-121.
[15]	国家卫生健康委. 手术室医学装备配置标准[EB/OL]. (2024-04-28) [2024-10-15]. http://www.nhc.gov.cn/fzs/s7852d/202404/086bb13397d04ce98dc329d982342b50.shtml.
	National Health Commission. Medical equipment configuration standard for operating department[EB/OL]. (2024-04-28) [2024-10-15]. http://www.nhc.gov.cn/fzs/s7852d/202404/086bb13397d04ce98dc329d982342b50.shtml.
[16]	孔珊珊, 邓露, 申海艳, 等. 剖宫产产妇术中低体温风险预测模型的构建及应用效果研究[J]. 中华护理杂志, 2021, 56(2):165-171. DOI
	Kong SS, Deng L, Shen HY, et al. Establishment of a risk predictive model of maternal hypothermia during caesarean section and its application effect test[J]. Chin J Nurs, 2021, 56(2):165-171. DOI
[17]	Shen HY, Deng L, Kong SS, et al. Development and validation of a risk prediction scale for hypothermia during cesarean section:a prospective study[J]. Int J Nurs Stud Adv, 2021, 4:100054.
[18]	Koh W, Chakravarthy M, Simon E, et al. Perioperative temperature management:a survey of 6 Asia-Pacific countries[J]. BMC Anesthesiol, 2021, 21(1):205.