老年腹腔镜手术患者术中低体温发生与手术室护士专业认知及护理行为的相关性研究

王毅; 王少微; 袁莉; 武亮

doi:10.16766/j.cnki.issn.1674-4152.004232

老年腹腔镜手术患者术中低体温发生与手术室护士专业认知及护理行为的相关性研究

doi: 10.16766/j.cnki.issn.1674-4152.004232

王毅¹,
王少微²,
袁莉²,
武亮^1, ,

1.
河北北方学院附属第一医院手术室，河北张家口 075000
2.
河北北方学院附属第一医院麻醉科

基金项目:

河北省卫健委医学科学研究课题计划 20241638

详细信息

通讯作者:
武亮，E-mail：283876031@qq.com

中图分类号: R616.5 R473.6
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出版历程
- 收稿日期: 2025-03-11

The correlation among intraoperative hypothermia in elderly patients undergoing laparoscopic surgery and professional cognition, nursing behavior of operating room nurses

WANG Yi¹,
WANG Shaowei²,
YUAN Li²,
WU Liang^{1
, ,}

1.
Operating Room, the First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei 075000, China

摘要

摘要: 目的分析老年腹腔镜手术患者术中低体温发生与手术室护士专业认知及护理行为的相关性。方法回顾性分析2023年1月—2024年1月河北北方学院附属第一医院收治进行腹腔镜手术老年患者的临床资料，选取80名手术室护士为研究对象，通过行一般调查表、术中低体温专业认知现状量表、低体温护理行为量表、职业倦怠(修订Maslach倦怠量表)及安全文化态度问卷，采用logistic回归分析影响术中低体温发生的因素。结果术中低体温发生率为7.87%(70/890)；参与低体温老年患者的腹腔镜手术的护士有32例，纳入低体温组，其余纳入无低体温组。低体温组专业认知[(74.54±5.51)分]、护理行为[(30.78±2.64)分]、职业倦怠中的情感疲惫[(21.54±0.80)分]和成就感降低[(20.04±0.79)分]、安全文化态度[(93.80±4.02)分]得分均明显低于无低体温组[(96.38±4.53)分，P＜0.05]；逐步logistic回归分析显示，护士专业认知低、护理行为不良、情感疲惫、成就感降低、安全文化态度差均是老年腹腔镜手术患者术中发生低体温的危险因素(P < 0.05)；Pearson相关分析显示，手术室护士护理行为与专业认知、安全文化态度有相关性(r=0.446、0.351，P＜0.05)。结论手术室护士专业认知、护理行为、职业倦怠和安全文化态度是老年腹腔镜手术患者术中低体温发生的相关因素，应当给予手术室护士专业培训，提升其认知、行为水平。
- 腹腔镜手术 /
- 术中低体温 /
- 手术室护士 /
- 专业认知
Abstract: Objective To analyze the correlation between intraoperative hypothermia in elderly patients undergoing laparoscopic surgery and professional cognition and nursing behaviors of operating room nurses. Methods The clinical records of elderly patients undergoing laparoscopic surgery at the First Affiliated Hospital of Hebei North University from January 2023 to January 2024 were retrospectively analyzed. A total of 80 operating room nurses were selected as the research objects. General questionnaire, intraoperative hypothermia professional cognition scale, hypothermia nursing behavior scale, job burnout (revised Maslach burnout scale), and safety culture attitude questionnaire were performed. Logistic regression was used to identify risk factors for intraoperative hypothermia. Results The incidence of intraoperative hypothermia was 7.87% (70/890). A total of 32 nurses who participated in laparoscopic surgery involving elderly patients with hypothermia were assigned to the hypothermia group, while the remainder were assigned to the non-hypothermia group. The scores of professional cognition [(74.54±5.51) points], nursing behavior [(30.78±2.64) points], emotional exhaustion in job burnout [(21.54±0.80) points], decreased sense of achievement [(20.04±0.79) points], and safety culture attitude [(93.80±4.02) points] in the hypothermia group were significantly lower than those in the non-hypothermia group [(96.38±4.53) points, P < 0.05]. Stepwise logistic regression showed that low professional cognition of nurses, inadequate nursing behavior, emotional fatigue, reduced sense of achievement, and poor safety culture attitude were independent risk factors for intraoperative hypothermia in elderly patients undergoing laparoscopic surgery (P < 0.05). Pearson correlation analysis further showed that the nursing behaviors were positively correlated with both professional cognition and safety culture attitude (r=0.446, 0.351, P < 0.05). Conclusion Professional cognition, nursing behavior, job burnout, and safety culture attitude of operating room nurses are key factors influencing the occurrence of intraoperative hypothermia in elderly patients undergoing laparoscopic surgery. Strengthening professional training for operating room nurses may improve cognitive and behavioral performance and reduce the risk of intraoperative hypothermia.
- Laparoscopic surgery /
- Intraoperative hypothermia /
- Operating room nurse /
- Professional cognition
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表 1 老年腹腔镜手术患者术中发生低体温和未发生低体温事件的护士资料比较

Table 1. Comparison of baseline characteristics between nurses managing geriatric laparoscopic patients with and without intraoperative hypothermia events

组别	例数	性别[例(%)]		年龄(x±s，岁)	工作年限(x±s，年)	职称级别[例(%)]
组别	例数	男性	女性	年龄(x±s，岁)	工作年限(x±s，年)	护士	护师	主管护士及以上
低体温组	32	1(3.13)	31(96.87)	29.35±3.78	6.63±1.78	18(56.25)	10(31.25)	4(12.50)
无低体温组	48	2(4.17)	46(95.83)	30.21±3.58	7.08±1.69	20(41.67)	21(43.75)	7(14.58)
统计量		0.130^a		1.029^b	1.142^b	1.125^a
P值		0.719		0.307	0.257	0.261

组别	例数	受教育程度[例(%)]		专业认知(x±s，分)	护理行为(x±s，分)	职业倦(x±s，分)			安全文化态度(x±s，分)
组别	例数	大专	本科及以上	专业认知(x±s，分)	护理行为(x±s，分)	情感疲惫	人格解体	成就感降低	安全文化态度(x±s，分)
低体温组	32	15(46.88)	17(53.12)	74.54±5.51	30.78±2.64	21.54±0.80	7.89±0.70	20.04±0.79	93.80±4.02
无低体温组	48	18(37.50)	30(62.50)	77.62±4.95	32.70±2.53	20.96±0.78	7.76±0.72	19.01±0.75	96.38±4.53
统计量		0.696^a		2.605^b	3.268^b	3.225^b	0.800^b	5.891^b	2.608^b
P值		0.404		0.011	0.002	0.002	0.426	＜0.001	0.011
注：^a为χ²值，^b为t值。

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表 2 老年腹腔镜手术患者术中发生低体温的因素分析

Table 2. Analysis of risk factors for intraoperative hypothermia in elderly patients undergoing laparoscopic surgery

因素	B	SE	Waldχ²	P值	OR值	95% CI
专业认知	1.325	0.450	8.670	0.003	3.762	1.557~9.088
护理行为	1.129	0.391	8.337	0.004	3.093	1.437~6.655
情感疲惫	0.598	0.184	10.563	0.001	1.818	1.268~2.608
成就感降低	0.749	0.292	6.580	0.011	2.115	1.193~3.748
安全文化态度	0.428	0.172	6.192	0.013	1.534	1.095~2.149

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表 3 手术室护士护理行为与专业认知、职业倦怠、安全文化态度的相关性

Table 3. Correlation between nursing behavior and professional cognition, job burnout and safety culture attitude of operating room nurses

指标	专业认知	情感疲惫	成就感降低	安全文化态度
r值	0.446	-0.085	-0.132	0.351
P值	0.003	0.376	0.318	0.010

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