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Effect of an Educational Intervention on Operating Room Nurses' Caring Behaviors During the COVID-19 Pandemic: A
Reza Mohebbi1,2, Mahboobeh Afzali3, Saeed Babajani-Vafsi4
1Department of Nursing, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.
Background And Objectives:
During outbreaks of acute respiratory infections (eg, COVID-19), operating room nurses face heightened exposure risks due to aerosol-generating procedures. Adherence to evidence-based caring behaviors is critical for both patient and staff safety, yet structured educational interventions in this high-stakes setting remain underexplored. This study aimed to evaluate the impact of a tailored, evidence-based education program on the caring behaviors of operating room nurses during such outbreaks.
Materials And Methods:
A quasi-experimental study was conducted from 2021 to 2022 with operating room nurses from four military hospitals in Tehran, Iran. Participants were allocated to intervention (n = 40) and control (n = 40) groups via convenience sampling. The intervention group received a structured, evidence-based education program focusing on infection prevention and patient safety protocols, delivered via a blended learning approach (asynchronous scientific posters and interactive webinars). Caring behaviors were assessed at baseline and post-intervention using the validated Caring Behaviors of Operating Room Nurses Questionnaire (CBIONQ; 21 items, score range: 21-105). Data were analyzed using paired and independent t-tests, with Cohen's d for effect sizes and Bonferroni correction for multiple domain-specific comparisons (adjusted α = 0.01).
Results:
At baseline, no significant difference existed between groups (p = 0.208). Post-intervention, caring behavior scores in the intervention group significantly increased from 57.20 ± 5.41 to 74.22 ± 8.39 (p < 0.001; Cohen's d = 2.77, 95% CI: 14.84 to 19.20), while the control group showed no significant change (55.65 ± 5.51 to 57.12 ± 6.39; p = 0.253, Cohen's d = 0.12). Domain-specific analyses revealed significant improvements across all five CBIONQ subscales (p < 0.001; Bonferroni-corrected α = 0.01), with the largest effect observed in the knowledge of surgical care domain (Cohen's d = 2.17).
Conclusion:
This study demonstrated significant improvements in self-reported caring behavior scores among operating room nurses following an evidence-based blended education program. However, given the quasi-experimental design, reliance on self-reported data, and absence of long-term follow-up, these findings should be interpreted as enhanced perceived competency rather than confirmed sustained behavioral change. Future research employing objective observational measures and delayed assessments is warranted to evaluate long-term sustainability.
