背景：全世界的人们都在关注气候变化的可能性，微塑料,空气污染,以及影响人类健康的极端天气。各国正在采取措施减少对环境的影响。护士起着至关重要的作用，主要通过绿色团队，在促进可持续做法和尽量减少卫生保健设施的环境足迹的过程中。尽管有这方面的知识，评估护士的环境意识和行为，包括他们面临的障碍，对于改善可持续的医疗保健实践至关重要。
目的：分析护士的环境意识和行为，尤其是护士领导，作为绿色团队的成员，并确定在创造可持续环境方面需要改进的领域。
方法：进行了一项序贯混合方法研究，以调查西班牙护士。这项研究利用了在线调查和访谈，包括参与者的观察。进行了一项在线调查，以收集有关环境意识和行为的定量数据。对特定地区的环境护士进行了定性访谈，专注于安达卢西亚，西班牙。
结果：大多数接受调查的护士（N=314）表现出中等的环境意识（70.4％），但他们在工作场所的环境行为和活动是有限的(52.23%的参与者很少执行相关的行动,35.03%表示这样做很困难)。表现出更高水平的环境意识的护士更有可能从事可持续的行为，如减少浪费，节能，和环保决策(p<0.05)。此外,调整后的模型表明，护士工作场所的环境行为和活动取决于其工作外环境行为的频率以及可持续知识（p<0.01）。定性研究的结果（N=10）强调了他们与环境可持续性相关的日常实践中的某些局限性，包括缺乏时间,缺乏垃圾箱和大流行。此外,必须改善护理领导和绿色团队的可持续环境行为。
结论：这项研究表明，大多数护士都有足够的知识，态度，以及与工作场所内外的环境可持续性相关的行为。局限性与他们在工作之外的知识和行为有关。这项研究还强调了护士在工作场所尝试进行适当的环境行为时所面临的障碍和困难。基于这些发现,应制定由护士和绿色团队领导的干预措施，以促进护士的可持续行为，并解决本研究中发现的障碍和局限性。
BACKGROUND: People worldwide are concerned with the possibility of climate change, microplastics, air pollution, and extreme weather affecting human health. Countries are implementing measures to reduce environmental impacts. Nurses play a vital role, primarily through Green Teams, in the process of promoting sustainable practices and minimizing the environmental footprint of health care facilities. Despite existing knowledge on this topic, assessing nurses\' environmental awareness and behavior, including the barriers they face, is crucial with regard to improving sustainable health care practices.
OBJECTIVE: To analyze the environmental awareness and behavior of nurses, especially nurse leaders, as members of the Green Team and to identify areas for improvement with regard to the creation of a sustainable environment.
METHODS: A sequential mixed-method study was conducted to investigate Spanish nurses. The study utilized an online survey and interviews, including participant observation. An online survey was administered to collect quantitative data regarding environmental awareness and behavior. Qualitative interviews were conducted with environmental nurses in specific regions, with a focus on Andalusia, Spain.
RESULTS: Most of the surveyed nurses (N = 314) exhibited moderate environmental awareness (70.4%), but their environmental behavior and activities in the workplace were limited (52.23% of participants rarely performed relevant actions, and 35.03% indicated that doing so was difficult). Nurses who exhibited higher levels of environmental awareness were more likely to engage in sustainable behaviors such as waste reduction, energy conservation, and environmentally conscious purchasing decisions (p < 0.05). Additionally, the adjusted model indicated that nurses\' environmental behavior and activities in the workplace depend on the frequency of their environmental behaviors outside work as well as their sustainable knowledge (p < 0.01). The results of the qualitative study (N = 10) highlighted certain limitations in their daily practices related to environmental sustainability, including a lack of time, a lack of bins and the pandemic. Additionally, sustainable environmental behavior on the part of nursing leadership and the Green Team must be improved.
CONCLUSIONS: This study revealed that most nurses have adequate knowledge, attitudes, and behaviors related to environmental sustainability both inside and outside the workplace. Limitations were associated with their knowledge and behaviors outside of work. This study also highlighted the barriers and difficulties that nurses face in their attempts to engage in adequate environmental behaviors in the workplace. Based on these findings, interventions led by nurses and the Green Team should be developed to promote sustainable behaviors among nurses and address the barriers and limitations identified in this research.
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