BMC Research Notes (Jul 2025)
Mental fatigue of operating room nurses and its relationship with missed perioperative nursing care: a descriptive-analytical study
Abstract
Abstract Introduction Mental fatigue is a psychological condition characterised by diminished alertness, impaired cognitive functioning, heightened error rates, and overall decreased performance. missed perioperative nursing care diminishes patient safety and increases the likelihood of adverse incidents. The correlation between mental fatigue among operating room nurses and missed perioperative care, despite its critical role in ensuring high-quality care, has been insufficiently investigated, particularly in Iranian hospitals where nurses face chronic understaffing, excessive workloads, and limited institutional support. Materials and methods A cross-sectional research was undertaken in 2023, including 385 operating room nurses working in Hospitals affiliated with Universities of Medical Sciences and Health Services in East Azarbaijan, Iran. Inclusion criteria were a minimum of six months’ work experience, holding an associate degree or higher in nursing or operating room disciplines, and currently having an active scrub or circulating role in the operating room. Exclusion criteria included unwillingness to participate, inactivity in scrub or circulating roles during the past month, diagnosed mental illness, or use of antidepressant medication. Stratified random sampling was used to select the participants. A demographic questionnaire, Johansson’s mental fatigue questionnaire, and Kalisch’s MISSCARE Survey-Operating Room questionnaire were used to collect data. The validity and reliability of both instruments were confirmed, with Cronbach’s alpha values of 0.85 for the mental fatigue questionnaire and 0.78 for the MISSCARE scale. Data were analyzed using SPSS version 16, employing descriptive statistics, non-parametric tests (Mann–Whitney, Kruskal–Wallis), correlation analyses (Spearman, Kendall), and quantile regression. Results The results of the present study showed that 77.9% of the participants experienced varying levels of mental fatigue, ranging from mild to severe. Operating room nurses scored an average of 102.03 (out of 132) on the missed perioperative nursing care scale, indicating a moderate level of missed care. The correlation analysis revealed a positive and statistically significant association between the mental fatigue of operating room nurses and the missed perioperative nursing care (p = 0.001; r = 0.319). Discussion Our operating room nurses reported a mild level of mental fatigue and a moderate level of missed perioperative nursing care. Given the implications of fatigue in operating room nurses, this likely impacts the standard of care provided prior to, during, and after surgery. Nursing authorities should regularly evaluate the mental fatigue experienced by operating room nurses, along with the reasons that contribute to it, and the frequency of missed perioperative nursing care in clinical environments. Implementing targeted interventions such as resilience training programs, improving nurse-to-patient ratios, and optimizing shift schedules may help reduce fatigue and enhance care quality.
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