# Knowledge, attitude, and practice toward hypothermia in severe trauma patients among healthcare professionals in emergency departments and trauma centers in Shanghai: a cross-sectional study

## TL;DR

This study assesses healthcare professionals' knowledge, attitudes, and practices regarding hypothermia management in severe trauma patients in Shanghai hospitals.

## Contribution

The study identifies gaps in hypothermia management practices and highlights the need for targeted training among emergency and trauma center staff.

## Key findings

- Healthcare professionals in Shanghai show positive attitudes but lack sufficient knowledge and practice in hypothermia management.
- Knowledge significantly correlates with attitudes and practices, suggesting a need for education to improve clinical outcomes.
- Handling patients and high patient volume directly and indirectly affect knowledge, attitudes, and practices in hypothermia management.

## Abstract

Hypothermia is a critical component of the trauma triad of death and has been shown to increase morbidity and mortality among severely injured patients. Early recognition and effective temperature management are essential to improving outcomes, yet clinical knowledge and implementation remain inconsistent. Understanding healthcare professionals’ preparedness for hypothermia management is therefore of great importance. To examine the knowledge, attitudes, and practices (KAP) of medical staff in emergency departments and trauma centers in Shanghai regarding the management of hypothermia in patients with severe trauma.

This cross-sectional study enrolled doctors, nurses, and technicians within their emergency and trauma centers from 13 tertiary and 2 secondary hospitals in Shanghai between April and May 2023. Demographic characteristics and KAP scores were collected through a self-made questionnaire.

A total of 439 participants were enrolled, 192 (43.7%) were aged between 26 and 34 years, 365 (83.1%) were females, of whom 426 (97.0%) were nurses. The mean knowledge, attitude, and practice scores were 13.00 [11.00, 17.00] (possible range: 0–26), 30.00 [28.00, 34.00] (possible range: 7–35), and 28.00 [25.00, 33.00] (possible range: 9–45), respectively. Pearson correlation analysis revealed significant positive relationships between knowledge and attitude (r = 0.419, p < 0.001), knowledge and practice (r = 0.490, p < 0.001), and attitude and practice (r = 0.337, p < 0.001). Path analysis demonstrated that handling patients (β = −0.206, p < 0.001) and patient volume (β = 0.178, p = 0.001) had direct effects on knowledge. Knowledge had direct effect on attitude (β = 0.357, p < 0.001) and practice (β = 0.480, p < 0.001). Furthermore, handling patients (β = −0.074 and −0.097, both p < 0.001) and patient volume (β = 0.064, p = 0.002 and β = 0.085, p = 0.001) had indirect effects on attitude and practice, respectively.

Medical staff in Shanghai’s emergency and trauma centers generally exhibit positive attitudes toward hypothermia management in severe trauma patients, but significant gaps remain in knowledge and practical application. These deficiencies suggest an urgent need for targeted educational interventions, incorporating evidence-based training, hands-on clinical experiences, and interdisciplinary collaboration to improve knowledge, practice, and patient outcomes.