Knowledge, behaviours, practices, and expectations regarding climate change and environmental sustainability among health workers in France: a multicentre, cross-sectional study

IF 24.1 1区 医学 Q1 ENVIRONMENTAL SCIENCES Lancet Planetary Health Pub Date : 2024-06-01 DOI:10.1016/S2542-5196(24)00099-8
Jérémy Guihenneuc PhD , Guillaume Cambien PhD , Pauline Blanc-Petitjean PhD , Emeline Papin , Noëlle Bernard MD , Bernard Jourdain , Isabelle Barcos , Cécile Saez , Prof Antoine Dupuis PhD , Sarah Ayraud-Thevenot PhD , Prof Virginie Migeot PhD
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Abstract

Background

Faced with climate change, hospitals are confronted with a dual challenge. On one hand, they need to embark on a far-reaching ecological transformation to reduce their contribution to greenhouse gas emissions and other environmental impacts; on the other hand, they need to limit the effects of climate change on their activities. We aimed to evaluate the knowledge, behaviours, practices, and expectations of health workers in French hospitals regarding climate change and environmental sustainability.

Methods

This multicentre, cross-sectional study was carried out in six French hospitals from June 1, 2021 to Dec 31, 2022. All health workers at the hospitals were eligible to participate and were recruited through internal publicity. We designed a structured questionnaire consisting of five parts: participant characteristics, knowledge and perceptions of climate change, pro-environmental behaviours, practices concerning environmental sustainability actions, and expectations. A multilevel logistic regression model was used to evaluate associations between the knowledge, behaviours, and practices of health workers and the characteristics of the health workers and hospitals.

Findings

Of 57 034 health workers across the six hospitals, 4552 (8·0%) participated in the study. Of those for whom gender data were available, 3518 (78·2%) participants were women and 979 (21·8%) were men. Participants considered energy consumption (71·0%) and waste and discharges related to medical activities (55·6%) and non-medical activities (50·2%) to be the three activities with the greatest environmental impact. On a scale of 1 (not a priority) to 10 (high priority), the median rating attributed by the participants to the commitment of their hospitals to ecological transformation was 5·0 (IQR 3·0–6·0). 1079 (23·7%) of 4552 participants had already initiated at least one environmental sustainability action in their hospital. Barriers reported by participants to the implementation of environmental sustainability-related projects were the lack of dedicated time (40·4%), hierarchical support (32·5%), methodological support (28·9%), and access to training (23·7%). The presence of a sustainable development steering committee, especially one with more than 5 years of activity, was positively associated with health workers feeling better informed about the ecological transformation of their hospital (adjusted odds ratio 1·78 [95% CI 1·29–2·45]), having better knowledge of the environmental impacts of their hospital (1·83 [1·32–2·53]), and initiating a larger number of environmental sustainability actions (1·74 [1·33–2·29]).

Interpretation

We showed that health workers in French hospitals seem to be committed to the ecological transformation of their workplaces, and identified some drivers and barriers to further support these essential transformations. There is an urgent need to bolster training for all health workers, enhance structural frameworks within hospitals, and encourage future interdisciplinary research on the vulnerability of health-care facilities to climate change.

Funding

The University Hospital of Poitiers.

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法国卫生工作者对气候变化和环境可持续性的认识、行为、做法和期望:一项多中心横断面研究
背景面对气候变化,医院面临着双重挑战。一方面,医院需要进行意义深远的生态转型,以减少温室气体排放和其他环境影响;另一方面,医院需要限制气候变化对其活动的影响。我们的目的是评估法国医院卫生工作者对气候变化和环境可持续性的认识、行为、实践和期望。方法这项多中心横断面研究于 2021 年 6 月 1 日至 2022 年 12 月 31 日在法国六家医院进行。医院的所有医护人员都有资格参与,并通过内部宣传招募。我们设计了一份结构化问卷,包括五个部分:参与者特征、对气候变化的认识和看法、支持环保的行为、有关环境可持续发展行动的实践以及期望。研究采用多层次逻辑回归模型来评估医务工作者的知识、行为和实践与医务工作者和医院特征之间的关联。在有性别数据的参与者中,女性有 3518 人(78-2%),男性有 979 人(21-8%)。参与者认为能源消耗(71-0%)以及与医疗活动(55-6%)和非医疗活动(50-2%)相关的废物和排放物是对环境影响最大的三种活动。在 1 分(不优先)到 10 分(高度优先)的评分中,参与者对其医院在生态转型方面的承诺的中位数为 5-0(IQR 3-0-6-0)。在 4552 名参与者中,有 1079 人(23-7%)已在其所在医院启动了至少一项环境可持续发展行动。参与者表示,实施环境可持续发展相关项目的障碍是缺乏专门时间(40-4%)、上级支持(32-5%)、方法支持(28-9%)和培训机会(23-7%)。可持续发展指导委员会的存在,尤其是成立时间超过 5 年的委员会的存在,与医护人员对其所在医院的生态转型更了解(调整后的几率比 1-78 [95% CI 1-29-2-45])、对其所在医院的环境影响更了解(1-83 [1-32-2-53])以及发起更多环境可持续发展行动(1-74 [1-33-2-29])呈正相关。释义我们发现,法国医院的医务工作者似乎致力于其工作场所的生态转型,并确定了进一步支持这些重要转型的一些驱动因素和障碍。当务之急是加强对所有医护人员的培训,强化医院内部的结构框架,并鼓励未来就医疗设施对气候变化的脆弱性开展跨学科研究。
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来源期刊
CiteScore
28.40
自引率
2.30%
发文量
272
审稿时长
8 weeks
期刊介绍: The Lancet Planetary Health is a gold Open Access journal dedicated to investigating and addressing the multifaceted determinants of healthy human civilizations and their impact on natural systems. Positioned as a key player in sustainable development, the journal covers a broad, interdisciplinary scope, encompassing areas such as poverty, nutrition, gender equity, water and sanitation, energy, economic growth, industrialization, inequality, urbanization, human consumption and production, climate change, ocean health, land use, peace, and justice. With a commitment to publishing high-quality research, comment, and correspondence, it aims to be the leading journal for sustainable development in the face of unprecedented dangers and threats.
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