The reflections of global climate change on wound and ostomy care: awareness, experiences, and strategies in nursing practices

Abstract

This study explores nurses' perceptions of how climate change may impact wound and ostomy care, focusing on their awareness, experiences, and perceived challenges in clinical practice. It also aims to contribute to the development of sustainable care strategies in nursing. A sequential mixed-methods design was used to collect quantitative data from 95 certified wound and ostomy nurses and conduct four focus group discussions with 23 nurses. The study followed the ‘Global Model for Operationalizing Sustainability in Nursing’, and qualitative data were analysed using thematic analysis. Nurses demonstrated moderate-to-high awareness of climate change, with the highest score in the ‘expectations’ subdimension (76.78 ± 10.21). Most nurses (96.9%) believed that rising temperature and humidity would increase wound infections, and 93.8% anticipated adverse effects on skin integrity based on clinical experience. Regarding stoma complications, 94.8% identified fungal infections and 89.6% reported peristomal moisture-related damage as significant concerns. Four key themes emerged: (1) Structural factors (Cultural Bridging and Resource Evaluation), (2) Process (Nurses' Actions and Educational Activities), (3) Outcome (Observed Changes and Professional Adaptation), and (4) Future perspective (Nurses' Leadership and Sustainability). This study reveals nurses' perceptions that climate change may affect wound and ostomy care. While based on subjective reports rather than empirical data, these findings reflect common clinical concerns. Highlighting the need for climate-focused education and planning, the study calls for greater integration of environmental awareness into nursing practice to support adaptive, patient-centred care. © 2025 Elsevier B.V., All rights reserved.