Factors Influencing the Preventive Behaviors of Nursing Staff in Tertiary General Hospitals Regarding Respiratory Infectious Diseases in the Context of Healthy China: A Qualitative Study Based on the COM- B Framework

Objective: The objective of this study was to investigate the factors that influence nurses' preventive behaviors during the pandemic of respiratory infectious diseases (RIDs) by utilizing capability, opportunity, and motivation as determinants of behavior(COM-B) theoretical frameworks. Background: Nurses’preventive actions are crucial for mitigating the impact of respiratory infectious diseases (RIDs) and facilitating the recovery process for affected patients. Understandingthe determinants that influence nurses' preventive behaviors in the context of health promotion in China is essential. Research suggests that utilizing a theoretical framework can enhance the understanding of behavioral dynamics, with the COM-B framework being a particularly well-regarded methodology. Methods: Semistructured interviews were conducted with eleven nursing managers who possess expertise in emergency care for respiratory infectious diseases. The verbatim transcripts of these interviews were subjected to thematic analysis. The findings were subsequently aligned with the COM-B framework. Results: A total of ten principal themes were identified: capability, which includes cognitive levels of risk identification, skills related to risk assessment, emergency response capabilities, and familiarity with disinfection and infection control technologies; opportunity, which encompasses mechanisms of reward and punishment, social responsibility, and psychological resilience; and motivation, which involves personal experiences, self-efficacy, policy regulations, and professional standards. Conclusions: A comprehensive analysis identified ten factors that influence the preventive behaviors of nurses. This study introduces two additional factors, namely, skills related to risk identification and systems of rewards and punishments, which contribute to a deeper understanding of nurses' preventive practices. The preventive behaviors exhibited by nurses are shaped by personal attributes as well as broader institutional and societal contexts. Therefore, interventions designed to enhance these behaviors must consider these multifaceted influences. Furthermore, promptly addressing the negative repercussions of the pandemic on the capability factors that affect nurses' preventive behaviorsis essential.