Int J Nurs Stud Adv. 2026 Aug 6;11:100652. doi: 10.1016/j.ijnsa.2026.100652. eCollection 2026 Dec.
ABSTRACT
BACKGROUND: Personal protective equipment (PPE) restricts heat dissipation from the body, and many healthcare workers experience heat-stress-related physical discomfort, including dizziness, headaches, fatigue, and excessive sweating, during clinical duties. Such thermal strain may compromise not only an individual’s well-being but also work performance and patient safety. Despite these concerns, evidence from routine clinical practice, particularly for PPE commonly used in nursing care, remains limited.
OBJECTIVE: This study aimed to investigate the effects of wearing PPE during simulated nursing care on physiological and psychological responses and to compare gowns and aprons.
METHODS: This study included 11 young women in simulated nursing care wearing PPE in three conditions: control, aprons, and gowns. The ear canal temperature, skin temperature, sweat rate, and subjective responses were evaluated.
RESULTS: Changes in ear canal temperature did not differ significantly among PPE conditions. PPE type and time interactions to changes in forearm skin temperature were observed (F(26,260) = 19.2, p < 0.001, partial η² = 0.66). The forearm skin temperature during nursing care was significantly higher in the gown condition than in the control and apron conditions in multiple comparisons. The sweat rate during simulated nursing care was significantly higher in the gown condition than in the control condition (p < 0.01, r = 0.91). The gown condition was associated with higher thermal sensations (p < 0.05, r = 0.87), more statistically significant thermal discomfort (p < 0.05, r = 0.87), and a stronger sweat sensation (p < 0.05, r = 0.87) than the control condition.
CONCLUSIONS: The simulated nursing care performed while wearing PPE for 20 min in this study did not produce enough heat load to affect the core temperature. However, the thermal sensation and discomfort subjectively increased with the heightened sweat rate in the gown condition. The study findings reinforce the need for evidence-based guidelines aimed at protecting nurses from heat stress associated with the use of protective clothing. Furthermore, this study provides quantitative evidence indicating that PPE type influences the magnitude of these responses, underscoring the necessity of considering PPE type when developing practical recommendations.
REGISTRATION: UMIN Clinical Trials Registry (UMIN000054105), Registered 01/05/2024, first recruitment date 27/05/2024.
PMID:42633357 | PMC:PMC13499407 | DOI:10.1016/j.ijnsa.2026.100652
