Environmental Awareness and Sustainable Behavior in the Nursing Field: A Scoping Review Based on Nola Pender’s Theory
DOI:
https://doi.org/10.5294/aqui.2025.25.4.5Keywords:
Environmentalism, nursing, practical nursing, health promotion, reviewAbstract
Introduction: Climate change is a global threat that impacts health, well-being, and healthcare systems. In this context, nursing holds a key role in promoting health and environmental sustainability. Objective: To map the existing evidence related to environmental awareness and sustainable behavior in nursing practice from the perspective of Nola Pender’s health promotion theory. Materials and Methods: A scoping review following the guidelines of Arksey and O’Malley and the Joanna Briggs Institute. The search used the following key terms: “Nursing” AND “Environmental Sustainability” AND “Sustainable Behaviors” in PubMed and Scopus. Articles in English and Spanish from the last five years were included. Preselection was based on the reading of the title, abstract, and introductory text; the selected studies covered areas of nursing practice. Results: Seven articles from Africa, Asia, and Europe met the criteria of this review, of which five were quantitative, one was qualitative, and one was mixed. Pender’s theory applied to nursing and environmental sustainability highlights the influence of cognitive, interpersonal, and environmental factors on nurses’ pro-ecological behavior. The environmental awareness of nursing professionals is a key factor in the adoption of sustainable practices; however, there are barriers that hinder the effective implementation of such practices. Conclusions: The findings highlight the importance of measuring and improving attitudes toward sustainability with validated tools, which would favor a sustainable and efficient work environment.
Downloads
References
Berger S, Wyss AM. Measuring Pro-Environmental Behavior Using the Carbon Emission Task. J Environ Psychol [Internet]. 2021; 75:1-10. DOI: https://doi.org/10.1016/j.jenvp.2021.101613
Ripple WJ, Wolf C, Newsome TM, Barnard P, Moomaw WR. World Scientists’ Warning of a Climate Emergency. BioScience [Internet]. 2019;(12):149-1155. DOI: https://doi.org/10.1093/biosci/biz088
Adamopoulos I, Frantzana A, Adamopoulou J, Syrou N. Climate Change and Adverse Public Health Impacts on Human Health and Water Resources. Env Sci Proc [Internet]. 2023;26(1):1-6. DOI: https://doi.org/10.3390/environsciproc2023026178
Agache I, Sampath V, Aguilera J, Akdis C, Akdis M, Barry M, et al. Climate Change and Global Health: A Call to More Research and More Action. Allergy [Internet]. 2022;77(5):1389-407. DOI: https://doi.org/10.1111/all.15229
Kaur R, Pandey P. Air Pollution, Climate Change, and Human Health in Indian Cities: A Brief Review. Front Sustain Cities [Internet]. 2021;3:1-18. DOI: https://doi.org/10.3389/frsc.2021.705131
Xu C, Kohler TA, Lenton TM, Svenning JC, Scheffer M. Future of the Human Climate Niche. Proc Natl Acad Sci [Internet]. 2020; 117(21):11350-5. DOI: https://doi.org/10.1073/pnas.1910114117
Campbell-Lendrum D, Neville T, Schweizer C, Neira M. Climate change and health: three grand challenges. Nat Med [Internet]. 2023;29(7):1631-8. DOI: https://doi.org/10.1038/s41591-023-02438-w
Rocque RJ, Beaudoin C, Ndjaboue R, Cameron L, Poirier-Bergeron L, Poulin-Rheault RA, Fallon C, Tricco AC, Witteman HO. Health Effects of Climate Change: An Overview of Systematic Reviews. BMJ Open [Internet]. 2021;11(6):1-14. DOI: https://doi.org/10.1136/bmjopen-2020-046333
Oyarzún G M, Valdivia C G. Impactos en la salud de la contaminación del aire. Rev Chil Enferm Respir [Internet]. 2021;37(2):103-6. DOI: https://doi.org/10.4067/s0717-73482021000200103
Romanello M, Di Napoli C, Drummond P, Green C, Kennard H, Lampard P, et al. The 2022 Europe Report of the Lancet Countdown on Health and Climate Change: Towards a Climate Resilient Future. Lancet [Internet]. 2022:1-87. DOI: https://doi.org/10.1016/s2468-2667(22)00197-9
Organización de las Naciones Unidas. Agenda 2030 y los Objetivos de Desarrollo Sostenible: Una oportunidad para América Latina y el Caribe [Internet]. Nueva York: ONU; 2016. 48 p. https://www.agcid.gob.cl/images/centro_documentacion/AGENDA_2030_y_los_ODS.pdf
Consejo Internacional de Enfermeras. Enfermeras, cambio climático y salud [Internet]. Ginebra: [editorial desconocido]; 2018. 7 p. https://www.icn.ch/sites/default/files/2023-04/PS_E_Nurses_climate%20change_health_Sp_0.pdf
Mohamed MA, Ghallab E, Hassan RA, Amin SM. Sustainability Consciousness among Nursing Students in Egypt: A Cross-Sectional Study. BMC Nurs [Internet]. 2024;23(1):1-12. DOI: https://doi.org/10.1186/s12912-024-01990-1
Iira T, Ruth M, Hannele T, Jouni J, Lauri K. Finnish Nurses’ Perceptions of the Health Impacts of Climate Change and Their Preparation to Address Those Impacts. Nurs Forum [Internet]. 2021;56(2):365-71. DOI: https://doi.org/10.1111/nuf.12540
Ward A, Heart D, Richards C, Bayliss LT, Holmes M, Keogh S, Best O. Reimagining the Role of Nursing Education in Emissions Reduction. Teach Learn Nurs [Internet]. 2022;17(4):410-6. DOI: https://doi.org/10.1016/j.teln.2022.02.003
Álvarez-Nieto C, Álvarez-García C, Parra-Anguita L, Sanz-Martos S, López-Medina IM. Effectiveness of Scenario-Based Learning and Augmented Reality for Nursing Students’ Attitudes and Awareness Toward Climate Change and Sustainability. BMC Nurs [Internet]. 2022;21(1):1-9. DOI: https://doi.org/10.1186/s12912-022-01023-9
Consejo Internacional de Enfermeras. Competencias centrales para la enfermería de catástrofes. Versión 2.0 [Internet]. Ginebra: [editorial desconocido]; 2019. 12 p. https://www.icn.ch/sites/default/files/2023-04/ICN_Disaster-Comp-Report_ES_WEB.pdf
Véliz-Rojas L, González-Geraldo AM, Alballay Torres A, Abarca Carvajal M, Leiva Arancibia C, Abarca Vivanco C. Una propuesta para incorporar el fenómeno de crisis ambiental global en la formación profesional de pregrado en enfermería. Cienc Enferm [Internet]. 2023;29:1-12. DOI: https://doi.org/10.29393/ce29-13uplc60013
Yeboah EA, Adegboye AR, Kneafsey R. Nurses’ Perceptions, Attitudes, and Perspectives in Relation to Climate Change and Sustainable Healthcare Practices: A Systematic Review. J Clim Chang Health [Internet]. 2023;16:1-7. DOI: https://doi.org/10.1016/j.joclim.2023.100290
Barreto Cardoso R, Pereira Caldas C, Gomes Brandão MA, Alfradique de Souza P, Ferreira Santana R. Healthy Aging Promotion Model Referenced in Nola Pender’s Theory. Rev Bras Enferm [Internet]. 2022;75(1):1-9. DOI: https://doi.org/10.1590/0034-7167-2020-0373
Pender NJ, Murdaugh CL, Parsons MA. Health Promotion in Nursing Practice. 7th ed. Boston: Pearson; 2015
Lenzen M, Malik A, Li M, Fry J, Weisz H, Pichler PP, et al. The Environmental Footprint of Health Care: A Global Assessment. Lancet Planet Health [Internet]. 2020;4(7):271-9. DOI: https://doi.org/10.1016/s2542-5196(20)30121-2
Salud sin daño. Chile: Ficha informativa sobre emisiones del sector de la salud [Internet]. [lugar desconocido: editorial desconocido]; 2015. https://accionclimaticaensalud.org/fact-sheets/es/Español%20-%20Chile
Arksey H, O’Malley L. Scoping Studies: Towards a Methodological Framework. Int J Soc Res Methodol [Internet]. 2005;8(1):19-32. DOI: https://doi.org/10.1080/1364557032000119616
Peters MDJ, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil H. Chapter 11: Scoping Reviews (2020 version). In: Aromataris E, Munn Z, editors. JBI Manual for Evidence Synthesis. Adelaide: Joanna Briggs Institute; 2020. https://doi.org/10.46658/JBIMES-20-12
Atalla AD, Mostafa WH, Ali MS. Inspiring nurses’ sustainability mindset: Exploring the Mediating Role of Organizational Culture on the relationship between Pro-social Leader behaviors and nurses’ sustainability consciousness. BMC Nurs [Internet]. 2024;23(1):1-14. DOI: https://doi.org/10.1186/s12912-024-02314-z
Bartoli D, Petrosino F, Midolo L, Pucciarelli G, Trotta F. Critical Care Nurses’ Experiences on Environmental Sustainability: A Qualitative Content Analysis. Intensive Crit Care Nurs [Internet]. 2024:1-9. DOI: https://doi.org/10.1016/j.iccn.2024.103847
Chung SJ, Jang SJ, Lee H. Validation of the Sustainability Attitudes in Nursing Survey-2 for Nurses: A Cross-Sectional Study. Nurse Educ Pr [Internet]. 2024;75:1-7. DOI: https://doi.org/10.1016/j.nepr.2024.103898
Chung SJ, Lee H, Jang SJ. Factors Affecting Environmental Sustainability Attitudes among Nurses – Focusing on Climate Change Cognition and Behaviours: A Cross‐Sectional Study. J Adv Nurs [Internet]. 2024:1-12. DOI: https://doi.org/10.1111/jan.16205
Li M, Gong Z, Gilal FG, Van Swol LM, Xu J, Li F. The Moderating Role of Ethical Leadership on Nurses’ Green Behavior Intentions and Real Green Behavior. BioMed Res Int [Internet]. 2021;1-7. DOI: https://doi.org/10.1155/2021/6628016
Luque-Alcaraz OM, Aparicio-Martínez P, Gomera A, Vaquero-Abellán M. The Environmental Awareness of Nurses as Environmentally Sustainable Health Care Leaders: A Mixed Method Analysis. BMC Nurs [Internet]. 2024;23(1):1-12. DOI: https://doi.org/10.1186/s12912-024-01895-z
Moustafa Saleh MS, Elsabahy HE, Abdel-Sattar SA, Abd-Elhamid ZN, Al Thobaity A, et al. Fostering Green Transformational Leadership: The Influence of Green Educational Intervention on Nurse Managers’ Green Behavior and Creativity. BMC Nurs [Internet]. 2024;23(1):1-15. DOI: https://doi.org/10.1186/s12912-024-01991-0
Romanello M, Walawender M, Hsu SC, Moskeland A, Palmeiro-Silva Y, Scamman D, et al. Informe 2024 de Lancet Countdown sobre salud y cambio climático: Enfrentando amenazas sin precedentes debido al retraso en la acción [Internet]. [lugar desconocido: editorial desconocido]; 2024. https://www.thelancet.com/pb-assets/Lancet/Hubs/countdown/translations/LC2024_Spanish_Lancet_Countdown_2024_Executive_Summary-1730374208497.pdf
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Catalina Sepúlveda Rivas, Edith Rivas Riveros, Edgardo Álvarez Muñoz, Catalina Manríquez Arriagada, Gabriela Mansilla Alvarado, Francisco Sarabia Inyelco
This work is licensed under a Creative Commons Attribution 4.0 International License.
1. Proposed Policy for Journals That Offer Open Access
Authors who publish with this journal agree to the following terms:
- The journal and its papers are published with the Creative Commons License Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0). You are free to share copy and redistribute the material in any medium or format if you: give appropriate credit, provide a link to the license, and indicate if changes were made; don’t use our material for commercial purposes; don’t remix, transform, or build upon the material.
