Sentiment Analysis of Operating Room Nurses in Acute Care Hospitals in Japan: Unveiling Passion for Perioperative Nursing Using ChatGPT

Sentiment Analysis of Operating Room Nurses in Acute Care Hospitals in Japan: Unveiling Passion for Perioperative Nursing Using ChatGPT | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Sentiment Analysis of Operating Room Nurses in Acute Care Hospitals in Japan: Unveiling Passion for Perioperative Nursing Using ChatGPT Kentaro Hara, Reika Tachibana, Ryosuke Kumashiro, Kodai Ichihara, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4505331/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 09 Jan, 2025 Read the published version in BMC Nursing → Version 1 posted 9 You are reading this latest preprint version Abstract Aim This study aimed to elucidate the emotions of operating room nurses in Japan towards perioperative nursing using generative AI and identify factors contributing to burnout and turnover. Methods This single-center cross-sectional study, conducted from February 2023 to February 2024, employed semi-structured interviews with 10 operating room nurses from a national hospital in Japan. The interviews were designed to capture detailed qualitative data about the nurses' emotional experiences. These interviews were transcribed verbatim and analyzed using thematic, sentiment, and subjectivity analysis with ChatGPT (OpenAI, San Francisco, CA). Data visualization techniques, including keyword co-occurrence networks and cluster analyses, were also employed to uncover patterns and relationships in the data. Results Thematic analysis revealed key themes related to patient care, surgical safety, and nursing skills. The sentiment analysis showed a range of emotional tones, with high subjectivity scores indicating that the nurses' reflections were deeply personal and empathetic. Keyword co-occurrence networks highlighted the interconnectedness of various themes, such as the relationship between patient care and safety protocols. Cluster analysis identified distinct groups of emotional experiences, demonstrating the diverse emotional landscape of operating room nurses. Conclusions This study demonstrated the potential of generative AI to provide nuanced insights into the emotions of operating room nurses. The findings underscore the importance of emotional support, effective communication, and robust safety protocols in enhancing nurse well-being and job satisfaction. By leveraging AI technologies, healthcare institutions can better understand and address the emotional challenges faced by nurses, potentially reducing burnout and improving retention rates. Future research with larger and more diverse samples is needed to validate these findings and explore the broader applicability of AI in healthcare settings. Operating Room Nurses Generative AI Emotion Analysis Sentiment Analysis Perioperative Nursing Burnout Job Satisfaction Figures Figure 1 Figure 2 Figure 3 Figure 4 Background For patients undergoing surgery, feeling safe and secure in the operating room is a critical concern. Operating room nurses play a central role in patient care throughout the perioperative period. They ensure patient safety during operations by promoting a culture of prevention and protection, organizing work into specialty teams, and addressing threats like increased speed and imbalanced staffing. 1 However, it has been revealed that operating room nurses' safety awareness regarding patient safety is influenced by their perception of stress and working conditions. 2 Additionally, there is a reported relationship between nurses' perception of stress and their emotions in performing their duties. 3 Nurses' emotions and coping strategies, influenced by patient suffering, work environment, and interprofessional relations, can impact the quality of care they provide. 4 Thus, the emotions of nurses are crucial in providing care for patients undergoing surgery. Previous studies have focused on nurses' emotions, including research on emotional regulation involving self-awareness, control, emotional expression, and proactive thinking, as well as moral emotions such as "blaming emotions," "self-conscious emotions," "suffering emotions," and "praising emotions". 5,6 However, while there are some studies focusing on the emotions of operating room nurses, they are limited in number, and there has been no research reported on the core passion required to work as an operating room nurse. 7 The lack of emotional analysis of operating room nurses may lead to burnout, turnover, and potentially negative impacts on organizations and patients. 8,9 Therefore, analyzing the emotions of operating room nurses is essential for providing safe and secure perioperative care to patients undergoing surgery. In recent years, artificial intelligence (AI) technology has gained attention in the medical field and has been used for analyzing the mental health of healthcare professionals. 10,11 By leveraging AI technology, advancements in natural language processing can allow for more detailed analysis of the emotions of both patients and healthcare professionals. However, there have been no studies using generative AI to analyze the emotions of operating room nurses. Therefore, the objective of this study is to elucidate the emotions of operating room nurses in Japan towards perioperative nursing using generative AI. By conducting this study, we aim not only to demonstrate that generative AI can reveal the emotions of operating room nurses towards perioperative nursing, but also to pave the way for its application and utilization in analyzing the emotions of healthcare professionals in other fields. Furthermore, by revealing these emotions, there is potential to address and prevent burnout and turnover. Research Questions This study seeks to address several key research questions. Firstly, it aims to identify the predominant emotions experienced by operating room nurses in Japan towards perioperative nursing. Additionally, it explores how themes such as patient care, surgical safety, and nursing skills interrelate in the emotional experiences of these nurses. The study also investigates the role of effective communication in mitigating the emotional challenges faced by operating room nurses. Finally, it evaluates whether generative AI, specifically ChatGPT, can reliably analyze the emotions of healthcare professionals and examines the limitations of this approach. Methods Study design and ethical considerations The objective of this study was to elucidate the emotions of operating room nurses in Japan towards perioperative nursing using generative AI. By conducting this analysis, we aimed to explore the potential for generative AI to identify emotional states and contribute to preventing burnout and turnover among operating room nurses. This was a single-center cross-sectional study. The study employed a qualitative research approach, utilizing semi-structured interviews to gather and analyze the emotions of operating room nurses. This study was designed and reported in accordance with the Consolidated criteria for reporting qualitative research (COREQ). 12 This study was approved by the Ethics Committee of Medical Center (Approval No. 2023058). This study was conducted in accordance with the ethical standards of the Declaration of Helsinki (1964) and its amendments. Informed consent was obtained from all participants prior to their inclusion in the study. The participants were approached face-to-face by the researcher. Participants were provided with detailed explanations of the study's purpose, methods, risks, and benefits, ensuring their voluntary participation. Privacy and confidentiality of the participants were strictly protected. The recorded data and interview content were anonymized and handled with the utmost care to ensure data security. Study setting and population The study was conducted at Medical Center, one of the national hospitals in Japan. The duration of this study was from February 2023 to February 2024. This facility was chosen due to its comprehensive perioperative care services and the presence of a well-established Clinical Ladder program for operating room nurses. The study setting provided an appropriate environment to explore the emotions and experiences of operating room nurses in a real-world clinical context. The study population consisted of operating room nurses employed at Medical Center. Participants were selected based on specific criteria: the inclusion criteria required participants to be operating room nurses with Clinical Ladder Level II or higher, with no restrictions on gender or age. Nurses with Clinical Ladder Level I were excluded from the study. A total of 10 participants were included in the study. These nurses represented a range of experiences and backgrounds, providing a comprehensive view of the emotional landscape in the operating room setting. The participants were aware that the researcher was a professional in perioperative nursing and had conducted extensive research in the field of perioperative nursing. Outcome and data collection The primary outcome of this study was to identify and analyze the emotions of operating room nurses towards perioperative nursing using generative AI. Data collection was conducted using semi-structured interviews to obtain in-depth qualitative data on the emotions and experiences of the operating room nurses. The interviews were scheduled during weekday daytime hours to fit within the nurses' regular work schedules. The data was collected at the participants' workplace. An IC recorder was used to capture the interviews, ensuring accurate and comprehensive data collection. The interviews were conducted by the chief researcher, a male, who possesses excellent interviewing skills and has conducted interviews in numerous previous studies. The chief researcher and the study participants had established a relationship prior to the commencement of the study through their shared experiences in operating room nursing. No one else was present besides the participants and the chief researcher. The interview guide included open-ended questions designed to elicit detailed responses about the nurses' emotional experiences, coping strategies, and perceptions of their work environment. The interview guide used in this study was specifically developed for this research. An English language version of the interview guide is provided as a supplementary file (Supplementary File 1). The interview questions and prompts were provided by the authors to the participants. The interview guide was pilot tested multiple times. The interviews covered topics such as stress factors, emotional challenges, sources of job satisfaction, and the impact of interprofessional relationships on their emotional well-being. Following data collection, the interviews were transcribed verbatim to ensure the accuracy of the data. The transcriptions were then reviewed for significant statements and phrases related to the emotional experiences and challenges faced by the operating room nurses. These significant statements were coded and grouped into broader themes for further analysis. The primary outcome focused on identifying key themes and patterns in the emotions expressed by the nurses, with an emphasis on understanding the factors contributing to their emotional well-being and job satisfaction. Analyses The data analysis for this study was comprehensive and multifaceted, aimed at thoroughly understanding the emotions of operating room nurses. The analysis proceeded through several stages, incorporating both qualitative and quantitative methods. All analyses were performed using ChatGPT (OpenAI, San Francisco, CA). Thematic Analysis: The initial phase of data analysis involved thematic analysis of the transcribed semi-structured interviews. Each interview was meticulously transcribed verbatim to ensure the accuracy of the data. The transcriptions were then reviewed to identify significant statements and phrases that related to the emotional experiences and challenges faced by the operating room nurses. These significant statements were coded and grouped into broader themes. Key themes that emerged included stress factors, emotional challenges, job satisfaction, coping strategies, and the impact of interprofessional relationships on the nurses' emotional well-being. Sentiment and Subjectivity Analysis: Following the thematic analysis, sentiment analysis was performed using generative AI to quantify the emotional tone of the interview data. This involved assessing whether the statements made by the nurses were positive, negative, or neutral. Sentiment scores were calculated for each interview, providing a quantitative measure of the emotional tone. Alongside sentiment analysis, subjectivity analysis was conducted to determine the extent to which the statements were based on personal opinions and feelings versus factual information. Subjectivity scores were also computed for each interview. Keyword Co-occurrence Network: To visualize the relationships between frequently mentioned terms in the interviews, a keyword co-occurrence network was created. This network depicted how different keywords were interconnected, helping to identify common themes and the relationships between various concepts discussed by the nurses. Cluster Analysis: Cluster analysis was performed on the sentiment and subjectivity scores to identify distinct groups of emotional experiences among the nurses. This statistical method grouped the data into clusters based on similarities in sentiment and subjectivity scores. The resulting clusters were analyzed to identify common characteristics and differences, providing deeper insights into the emotional dynamics and varied experiences of the nurses. Statistical Analysis: Descriptive statistics were used to summarize the distributions of sentiment and subjectivity scores. Various visualizations, including scatter plots and histograms, were generated to illustrate the relationships between sentiment scores, subjectivity scores, and other relevant variables such as text length. These visual tools helped to provide a clearer understanding of the data and highlighted key patterns and trends. Visualization The results of these analyses were visualized through several types of charts and graphs. The keyword co-occurrence network illustrated the relationships between frequently mentioned keywords, providing insights into common themes and connections between various concepts. The cluster analysis on sentiment and subjectivity scores was visualized to show how the data grouped into distinct clusters, revealing patterns of emotional experiences among the nurses. The distribution of sentiment scores was displayed using histograms, highlighting the frequency and range of emotional tones expressed by the participants. Scatter plots were used to depict the relationships between sentiment scores and subjectivity scores, as well as the relationship between text length and sentiment scores. These visualizations collectively offered a comprehensive view of the emotional states of operating room nurses, aiding in the identification of areas for potential intervention to enhance their well-being and job satisfaction. Use of ChatGPT for English Proofreading For the English proofreading of this manuscript, we utilized ChatGPT, a large language model developed by OpenAI. ChatGPT contributed to the improvement of grammar, vocabulary, style, and structure, thereby enhancing the quality of the manuscript. Specifically, it provided suggestions to improve the clarity and consistency of the text. Care was taken to ensure that the model's suggestions accurately reflected the researchers' intentions and that technical terms and specialized content were appropriately conveyed. All suggestions and modifications generated by ChatGPT were reviewed and approved by the researchers before being incorporated into the final manuscript. Results Participant demographics and background The study included 10 operating room nurses from Medical Center. No participants refused to participate or dropped out of the study. Their demographics and professional backgrounds are summarized in Table 1 . These participants represented a range of experiences and backgrounds, providing a comprehensive view of the emotional landscape in the operating room setting. All participants were full-time employees, with varying years of nursing experience and operating room experience. Some participants also had experience outside the operating room and held licenses other than nursing. The highest educational qualifications of the participants ranged from vocational school to master’s degrees. Only one interview was conducted with each participant. The total interview time was 200 minutes, with an average of 20 minutes per interview. Table 1 Participant Demographics and Background Nurse ID Years of Nursing Experience Years of Operating Room Experience Experience Outside Operating Room Highest Educational Institution Licenses Other Than RN Employment Status A 24 21 Yes Vocational School No Full-time B 25 20 Yes Vocational School Yes Full-time C 5 5 No Vocational School No Full-time D 28 20 Yes Vocational School Yes Full-time E 6 6 No Master's Yes Full-time F 6 6 No University Yes Full-time G 8 4 Yes Vocational School Yes Full-time H 5 5 No Vocational School No Full-time I 27 17 Yes Vocational School No Full-time J 22 5 Yes Vocational School No Full-time Detailed Categorized Analysis The interview data was categorized into several key themes, which are summarized in Table 2 along with their corresponding sentiment and subjectivity scores. Table 2 Detailed Categorized Analysis Text Category Sentiment Score Subjectivity Score Skills, tools, materials, sterilization, and preparation are all part of our daily routine that everyone checks daily. (C) Nursing Skills 0 -100 Since I can't be involved much with patients in the operating room before the surgery, I try to understand their thoughts and wishes during the surgery. (A) Patient Care 20 -60 I strive to say difficult things for the benefit of the patients and coordinate various aspects while considering many things during nursing. (F) Patient Care 0 33.33333333 Not all patients overcome the surgery and recover; not everyone gets better. (A) Patient Care 50 0 It seems my goal is to ensure that patients enter and leave the surgery safely. (B) Patient Care 50 0 Especially for patients under general anesthesia, being unconscious during surgery is a significant factor. (D) Patient Care 14.16666667 58.33333333 Compared to wards, the opportunities to speak directly with patients are relatively fewer in the operating room. (E) Patient Care 5 -60 Nursing isn't just about talking or interacting with patients; it's crucial to ensure that patients can start their surgery safely and comfortably. (G) Patient Care 30 53.33333333 It's important how much pre-surgical nursing can reduce patient anxiety before surgery and how nursing afterwards supports their recovery. (I) Patient Care 30 20 Patients are greatly anxious about being operated on while unconscious, so it's crucial that they understand the flow in the operating room. (J) Patient Care -12.5 100 A notable difference from ward nursing is the significantly shorter duration of interaction with patients. (A) Patient Care 43.75 37.5 Although the time is short, surgery is a major event for patients, and it's important to proceed smoothly while considering their feelings. (B) Patient Care 21.5625 15 This medical center is perceived as the last fortress in the community, and I feel a responsibility towards the patients under my care. (F) Patient Care -3.333333333 -88.88888889 Working here involves dealing with patients who are anxious and have been referred from other hospitals. (E) Patient Care -18.75 37.5 I primarily focus on understanding the psychological aspects of patients and provide reassurance through my interactions. (C) Patient Care 20 -40 When children are admitted, their families also come, so I take care to communicate with and consider the family's presence. (A) Patient Care 0 -100 I think the most important thing is to ensure no medical accidents occur and to maintain true safety for patients. (B) Patient Care 31.25 7.5 I empathize with the patients' feelings; even though the surgeons may be focused on the organs or the surgery itself, we prioritize the patient's well-being. (J) Patient Care 0 -100 Since we are dealing with precious lives, I meticulously check for hidden dangers and risks that could affect the patients' lives. (I) Patient Care 16.66666667 33.33333333 Specifically, for patients under general anesthesia, care is needed for issues like skin problems, nerve damage due to positioning, and temperature management. (G) Patient Care -3.75 -12.5 Being an advocate for the patients is something I consider very important. (H) Patient Care 52 100 It's important to convey the true thoughts of patients to ward nurses and the surgeon during pre-surgical visits. (H) Patient Care 37.5 65 I aim to perceive things that are difficult for patients to express and to proactively address them. (J) Patient Care -50 100 I make sure never to forget the feelings of those who come here for surgery and how they feel about their treatment. (D) Patient Care 50 77.77777778 Working here, I always remember to consider the patients' feelings and why they have come to this place. (E) Patient Care 0 -100 Interactions with cancer patients during pre-surgical visits are often brief, and we tend to discuss only the essentials due to time constraints. (F) Patient Care -4.166666667 13.88888889 Surgical nursing is challenging, but it's crucial to engage from pre-surgery, taking into account the patient's feelings as we proceed. (C) Patient Care 25 100 I check things like sterilization deadlines daily as part of my routine, as everything relates back to the patient's safety. (J) Patient Care 0 -100 If patients are sent here with any anxiety, I make it a priority to reassure them and put their needs first. (G) Patient Care 25 -33.33333333 I take great pride in being involved in surgical nursing, always striving to do the best for the patients I interact with. (D) Patient Care 90 5 Such things are outdated, but nowadays, proper explanations are given to ensure patients are well-informed and ready for surgery. (B) Patient Care -5 -13.33333333 I believe there are still things patients are unable to express, so I try to understand these as much as possible and proceed with the surgery. (C) Patient Care -25 50 While I often meet patients for the first time, pre-surgical visits allow me to gather information and base my nursing on that. (A) Patient Care -27.5 33.33333333 Surgery can be a frightening and unfamiliar environment for patients, so I make sure to provide emotional support. (E) Patient Care 0 69.25925926 As surgery places physical stress on patients, I communicate with doctors and anesthesiologists from pre- to post-surgery to ensure everything goes smoothly. (F) Patient Care 20 -35.71428571 I carefully consider the patients' feelings, focusing on their needs especially after they are under general anesthesia and unconscious. (E) Patient Care -1.666666667 66.66666667 The nursing care we provide during surgery for unconscious patients significantly affects their postoperative recovery, which I am mindful of. (G) Patient Care 37.5 75 I hope the surgery ends safely and without incident. (C) Surgical Safety 50 0 Surgical nursing is difficult, but the job of a nurse, or rather, human capabilities, are truly challenging in any ward, I believe. (A) Surgical Safety 0 40 Surgical nursing is somewhat unique. (F) Surgical Safety 37.5 100 Ensuring safety and helping patients feel at ease going into surgery, as well as facilitating their return to normal life, are key aspects of a nurse's job. (E) Surgical Safety 7.5 65 Of course, it is essential that patients undergo surgery safely and securely, but first and foremost, I must ensure my own safety. (H) Surgical Safety 35 9.333333333 Safety is my top priority, and if something concerns me, I always consult with others instead of deciding alone. (H) Surgical Safety 50 0 As the patient is unconscious, I treat them as if they were my own family, ensuring they undergo surgery safely and with peace of mind. (A) Surgical Safety 55 50 When I underwent surgery as a child, I was very scared because I was led to the operating room without any explanation. (H) Surgical Safety 20 -40 I am careful with monitoring and assistance during surgery to prevent any physical disabilities afterward. (G) Surgical Safety -5 14.28571429 Personally, I find direct patient interaction challenging, but as a surgical nurse, I have less direct contact than ward nurses. (H) Surgical Safety 10.66666667 -13.33333333 It's about safety aspects. (I) Surgical Safety 0 -100 Ensuring patient safety and promptly addressing any concerns is our job. (J) Surgical Safety 0 -100 I never think I am suited for this, and no matter how many years pass, I never feel satisfied or that I've done well. (B) Uncategorized 50 50 Medical knowledge is important, but the ability to adjust and coordinate is also crucial. (C) Uncategorized 13.33333333 33.33333333 Lately, I've been especially careful to proceed cautiously and carefully, as there are many things that require urgent attention. (D) Uncategorized -2.5 55 I make it a point to double or triple-check, as risks can lurk in many places, requiring careful verification. (H) Uncategorized 13.33333333 0 I am always mindful that what other medical engineers do is connected to what I do, keeping this connection in focus. (I) Uncategorized -6.25 -62.5 As this is a hospital where advanced knowledge is required, it can be quite challenging for me in the current circumstances. (J) Uncategorized 30 33.33333333 Patient Care emerged as a dominant theme, with nurses frequently discussing their interactions with patients, the emotional challenges they face, and their efforts to ensure patient safety and comfort. Statements in this category reflected a range of emotions, from the stress of dealing with anxious patients to the satisfaction of successfully advocating for patient needs. The sentiment scores for patient care varied widely, indicating both positive and negative emotional tones. Subjectivity scores in this category were generally high, highlighting the personal and empathetic nature of the nurses' reflections. Surgical Safety was another significant theme. Nurses emphasized the importance of maintaining a safe surgical environment, both for patients and for themselves. They described meticulous routines for checking equipment and procedures, and the critical need for effective communication among surgical team members. The sentiment scores in this category were generally positive, reflecting a strong commitment to safety and the professional fulfillment derived from ensuring patient well-being. Subjectivity scores were also high, underscoring the personal investment nurses have in their roles. Nursing Skills involved discussions about the technical and practical aspects of the nurses' daily routines. Statements here included the use of skills, tools, and materials essential for surgical procedures. The sentiment scores were relatively neutral, suggesting that these tasks are viewed as routine but crucial components of their job. The subjectivity scores were lower compared to other categories, indicating a more objective focus on technical proficiency. Several uncategorized statements revealed additional insights into the nurses' professional lives and personal reflections. These included comments on the challenges of maintaining professional standards, the need for continuous learning, and the emotional toll of dealing with life-and-death situations. The sentiment scores for these statements varied, reflecting a mix of frustration, determination, and pride. Subjectivity scores were generally high, indicating the deeply personal nature of these reflections. Keyword Co-occurrence Network The keyword co-occurrence network provided a visual representation of the relationships between frequently mentioned terms in the interview data, highlighting key concepts and their interconnections (Fig. 1 ). At the center of the network was the node "patients," indicating that much of the discussion revolved around patient-related topics. Surrounding this central node were several significant themes. One prominent theme was "surgery" and "safety," which were closely linked. This reflected the nurses' emphasis on ensuring safe surgical procedures, highlighting the critical importance of safety protocols and practices in the operating room. Another key theme was "support" and "care," underscoring the nurses' focus on providing both emotional and practical support to patients. This theme emphasized the holistic approach to patient care, addressing both physical and emotional needs. Similarly, "recovery" and "treatment" were significant terms in the network, indicating the nurses' involvement in the postoperative phase and their role in facilitating patient recovery and managing treatment plans. The terms "communicate" and "understanding" highlighted the importance of effective communication between nurses, patients, and other healthcare professionals. Effective communication was crucial for understanding patient needs and providing appropriate care. Additionally, the presence of the keywords "emotional" and "feelings" pointed to the emotional aspect of nursing work, where nurses dealt with their own and patients' emotions. This reflected the psychological and empathetic dimensions of their roles. Challenges in nurse-patient interactions were suggested by the terms "interaction" and "difficult," particularly in the context of stressful and high-stakes surgical environments. This pointed to the complexities of maintaining effective communication and emotional support under pressure. Furthermore, the keywords "needs" and "discuss" emphasized the importance of understanding and addressing patient needs through discussions and consultations, highlighting the nurses' proactive approach in identifying and meeting patient requirements. Cluster and Scatter Plot Analyses The cluster analysis, depicted in Fig. 2 , revealed three distinct clusters based on sentiment and subjectivity scores. Cluster 1 (red) represented statements with predominantly positive sentiment and moderate to high subjectivity. These statements often highlighted positive aspects of patient care, job satisfaction, and effective communication. Cluster 2 (green) encompassed statements with lower sentiment scores and varying levels of subjectivity, indicating a mix of neutral or slightly negative sentiments often associated with challenges and routine tasks. Cluster 3 (blue) included statements with a wider range of sentiment scores but consistently high subjectivity, reflecting personal and empathetic responses to both positive and negative experiences in the operating room. The scatter plot in Fig. 3 illustrated the relationship between sentiment scores and subjectivity scores for all analyzed statements. The plot showed a broad distribution of sentiment scores, ranging from highly negative to highly positive. Most statements had high subjectivity scores, indicating that the nurses’ reflections were predominantly based on personal opinions and feelings rather than objective observations. This highlights the deeply emotional and personal nature of the nurses' experiences and the variability in their emotional responses to different aspects of their work. The scatter plot in Fig. 4 explored the relationship between the length of the interview responses and their sentiment scores. The analysis revealed that longer responses tended to have more varied sentiment scores, ranging from highly negative to highly positive. This suggests that longer statements provided more detailed and nuanced reflections, capturing a wider range of emotions. Shorter statements, on the other hand, were more likely to have neutral or moderately positive sentiment scores, indicating more concise and focused responses. All findings were provided as feedback to the participants. Discussion The aim of this study was to elucidate the emotions of operating room nurses in Japan towards perioperative nursing using generative AI. The findings provide valuable insights into the emotional landscape of these nurses, revealing key themes related to patient care, surgical safety, and nursing skills. This discussion will explore the implications of these findings, compare them with existing literature, and highlight the potential benefits and limitations of using generative AI for emotional analysis in healthcare. Emotional Landscape of Operating Room Nurses The detailed categorized analysis showed that patient care emerged as a main theme, with nurses frequently discussing their interactions with patients and the emotional challenges they face. The variability in sentiment scores, ranging from positive to negative, highlights the complex nature of patient care in the operating room. These findings align with previous studies that have emphasized the emotional demands of nursing and the impact of patient interactions on nurses' well-being. 3,4 Understanding how to transform these negative feelings into positive ones will be crucial in supporting the passion of operating room nurses. Nursing managers, colleagues, and educators need to be involved in ways that improve nurses' work motivation. 13 Surgical safety was another significant theme, with nurses emphasizing the importance of maintaining a safe surgical environment. The generally positive sentiment scores in this category reflect a strong commitment to safety and professional fulfillment. This is consistent with existing literature that underscores the critical role of safety protocols and effective communication in the operating room. 1,2 Operating room nurses believe that securing patient safety and preventing mistakes are key elements in their work, and they consider the culture of prevention and protection crucial in enhancing safety. 14 To develop safety-conscious nurses, it is necessary to maintain a high level of teamwork and communication. 15 Safety awareness and operating room nurses' emotions are connected and need to be valued. Nursing skills involved discussions about the technical and practical aspects of the nurses' daily routines. The neutral sentiment scores suggest that these tasks are viewed as routine but essential components of their job. 16 This finding highlights the importance of technical proficiency and routine in ensuring the smooth operation of surgical procedures. Preventing Nurse Turnover and Burnout The study's findings highlight the importance of addressing emotional support, effective communication, and safety protocols to prevent nurse turnover and burnout. Emotional support programs, such as counseling and peer support groups, can help nurses manage stress. 17 Effective communication within the surgical team can reduce misunderstandings and improve teamwork. 18, 19 Maintaining robust safety protocols and involving nurses in their development can enhance their sense of control and job satisfaction. Recognizing nurses' contributions and providing career development opportunities are also crucial for motivation and retention. 20 Promoting work-life balance through flexible scheduling and wellness programs can further prevent burnout. Organizational support, including mental health resources and proactive leadership, is essential to create a supportive work environment. 21 Future research should continue to explore these areas to develop comprehensive interventions for improving nurse well-being and job satisfaction. Generative AI in Emotional Analysis This study utilized generative AI, specifically ChatGPT, for sentiment and subjectivity analysis. The use of AI allowed for a detailed and quantitative analysis of the emotional tone of the interview data. The keyword co-occurrence network and cluster analysis provided additional layers of understanding, revealing the interconnected nature of various themes and the distinct emotional experiences of nurses. The application of AI in this context offers several advantages. It provides an objective method to quantify emotions, reducing potential biases that may arise from manual coding. Furthermore, AI can process large volumes of text data quickly and efficiently, making it a valuable tool for large-scale studies. However, there are also limitations to consider. AI-based analysis relies on the quality and representativeness of the input data. In this study, the sample size was relatively small, consisting of only 10 participants. While this allowed for in-depth qualitative analysis, it may not capture the full diversity of experiences among operating room nurses. Future studies with larger and more diverse samples are needed to validate and extend these findings. Conclusions This study demonstrated the potential of generative AI to analyze the emotions of operating room nurses, revealing key themes related to patient care, surgical safety, and nursing skills. The findings highlight the complex and multifaceted nature of nursing work, underscoring the importance of emotional support and effective communication in promoting nurse well-being and job satisfaction. While the use of AI offers several advantages, future research with larger samples is needed to validate these findings and explore the broader applicability of AI in emotional analysis in healthcare. Declarations Ethical approval and consent to participate This study was approved by the Ethics Committee of Nagasaki Medical Center (Approval No. 2023058). All methods were performed in accordance with relevant guidelines and regulations. This study was conducted in accordance with the ethical standards of the Declaration of Helsinki (1964) and its amendments. All observational protocols were approved by the institutional and licensing committees of Nagasaki Medical Center. Informed consent was obtained from all participants prior to their inclusion in the study. Participants were provided with detailed explanations of the study's purpose, methods, risks, and benefits to ensure their voluntary participation. Privacy and confidentiality of the participants were strictly protected, and the recorded data and interview content were anonymized and handled with the utmost care to ensure data security. Consent for publication Not applicable Availability of data and materials The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request. Acknowledgments We gratefully acknowledge the work of the past and present members of our medical center. Competing interests and Funding The authors declare no competing interests and have not received any external financial support for this work. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The authors declare that they have no conflicts of interest. Authors’ contributions Kentaro Hara was responsible for the organization and coordination of the study. Kentaro Hara was the chief investigator responsible for the data analysis. Reika Tachibana and Ryosuke Kumashiro provided the study data. Kodai Ichihara, Takahiro Uemura, Hiroshi Maeda, Michiko Yamaguchi and Takahiro Inoue made critical revisions to incorporate the relevant information. The authors have checked to make sure that our submission conforms as applicable to the Journal’s statistical guidelines described here. All authors contributed to the writing of the final manuscript and have approved it. References Alfredsdottir H, Bjornsdottir K. Nursing and patient safety in the operating room. J Adv Nurs . 2008;61(1):29-37. doi:10.1111/j.1365-2648.2007.04462.x Liao X, Zhang P, Xu X, Zheng D, Wang J, Li Y, Xie L. Analysis of factors influencing safety attitudes of operating room nurses and their cognition and attitudes toward adverse event reporting. 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BMC Nurs . 2020;19:60. doi:10.1186/s12912-020-00438-6 James I, Andershed B, Gustavsson B, Ternestedt BM. Emotional knowing in nursing practice: In the encounter between life and death. Int J Qual Stud Health Well-being . 2010;5(2):5367. doi:10.3402/qhw.v5i2.5367 Teymoori E, Zareiyan A, Babajani-Vafsi S, Laripour R. Viewpoint of operating room nurses about factors associated with occupational burnout: A qualitative study. Front Psychol . 2022;13:947189. doi:10.3389/fpsyg.2022.947189 Li N, Zhang L, Li X, Lu Q. The influence of operating room nurses' job stress on burnout and organizational commitment: The moderating effect of over-commitment. J Adv Nurs . 2021;77(4):1772-1782. doi:10.1111/jan.14725 Fogel AL, Kvedar JC. Artificial intelligence powers digital medicine. NPJ Digit Med . 2018;1:5. doi:10.1038/s41746-017-0012-2 Montero Quispe K, Utyiama DMS, Dos Santos EMBF, Oliveira HABF, Souto EJP. Applying self-supervised representation learning for emotion recognition using physiological signals. Sensors (Basel) . 2022;22(23):9102. doi:10.3390/s22239102 Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. Int J Qual Health Care . 2007;19(6):349-357. doi:10.1093/intqhc/mzm042 Göktepe N, Yalçın B, Türkmen E, Dirican Ü, Aydın M. The relationship between nurses' work-related variables, colleague solidarity, and job motivation. J Nurs Manag . 2020;28(3):514-521. doi:10.1111/jonm.12949 Hanssen I, Smith Jacobsen IL, Skråmm SH. Non-technical skills in operating room nursing: Ethical aspects. Nurs Ethics . 2020;27(5):1364-1372. doi:10.1177/0969733020914376 Bahar S, Önler E. Turkish surgical nurses' attitudes related to patient safety: A questionnaire study. Niger J Clin Pract . 2020;23(4):470-475. doi:10.4103/njcp.njcp_677_18 Zisberg A, Young HM, Schepp K, Zysberg L. A concept analysis of routine: Relevance to nursing. J Adv Nurs . 2007;57(4):442-453. doi:10.1111/j.1365-2648.2007.04103.x Bernburg M, Groneberg DA, Mache S. Mental Health Promotion Intervention for Nurses Working in German Psychiatric Hospital Departments: A Pilot Study. Issues Ment Health Nurs . 2019;40(8):706-711. doi:10.1080/01612840.2019.1565878 Leonard M, Graham S, Bonacum D. The human factor: the critical importance of effective teamwork and communication in providing safe care. Qual Saf Health Care . 2004;13 Suppl 1(Suppl 1):i85-i90. doi:10.1136/qhc.13.suppl_1.i85 Kumar H, Morad R, Sonsati M. Surgical team: improving teamwork, a review. Postgrad Med J . 2019;95(1124):334-339. doi:10.1136/postgradmedj-2018-135943 Wilkinson S, Hayward R. Band 5 nurses' perceptions and experiences of professional development. Nurs Manag (Harrow) . 2017;24(2):30-37. doi:10.7748/nm.2017.e1537 Boamah SA, Laschinger H. The influence of areas of worklife fit and work-life interference on burnout and turnover intentions among new graduate nurses. J Nurs Manag . 2016;24(2):E164-E174. doi:10.1111/jonm.12318 Additional Declarations No competing interests reported. Supplementary Files ISSMCOREQChecklist.pdf InterviewGuide.docx Cite Share Download PDF Status: Published Journal Publication published 09 Jan, 2025 Read the published version in BMC Nursing → Version 1 posted Editorial decision: Revision requested 15 Jul, 2024 Reviews received at journal 13 Jul, 2024 Reviews received at journal 12 Jul, 2024 Reviewers agreed at journal 01 Jul, 2024 Reviewers agreed at journal 01 Jul, 2024 Reviewers invited by journal 01 Jul, 2024 Editor assigned by journal 07 Jun, 2024 Submission checks completed at journal 07 Jun, 2024 First submitted to journal 30 May, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4505331","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":314710937,"identity":"8cebf3a3-caac-41e6-84cd-9f1772079a42","order_by":0,"name":"Kentaro Hara","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA6klEQVRIiWNgGAWjYBACAyBmbGBg4GFjb0h8AOTw8BGrRYaP58BjEIeHjVgtNnISic8kQCIEtZizn334cUbFHaDhyWmVX3PsZNgYmB8+uoFHi2VPurHkhjPPgFqOpd2W3ZYMZLAZG+fgc9iBNAbJh22HedgYe9JuS25jBmrhYZPGq+X8M+afD/8BtTDzfyuW3FZPhJYbaWySGxuAWtgY0hg/bjtMjJZnbJYzjgFV8jAkSzNuOw60jpBfzqcx3+ypOWwvP/9B4sef26rt+dmbHz7GpwUFMPOASWKVgwDjD1JUj4JRMApGwYgBAK99RmoIBTb/AAAAAElFTkSuQmCC","orcid":"","institution":"Nagasaki Medical Center","correspondingAuthor":true,"prefix":"","firstName":"Kentaro","middleName":"","lastName":"Hara","suffix":""},{"id":314710938,"identity":"6b997ba8-06e1-457f-8d3f-7502d9509f4d","order_by":1,"name":"Reika Tachibana","email":"","orcid":"","institution":"Nagasaki Medical Center","correspondingAuthor":false,"prefix":"","firstName":"Reika","middleName":"","lastName":"Tachibana","suffix":""},{"id":314710939,"identity":"199c6e00-aa39-44bd-aefb-f60b3b4e746b","order_by":2,"name":"Ryosuke Kumashiro","email":"","orcid":"","institution":"Nagasaki Medical Center","correspondingAuthor":false,"prefix":"","firstName":"Ryosuke","middleName":"","lastName":"Kumashiro","suffix":""},{"id":314710940,"identity":"397f5a05-6d84-406f-a0e5-9992cd6dde90","order_by":3,"name":"Kodai Ichihara","email":"","orcid":"","institution":"Nagasaki Medical Center","correspondingAuthor":false,"prefix":"","firstName":"Kodai","middleName":"","lastName":"Ichihara","suffix":""},{"id":314710941,"identity":"fa1756cc-6622-4b1c-8b88-6fdd1479f439","order_by":4,"name":"Takahiro Uemura","email":"","orcid":"","institution":"Nagasaki Medical Center","correspondingAuthor":false,"prefix":"","firstName":"Takahiro","middleName":"","lastName":"Uemura","suffix":""},{"id":314710942,"identity":"43d4bbd6-c257-4a23-8ad6-a6cffc744012","order_by":5,"name":"Hiroshi Maeda","email":"","orcid":"","institution":"Juntendo University Hospital","correspondingAuthor":false,"prefix":"","firstName":"Hiroshi","middleName":"","lastName":"Maeda","suffix":""},{"id":314710943,"identity":"cd2fda7b-01f3-43b6-ad2a-9a7aba48083d","order_by":6,"name":"Michiko Yamaguchi","email":"","orcid":"","institution":"Nagasaki Medical Center","correspondingAuthor":false,"prefix":"","firstName":"Michiko","middleName":"","lastName":"Yamaguchi","suffix":""},{"id":314710944,"identity":"3e82e3d5-c4f3-4375-b386-eb2a1d885ec7","order_by":7,"name":"Takahiro Inoue","email":"","orcid":"","institution":"Chiba University Hospital","correspondingAuthor":false,"prefix":"","firstName":"Takahiro","middleName":"","lastName":"Inoue","suffix":""}],"badges":[],"createdAt":"2024-05-30 23:23:08","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4505331/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4505331/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12912-024-02655-9","type":"published","date":"2025-01-09T15:57:38+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":59240634,"identity":"61d1c4d3-5476-4108-b2c2-62d2ec0eeca9","added_by":"auto","created_at":"2024-06-28 05:20:47","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":209009,"visible":true,"origin":"","legend":"\u003cp\u003eKeyword Co-occurrence Network of Interview Data\u003c/p\u003e\n\u003cp\u003eThis figure illustrates the relationships between frequently mentioned terms in the interview data of operating room nurses. The central node represents \"patients,\" indicating the focus of discussions. Significant themes such as \"surgery,\" \"safety,\" \"support,\" \"care,\" \"recovery,\" and \"treatment\" are connected, highlighting the interconnectedness of patient care, emotional support, and surgical safety.\u003c/p\u003e","description":"","filename":"Fig.1.png","url":"https://assets-eu.researchsquare.com/files/rs-4505331/v1/c10fccfdbc20a8870fec4cd6.png"},{"id":59241436,"identity":"fe41c025-1043-4c94-bfac-46b88802eb99","added_by":"auto","created_at":"2024-06-28 05:28:47","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":96771,"visible":true,"origin":"","legend":"\u003cp\u003eCluster Analysis of Sentiment and Subjectivity Scores\u003c/p\u003e\n\u003cp\u003eThis figure shows the cluster analysis of sentiment and subjectivity scores from the interviews. Three distinct clusters are identified: Cluster 1 (red) represents positive sentiment and moderate to high subjectivity; Cluster 2 (green) includes neutral or slightly negative sentiments; Cluster 3 (blue) consists of varied sentiments with consistently high subjectivity. These clusters provide insights into the diverse emotional experiences of operating room nurses.\u003c/p\u003e","description":"","filename":"Fig.2.png","url":"https://assets-eu.researchsquare.com/files/rs-4505331/v1/482063df2472536527eaa94b.png"},{"id":59240640,"identity":"feea8003-51bf-407d-83be-68be5bbd902a","added_by":"auto","created_at":"2024-06-28 05:20:48","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":87716,"visible":true,"origin":"","legend":"\u003cp\u003eScatter Plot of Sentiment Scores and Subjectivity Scores\u003c/p\u003e\n\u003cp\u003eThis scatter plot illustrates the relationship between sentiment scores and subjectivity scores for all analyzed statements. The wide distribution of sentiment scores, ranging from highly negative to highly positive, and predominantly high subjectivity scores, reflect the personal and emotional nature of the nurses' reflections.\u003c/p\u003e","description":"","filename":"Fig.3.png","url":"https://assets-eu.researchsquare.com/files/rs-4505331/v1/894923fc0d30c04525379ae3.png"},{"id":59240639,"identity":"ff32e832-07e7-49a9-af51-2ec45e51ab44","added_by":"auto","created_at":"2024-06-28 05:20:48","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":87620,"visible":true,"origin":"","legend":"\u003cp\u003eScatter Plot of Text Length and Sentiment Scores\u003c/p\u003e\n\u003cp\u003eThis scatter plot depicts the relationship between the length of interview responses and their sentiment scores. Longer responses tend to have more varied sentiment scores, capturing a broader range of emotions, while shorter responses generally show neutral or moderately positive sentiment scores. This indicates that detailed reflections often encompass a wider array of emotional tones.\u003c/p\u003e","description":"","filename":"Fig.4.png","url":"https://assets-eu.researchsquare.com/files/rs-4505331/v1/5e87ee04a844161b654138eb.png"},{"id":73694676,"identity":"ea0e02f8-3350-44b2-a2d8-8d32cc7eac77","added_by":"auto","created_at":"2025-01-13 16:13:32","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1460771,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4505331/v1/144e32bc-3989-4737-93e0-f54e061ee5e6.pdf"},{"id":59240637,"identity":"e1238d92-44d9-48d6-b1f0-d7624c475403","added_by":"auto","created_at":"2024-06-28 05:20:47","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":517070,"visible":true,"origin":"","legend":"","description":"","filename":"ISSMCOREQChecklist.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4505331/v1/8bb9abdac721c154913c696d.pdf"},{"id":59240635,"identity":"6e548637-8ba1-4982-a622-356374d030e2","added_by":"auto","created_at":"2024-06-28 05:20:47","extension":"docx","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":27552,"visible":true,"origin":"","legend":"","description":"","filename":"InterviewGuide.docx","url":"https://assets-eu.researchsquare.com/files/rs-4505331/v1/39d09e533703cecc33c03518.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Sentiment Analysis of Operating Room Nurses in Acute Care Hospitals in Japan: Unveiling Passion for Perioperative Nursing Using ChatGPT","fulltext":[{"header":"Background","content":"\u003cp\u003eFor patients undergoing surgery, feeling safe and secure in the operating room is a critical concern. Operating room nurses play a central role in patient care throughout the perioperative period. They ensure patient safety during operations by promoting a culture of prevention and protection, organizing work into specialty teams, and addressing threats like increased speed and imbalanced staffing.\u003csup\u003e1\u003c/sup\u003e However, it has been revealed that operating room nurses' safety awareness regarding patient safety is influenced by their perception of stress and working conditions.\u003csup\u003e2\u003c/sup\u003e Additionally, there is a reported relationship between nurses' perception of stress and their emotions in performing their duties.\u003csup\u003e3\u003c/sup\u003e Nurses' emotions and coping strategies, influenced by patient suffering, work environment, and interprofessional relations, can impact the quality of care they provide.\u003csup\u003e4\u003c/sup\u003e Thus, the emotions of nurses are crucial in providing care for patients undergoing surgery.\u003c/p\u003e \u003cp\u003ePrevious studies have focused on nurses' emotions, including research on emotional regulation involving self-awareness, control, emotional expression, and proactive thinking, as well as moral emotions such as \"blaming emotions,\" \"self-conscious emotions,\" \"suffering emotions,\" and \"praising emotions\".\u003csup\u003e5,6\u003c/sup\u003e However, while there are some studies focusing on the emotions of operating room nurses, they are limited in number, and there has been no research reported on the core passion required to work as an operating room nurse.\u003csup\u003e7\u003c/sup\u003e The lack of emotional analysis of operating room nurses may lead to burnout, turnover, and potentially negative impacts on organizations and patients.\u003csup\u003e8,9\u003c/sup\u003e Therefore, analyzing the emotions of operating room nurses is essential for providing safe and secure perioperative care to patients undergoing surgery.\u003c/p\u003e \u003cp\u003eIn recent years, artificial intelligence (AI) technology has gained attention in the medical field and has been used for analyzing the mental health of healthcare professionals.\u003csup\u003e10,11\u003c/sup\u003e By leveraging AI technology, advancements in natural language processing can allow for more detailed analysis of the emotions of both patients and healthcare professionals. However, there have been no studies using generative AI to analyze the emotions of operating room nurses. Therefore, the objective of this study is to elucidate the emotions of operating room nurses in Japan towards perioperative nursing using generative AI. By conducting this study, we aim not only to demonstrate that generative AI can reveal the emotions of operating room nurses towards perioperative nursing, but also to pave the way for its application and utilization in analyzing the emotions of healthcare professionals in other fields. Furthermore, by revealing these emotions, there is potential to address and prevent burnout and turnover.\u003c/p\u003e \u003cdiv id=\"Sec2\" class=\"Section2\"\u003e \u003ch2\u003eResearch Questions\u003c/h2\u003e \u003cp\u003eThis study seeks to address several key research questions. Firstly, it aims to identify the predominant emotions experienced by operating room nurses in Japan towards perioperative nursing. Additionally, it explores how themes such as patient care, surgical safety, and nursing skills interrelate in the emotional experiences of these nurses. The study also investigates the role of effective communication in mitigating the emotional challenges faced by operating room nurses. Finally, it evaluates whether generative AI, specifically ChatGPT, can reliably analyze the emotions of healthcare professionals and examines the limitations of this approach.\u003c/p\u003e \u003c/div\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eStudy design and ethical considerations\u003c/h2\u003e \u003cp\u003eThe objective of this study was to elucidate the emotions of operating room nurses in Japan towards perioperative nursing using generative AI. By conducting this analysis, we aimed to explore the potential for generative AI to identify emotional states and contribute to preventing burnout and turnover among operating room nurses. This was a single-center cross-sectional study. The study employed a qualitative research approach, utilizing semi-structured interviews to gather and analyze the emotions of operating room nurses. This study was designed and reported in accordance with the Consolidated criteria for reporting qualitative research (COREQ).\u003csup\u003e12\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThis study was approved by the Ethics Committee of Medical Center (Approval No. 2023058). This study was conducted in accordance with the ethical standards of the Declaration of Helsinki (1964) and its amendments. Informed consent was obtained from all participants prior to their inclusion in the study. The participants were approached face-to-face by the researcher. Participants were provided with detailed explanations of the study's purpose, methods, risks, and benefits, ensuring their voluntary participation. Privacy and confidentiality of the participants were strictly protected. The recorded data and interview content were anonymized and handled with the utmost care to ensure data security.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eStudy setting and population\u003c/h2\u003e \u003cp\u003eThe study was conducted at Medical Center, one of the national hospitals in Japan. The duration of this study was from February 2023 to February 2024. This facility was chosen due to its comprehensive perioperative care services and the presence of a well-established Clinical Ladder program for operating room nurses. The study setting provided an appropriate environment to explore the emotions and experiences of operating room nurses in a real-world clinical context. The study population consisted of operating room nurses employed at Medical Center. Participants were selected based on specific criteria: the inclusion criteria required participants to be operating room nurses with Clinical Ladder Level II or higher, with no restrictions on gender or age. Nurses with Clinical Ladder Level I were excluded from the study. A total of 10 participants were included in the study. These nurses represented a range of experiences and backgrounds, providing a comprehensive view of the emotional landscape in the operating room setting. The participants were aware that the researcher was a professional in perioperative nursing and had conducted extensive research in the field of perioperative nursing.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eOutcome and data collection\u003c/h2\u003e \u003cp\u003eThe primary outcome of this study was to identify and analyze the emotions of operating room nurses towards perioperative nursing using generative AI. Data collection was conducted using semi-structured interviews to obtain in-depth qualitative data on the emotions and experiences of the operating room nurses. The interviews were scheduled during weekday daytime hours to fit within the nurses' regular work schedules. The data was collected at the participants' workplace. An IC recorder was used to capture the interviews, ensuring accurate and comprehensive data collection. The interviews were conducted by the chief researcher, a male, who possesses excellent interviewing skills and has conducted interviews in numerous previous studies. The chief researcher and the study participants had established a relationship prior to the commencement of the study through their shared experiences in operating room nursing. No one else was present besides the participants and the chief researcher. The interview guide included open-ended questions designed to elicit detailed responses about the nurses' emotional experiences, coping strategies, and perceptions of their work environment. The interview guide used in this study was specifically developed for this research. An English language version of the interview guide is provided as a supplementary file (Supplementary File 1). The interview questions and prompts were provided by the authors to the participants. The interview guide was pilot tested multiple times. The interviews covered topics such as stress factors, emotional challenges, sources of job satisfaction, and the impact of interprofessional relationships on their emotional well-being. Following data collection, the interviews were transcribed verbatim to ensure the accuracy of the data. The transcriptions were then reviewed for significant statements and phrases related to the emotional experiences and challenges faced by the operating room nurses. These significant statements were coded and grouped into broader themes for further analysis. The primary outcome focused on identifying key themes and patterns in the emotions expressed by the nurses, with an emphasis on understanding the factors contributing to their emotional well-being and job satisfaction.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eAnalyses\u003c/h2\u003e \u003cp\u003eThe data analysis for this study was comprehensive and multifaceted, aimed at thoroughly understanding the emotions of operating room nurses. The analysis proceeded through several stages, incorporating both qualitative and quantitative methods. All analyses were performed using ChatGPT (OpenAI, San Francisco, CA).\u003c/p\u003e \u003cp\u003eThematic Analysis: The initial phase of data analysis involved thematic analysis of the transcribed semi-structured interviews. Each interview was meticulously transcribed verbatim to ensure the accuracy of the data. The transcriptions were then reviewed to identify significant statements and phrases that related to the emotional experiences and challenges faced by the operating room nurses. These significant statements were coded and grouped into broader themes. Key themes that emerged included stress factors, emotional challenges, job satisfaction, coping strategies, and the impact of interprofessional relationships on the nurses' emotional well-being.\u003c/p\u003e \u003cp\u003eSentiment and Subjectivity Analysis: Following the thematic analysis, sentiment analysis was performed using generative AI to quantify the emotional tone of the interview data. This involved assessing whether the statements made by the nurses were positive, negative, or neutral. Sentiment scores were calculated for each interview, providing a quantitative measure of the emotional tone. Alongside sentiment analysis, subjectivity analysis was conducted to determine the extent to which the statements were based on personal opinions and feelings versus factual information. Subjectivity scores were also computed for each interview.\u003c/p\u003e \u003cp\u003eKeyword Co-occurrence Network: To visualize the relationships between frequently mentioned terms in the interviews, a keyword co-occurrence network was created. This network depicted how different keywords were interconnected, helping to identify common themes and the relationships between various concepts discussed by the nurses.\u003c/p\u003e \u003cp\u003eCluster Analysis: Cluster analysis was performed on the sentiment and subjectivity scores to identify distinct groups of emotional experiences among the nurses. This statistical method grouped the data into clusters based on similarities in sentiment and subjectivity scores. The resulting clusters were analyzed to identify common characteristics and differences, providing deeper insights into the emotional dynamics and varied experiences of the nurses.\u003c/p\u003e \u003cp\u003eStatistical Analysis: Descriptive statistics were used to summarize the distributions of sentiment and subjectivity scores. Various visualizations, including scatter plots and histograms, were generated to illustrate the relationships between sentiment scores, subjectivity scores, and other relevant variables such as text length. These visual tools helped to provide a clearer understanding of the data and highlighted key patterns and trends.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eVisualization\u003c/h2\u003e \u003cp\u003eThe results of these analyses were visualized through several types of charts and graphs. The keyword co-occurrence network illustrated the relationships between frequently mentioned keywords, providing insights into common themes and connections between various concepts. The cluster analysis on sentiment and subjectivity scores was visualized to show how the data grouped into distinct clusters, revealing patterns of emotional experiences among the nurses. The distribution of sentiment scores was displayed using histograms, highlighting the frequency and range of emotional tones expressed by the participants. Scatter plots were used to depict the relationships between sentiment scores and subjectivity scores, as well as the relationship between text length and sentiment scores. These visualizations collectively offered a comprehensive view of the emotional states of operating room nurses, aiding in the identification of areas for potential intervention to enhance their well-being and job satisfaction.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eUse of ChatGPT for English Proofreading\u003c/h2\u003e \u003cp\u003eFor the English proofreading of this manuscript, we utilized ChatGPT, a large language model developed by OpenAI. ChatGPT contributed to the improvement of grammar, vocabulary, style, and structure, thereby enhancing the quality of the manuscript. Specifically, it provided suggestions to improve the clarity and consistency of the text. Care was taken to ensure that the model's suggestions accurately reflected the researchers' intentions and that technical terms and specialized content were appropriately conveyed. All suggestions and modifications generated by ChatGPT were reviewed and approved by the researchers before being incorporated into the final manuscript.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eParticipant demographics and background\u003c/h2\u003e \u003cp\u003eThe study included 10 operating room nurses from Medical Center. No participants refused to participate or dropped out of the study. Their demographics and professional backgrounds are summarized in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. These participants represented a range of experiences and backgrounds, providing a comprehensive view of the emotional landscape in the operating room setting. All participants were full-time employees, with varying years of nursing experience and operating room experience. Some participants also had experience outside the operating room and held licenses other than nursing. The highest educational qualifications of the participants ranged from vocational school to master\u0026rsquo;s degrees. Only one interview was conducted with each participant. The total interview time was 200 minutes, with an average of 20 minutes per interview.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eParticipant Demographics and Background\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNurse ID\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYears of Nursing Experience\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYears of Operating Room Experience\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eExperience Outside Operating Room\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eHighest Educational Institution\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eLicenses Other Than RN\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eEmployment Status\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eVocational School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eFull-time\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eVocational School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eFull-time\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eVocational School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eFull-time\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eVocational School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eFull-time\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMaster's\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eFull-time\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eUniversity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eFull-time\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eG\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eVocational School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eFull-time\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eVocational School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eFull-time\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eVocational School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eFull-time\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eJ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eVocational School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eFull-time\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eDetailed Categorized Analysis\u003c/h2\u003e \u003cp\u003eThe interview data was categorized into several key themes, which are summarized in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e along with their corresponding sentiment and subjectivity scores.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDetailed Categorized Analysis\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eText\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSentiment Score\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSubjectivity Score\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSkills, tools, materials, sterilization, and preparation are all part of our daily routine that everyone checks daily. (C)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNursing Skills\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSince I can't be involved much with patients in the operating room before the surgery, I try to understand their thoughts and wishes during the surgery. (A)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatient Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-60\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI strive to say difficult things for the benefit of the patients and coordinate various aspects while considering many things during nursing. (F)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatient Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33.33333333\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot all patients overcome the surgery and recover; not everyone gets better. (A)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatient Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIt seems my goal is to ensure that patients enter and leave the surgery safely. (B)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatient Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEspecially for patients under general anesthesia, being unconscious during surgery is a significant factor. (D)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatient Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14.16666667\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e58.33333333\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCompared to wards, the opportunities to speak directly with patients are relatively fewer in the operating room. (E)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatient Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-60\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNursing isn't just about talking or interacting with patients; it's crucial to ensure that patients can start their surgery safely and comfortably. (G)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatient Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e53.33333333\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIt's important how much pre-surgical nursing can reduce patient anxiety before surgery and how nursing afterwards supports their recovery. (I)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatient Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePatients are greatly anxious about being operated on while unconscious, so it's crucial that they understand the flow in the operating room. (J)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatient Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-12.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA notable difference from ward nursing is the significantly shorter duration of interaction with patients. (A)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatient Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e37.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlthough the time is short, surgery is a major event for patients, and it's important to proceed smoothly while considering their feelings. (B)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatient Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21.5625\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThis medical center is perceived as the last fortress in the community, and I feel a responsibility towards the patients under my care. (F)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatient Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-3.333333333\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-88.88888889\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWorking here involves dealing with patients who are anxious and have been referred from other hospitals. (E)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatient Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-18.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e37.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI primarily focus on understanding the psychological aspects of patients and provide reassurance through my interactions. (C)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatient Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-40\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhen children are admitted, their families also come, so I take care to communicate with and consider the family's presence. (A)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatient Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI think the most important thing is to ensure no medical accidents occur and to maintain true safety for patients. (B)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatient Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI empathize with the patients' feelings; even though the surgeons may be focused on the organs or the surgery itself, we prioritize the patient's well-being. (J)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatient Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSince we are dealing with precious lives, I meticulously check for hidden dangers and risks that could affect the patients' lives. (I)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatient Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16.66666667\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33.33333333\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSpecifically, for patients under general anesthesia, care is needed for issues like skin problems, nerve damage due to positioning, and temperature management. (G)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatient Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-3.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-12.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBeing an advocate for the patients is something I consider very important. (H)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatient Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIt's important to convey the true thoughts of patients to ward nurses and the surgeon during pre-surgical visits. (H)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatient Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e37.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e65\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI aim to perceive things that are difficult for patients to express and to proactively address them. (J)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatient Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI make sure never to forget the feelings of those who come here for surgery and how they feel about their treatment. (D)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatient Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e77.77777778\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWorking here, I always remember to consider the patients' feelings and why they have come to this place. (E)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatient Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInteractions with cancer patients during pre-surgical visits are often brief, and we tend to discuss only the essentials due to time constraints. (F)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatient Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-4.166666667\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.88888889\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSurgical nursing is challenging, but it's crucial to engage from pre-surgery, taking into account the patient's feelings as we proceed. (C)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatient Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI check things like sterilization deadlines daily as part of my routine, as everything relates back to the patient's safety. (J)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatient Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIf patients are sent here with any anxiety, I make it a priority to reassure them and put their needs first. (G)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatient Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-33.33333333\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI take great pride in being involved in surgical nursing, always striving to do the best for the patients I interact with. (D)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatient Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSuch things are outdated, but nowadays, proper explanations are given to ensure patients are well-informed and ready for surgery. (B)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatient Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-13.33333333\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI believe there are still things patients are unable to express, so I try to understand these as much as possible and proceed with the surgery. (C)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatient Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhile I often meet patients for the first time, pre-surgical visits allow me to gather information and base my nursing on that. (A)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatient Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-27.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33.33333333\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSurgery can be a frightening and unfamiliar environment for patients, so I make sure to provide emotional support. (E)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatient Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e69.25925926\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAs surgery places physical stress on patients, I communicate with doctors and anesthesiologists from pre- to post-surgery to ensure everything goes smoothly. (F)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatient Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-35.71428571\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI carefully consider the patients' feelings, focusing on their needs especially after they are under general anesthesia and unconscious. (E)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatient Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-1.666666667\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e66.66666667\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe nursing care we provide during surgery for unconscious patients significantly affects their postoperative recovery, which I am mindful of. (G)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatient Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e37.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e75\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI hope the surgery ends safely and without incident. (C)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSurgical Safety\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSurgical nursing is difficult, but the job of a nurse, or rather, human capabilities, are truly challenging in any ward, I believe. (A)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSurgical Safety\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSurgical nursing is somewhat unique. (F)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSurgical Safety\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e37.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEnsuring safety and helping patients feel at ease going into surgery, as well as facilitating their return to normal life, are key aspects of a nurse's job. (E)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSurgical Safety\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e65\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOf course, it is essential that patients undergo surgery safely and securely, but first and foremost, I must ensure my own safety. (H)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSurgical Safety\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.333333333\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSafety is my top priority, and if something concerns me, I always consult with others instead of deciding alone. (H)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSurgical Safety\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAs the patient is unconscious, I treat them as if they were my own family, ensuring they undergo surgery safely and with peace of mind. (A)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSurgical Safety\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhen I underwent surgery as a child, I was very scared because I was led to the operating room without any explanation. (H)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSurgical Safety\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-40\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI am careful with monitoring and assistance during surgery to prevent any physical disabilities afterward. (G)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSurgical Safety\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14.28571429\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePersonally, I find direct patient interaction challenging, but as a surgical nurse, I have less direct contact than ward nurses. (H)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSurgical Safety\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.66666667\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-13.33333333\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIt's about safety aspects. (I)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSurgical Safety\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEnsuring patient safety and promptly addressing any concerns is our job. (J)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSurgical Safety\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI never think I am suited for this, and no matter how many years pass, I never feel satisfied or that I've done well. (B)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUncategorized\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedical knowledge is important, but the ability to adjust and coordinate is also crucial. (C)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUncategorized\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13.33333333\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33.33333333\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLately, I've been especially careful to proceed cautiously and carefully, as there are many things that require urgent attention. (D)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUncategorized\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-2.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e55\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI make it a point to double or triple-check, as risks can lurk in many places, requiring careful verification. (H)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUncategorized\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13.33333333\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI am always mindful that what other medical engineers do is connected to what I do, keeping this connection in focus. (I)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUncategorized\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-6.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-62.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAs this is a hospital where advanced knowledge is required, it can be quite challenging for me in the current circumstances. (J)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUncategorized\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33.33333333\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e Patient Care emerged as a dominant theme, with nurses frequently discussing their interactions with patients, the emotional challenges they face, and their efforts to ensure patient safety and comfort. Statements in this category reflected a range of emotions, from the stress of dealing with anxious patients to the satisfaction of successfully advocating for patient needs. The sentiment scores for patient care varied widely, indicating both positive and negative emotional tones. Subjectivity scores in this category were generally high, highlighting the personal and empathetic nature of the nurses' reflections.\u003c/p\u003e \u003cp\u003eSurgical Safety was another significant theme. Nurses emphasized the importance of maintaining a safe surgical environment, both for patients and for themselves. They described meticulous routines for checking equipment and procedures, and the critical need for effective communication among surgical team members. The sentiment scores in this category were generally positive, reflecting a strong commitment to safety and the professional fulfillment derived from ensuring patient well-being. Subjectivity scores were also high, underscoring the personal investment nurses have in their roles.\u003c/p\u003e \u003cp\u003eNursing Skills involved discussions about the technical and practical aspects of the nurses' daily routines. Statements here included the use of skills, tools, and materials essential for surgical procedures. The sentiment scores were relatively neutral, suggesting that these tasks are viewed as routine but crucial components of their job. The subjectivity scores were lower compared to other categories, indicating a more objective focus on technical proficiency.\u003c/p\u003e \u003cp\u003eSeveral uncategorized statements revealed additional insights into the nurses' professional lives and personal reflections. These included comments on the challenges of maintaining professional standards, the need for continuous learning, and the emotional toll of dealing with life-and-death situations. The sentiment scores for these statements varied, reflecting a mix of frustration, determination, and pride. Subjectivity scores were generally high, indicating the deeply personal nature of these reflections.\u003c/p\u003e \u003cp\u003e \u003cb\u003eKeyword Co-occurrence Network\u003c/b\u003e \u003c/p\u003e \u003cp\u003e The keyword co-occurrence network provided a visual representation of the relationships between frequently mentioned terms in the interview data, highlighting key concepts and their interconnections (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). At the center of the network was the node \"patients,\" indicating that much of the discussion revolved around patient-related topics. Surrounding this central node were several significant themes. One prominent theme was \"surgery\" and \"safety,\" which were closely linked. This reflected the nurses' emphasis on ensuring safe surgical procedures, highlighting the critical importance of safety protocols and practices in the operating room. Another key theme was \"support\" and \"care,\" underscoring the nurses' focus on providing both emotional and practical support to patients. This theme emphasized the holistic approach to patient care, addressing both physical and emotional needs. Similarly, \"recovery\" and \"treatment\" were significant terms in the network, indicating the nurses' involvement in the postoperative phase and their role in facilitating patient recovery and managing treatment plans. The terms \"communicate\" and \"understanding\" highlighted the importance of effective communication between nurses, patients, and other healthcare professionals. Effective communication was crucial for understanding patient needs and providing appropriate care. Additionally, the presence of the keywords \"emotional\" and \"feelings\" pointed to the emotional aspect of nursing work, where nurses dealt with their own and patients' emotions. This reflected the psychological and empathetic dimensions of their roles. Challenges in nurse-patient interactions were suggested by the terms \"interaction\" and \"difficult,\" particularly in the context of stressful and high-stakes surgical environments. This pointed to the complexities of maintaining effective communication and emotional support under pressure. Furthermore, the keywords \"needs\" and \"discuss\" emphasized the importance of understanding and addressing patient needs through discussions and consultations, highlighting the nurses' proactive approach in identifying and meeting patient requirements.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eCluster and Scatter Plot Analyses\u003c/h2\u003e \u003cp\u003eThe cluster analysis, depicted in Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, revealed three distinct clusters based on sentiment and subjectivity scores. Cluster 1 (red) represented statements with predominantly positive sentiment and moderate to high subjectivity. These statements often highlighted positive aspects of patient care, job satisfaction, and effective communication. Cluster 2 (green) encompassed statements with lower sentiment scores and varying levels of subjectivity, indicating a mix of neutral or slightly negative sentiments often associated with challenges and routine tasks. Cluster 3 (blue) included statements with a wider range of sentiment scores but consistently high subjectivity, reflecting personal and empathetic responses to both positive and negative experiences in the operating room.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eThe scatter plot in Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e illustrated the relationship between sentiment scores and subjectivity scores for all analyzed statements. The plot showed a broad distribution of sentiment scores, ranging from highly negative to highly positive. Most statements had high subjectivity scores, indicating that the nurses\u0026rsquo; reflections were predominantly based on personal opinions and feelings rather than objective observations. This highlights the deeply emotional and personal nature of the nurses' experiences and the variability in their emotional responses to different aspects of their work.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eThe scatter plot in Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e explored the relationship between the length of the interview responses and their sentiment scores. The analysis revealed that longer responses tended to have more varied sentiment scores, ranging from highly negative to highly positive. This suggests that longer statements provided more detailed and nuanced reflections, capturing a wider range of emotions. Shorter statements, on the other hand, were more likely to have neutral or moderately positive sentiment scores, indicating more concise and focused responses.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eAll findings were provided as feedback to the participants.\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe aim of this study was to elucidate the emotions of operating room nurses in Japan towards perioperative nursing using generative AI. The findings provide valuable insights into the emotional landscape of these nurses, revealing key themes related to patient care, surgical safety, and nursing skills. This discussion will explore the implications of these findings, compare them with existing literature, and highlight the potential benefits and limitations of using generative AI for emotional analysis in healthcare.\u003c/p\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eEmotional Landscape of Operating Room Nurses\u003c/h2\u003e \u003cp\u003eThe detailed categorized analysis showed that patient care emerged as a main theme, with nurses frequently discussing their interactions with patients and the emotional challenges they face. The variability in sentiment scores, ranging from positive to negative, highlights the complex nature of patient care in the operating room. These findings align with previous studies that have emphasized the emotional demands of nursing and the impact of patient interactions on nurses' well-being.\u003csup\u003e3,4\u003c/sup\u003e Understanding how to transform these negative feelings into positive ones will be crucial in supporting the passion of operating room nurses. Nursing managers, colleagues, and educators need to be involved in ways that improve nurses' work motivation.\u003csup\u003e13\u003c/sup\u003e Surgical safety was another significant theme, with nurses emphasizing the importance of maintaining a safe surgical environment. The generally positive sentiment scores in this category reflect a strong commitment to safety and professional fulfillment. This is consistent with existing literature that underscores the critical role of safety protocols and effective communication in the operating room.\u003csup\u003e1,2\u003c/sup\u003e Operating room nurses believe that securing patient safety and preventing mistakes are key elements in their work, and they consider the culture of prevention and protection crucial in enhancing safety.\u003csup\u003e14\u003c/sup\u003e To develop safety-conscious nurses, it is necessary to maintain a high level of teamwork and communication.\u003csup\u003e15\u003c/sup\u003e Safety awareness and operating room nurses' emotions are connected and need to be valued. Nursing skills involved discussions about the technical and practical aspects of the nurses' daily routines. The neutral sentiment scores suggest that these tasks are viewed as routine but essential components of their job.\u003csup\u003e16\u003c/sup\u003e This finding highlights the importance of technical proficiency and routine in ensuring the smooth operation of surgical procedures.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003ePreventing Nurse Turnover and Burnout\u003c/h2\u003e \u003cp\u003eThe study's findings highlight the importance of addressing emotional support, effective communication, and safety protocols to prevent nurse turnover and burnout. Emotional support programs, such as counseling and peer support groups, can help nurses manage stress.\u003csup\u003e17\u003c/sup\u003e Effective communication within the surgical team can reduce misunderstandings and improve teamwork.\u003csup\u003e18, 19\u003c/sup\u003e Maintaining robust safety protocols and involving nurses in their development can enhance their sense of control and job satisfaction. Recognizing nurses' contributions and providing career development opportunities are also crucial for motivation and retention.\u003csup\u003e20\u003c/sup\u003e Promoting work-life balance through flexible scheduling and wellness programs can further prevent burnout. Organizational support, including mental health resources and proactive leadership, is essential to create a supportive work environment.\u003csup\u003e21\u003c/sup\u003e Future research should continue to explore these areas to develop comprehensive interventions for improving nurse well-being and job satisfaction.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eGenerative AI in Emotional Analysis\u003c/h2\u003e \u003cp\u003eThis study utilized generative AI, specifically ChatGPT, for sentiment and subjectivity analysis. The use of AI allowed for a detailed and quantitative analysis of the emotional tone of the interview data. The keyword co-occurrence network and cluster analysis provided additional layers of understanding, revealing the interconnected nature of various themes and the distinct emotional experiences of nurses. The application of AI in this context offers several advantages. It provides an objective method to quantify emotions, reducing potential biases that may arise from manual coding. Furthermore, AI can process large volumes of text data quickly and efficiently, making it a valuable tool for large-scale studies. However, there are also limitations to consider. AI-based analysis relies on the quality and representativeness of the input data. In this study, the sample size was relatively small, consisting of only 10 participants. While this allowed for in-depth qualitative analysis, it may not capture the full diversity of experiences among operating room nurses. Future studies with larger and more diverse samples are needed to validate and extend these findings.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThis study demonstrated the potential of generative AI to analyze the emotions of operating room nurses, revealing key themes related to patient care, surgical safety, and nursing skills. The findings highlight the complex and multifaceted nature of nursing work, underscoring the importance of emotional support and effective communication in promoting nurse well-being and job satisfaction. While the use of AI offers several advantages, future research with larger samples is needed to validate these findings and explore the broader applicability of AI in emotional analysis in healthcare.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003e\u003cem\u003eEthical approval and consent to participate\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by the Ethics Committee of\u0026nbsp;Nagasaki\u0026nbsp;Medical Center (Approval No. 2023058).\u0026nbsp;All methods were performed in accordance with relevant guidelines and regulations. This study was conducted in accordance with the ethical standards of the Declaration of Helsinki (1964) and its amendments. All observational protocols were approved by the institutional and licensing committees of\u0026nbsp;Nagasaki\u0026nbsp;Medical Center.\u0026nbsp;Informed consent was obtained from all participants prior to their inclusion in the study. Participants were provided with detailed explanations of the study\u0026apos;s purpose, methods, risks, and benefits to ensure their voluntary participation. Privacy and confidentiality of the participants were strictly protected, and the recorded data and interview content were anonymized and handled with the utmost care to ensure data security.\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eConsent for publication\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAvailability of data and materials\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAcknowledgments\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe gratefully acknowledge the work of the past and present members of our medical center.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eCompeting interests and Funding\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests and have not received any external financial support for this work. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The authors declare that they have no conflicts of interest.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAuthors\u0026rsquo; contributions\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eKentaro Hara was responsible for the organization and coordination of the study. Kentaro Hara was the chief investigator responsible for the data analysis. Reika Tachibana and Ryosuke Kumashiro provided the study data. Kodai Ichihara, Takahiro Uemura, Hiroshi Maeda, Michiko Yamaguchi and Takahiro Inoue made critical revisions to incorporate the relevant information. The authors have checked to make sure that our submission conforms as applicable to the Journal\u0026rsquo;s statistical guidelines described here. All authors contributed to the writing of the final manuscript and have approved it.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAlfredsdottir H, Bjornsdottir K. Nursing and patient safety in the operating room. \u003cem\u003eJ Adv Nurs\u003c/em\u003e. 2008;61(1):29-37. doi:10.1111/j.1365-2648.2007.04462.x\u003c/li\u003e\n\u003cli\u003eLiao X, Zhang P, Xu X, Zheng D, Wang J, Li Y, Xie L. Analysis of factors influencing safety attitudes of operating room nurses and their cognition and attitudes toward adverse event reporting. \u003cem\u003eJ Healthc Eng\u003c/em\u003e. 2022;2022:8315511. doi:10.1155/2022/8315511\u003c/li\u003e\n\u003cli\u003eMolero Jurado MDM, P\u0026eacute;rez-Fuentes MCD, Oropesa Ruiz NF, Sim\u0026oacute;n M\u0026aacute;rquez MDM, G\u0026aacute;zquez Linares JJ. Self-efficacy and emotional intelligence as predictors of perceived stress in nursing professionals. \u003cem\u003eMedicina (Kaunas)\u003c/em\u003e. 2019;55(6):237. doi:10.3390/medicina55060237\u003c/li\u003e\n\u003cli\u003eFont-Jimenez I, Ortega-Sanz L, Acebedo-Uridales MS, Aguaron-Garcia MJ, de Molina-Fern\u0026aacute;ndez I, Jim\u0026eacute;nez-Herrera MF. Nurses\u0026apos; emotions on care relationship: A qualitative study. \u003cem\u003eJ Nurs Manag\u003c/em\u003e. 2020;28(8):2247-2256. doi:10.1111/jonm.12934\u003c/li\u003e\n\u003cli\u003eFasbinder A, Shidler K, Caboral-Stevens M. A concept analysis: Emotional regulation of nurses. \u003cem\u003eNurs Forum\u003c/em\u003e. 2020;55(2):118-127. doi:10.1111/nuf.12405\u003c/li\u003e\n\u003cli\u003eJim\u0026eacute;nez-Herrera MF, Llaurad\u0026oacute;-Serra M, Acebedo-Urdiales S, Bazo-Hern\u0026aacute;ndez L, Font-Jim\u0026eacute;nez I, Axelsson C. Emotions and feelings in critical and emergency caring situations: A qualitative study. \u003cem\u003eBMC Nurs\u003c/em\u003e. 2020;19:60. doi:10.1186/s12912-020-00438-6\u003c/li\u003e\n\u003cli\u003eJames I, Andershed B, Gustavsson B, Ternestedt BM. Emotional knowing in nursing practice: In the encounter between life and death. \u003cem\u003eInt J Qual Stud Health Well-being\u003c/em\u003e. 2010;5(2):5367. doi:10.3402/qhw.v5i2.5367\u003c/li\u003e\n\u003cli\u003eTeymoori E, Zareiyan A, Babajani-Vafsi S, Laripour R. Viewpoint of operating room nurses about factors associated with occupational burnout: A qualitative study. \u003cem\u003eFront Psychol\u003c/em\u003e. 2022;13:947189. doi:10.3389/fpsyg.2022.947189\u003c/li\u003e\n\u003cli\u003eLi N, Zhang L, Li X, Lu Q. The influence of operating room nurses\u0026apos; job stress on burnout and organizational commitment: The moderating effect of over-commitment. \u003cem\u003eJ Adv Nurs\u003c/em\u003e. 2021;77(4):1772-1782. doi:10.1111/jan.14725\u003c/li\u003e\n\u003cli\u003eFogel AL, Kvedar JC. Artificial intelligence powers digital medicine. \u003cem\u003eNPJ Digit Med\u003c/em\u003e. 2018;1:5. doi:10.1038/s41746-017-0012-2\u003c/li\u003e\n\u003cli\u003eMontero Quispe K, Utyiama DMS, Dos Santos EMBF, Oliveira HABF, Souto EJP. Applying self-supervised representation learning for emotion recognition using physiological signals. \u003cem\u003eSensors (Basel)\u003c/em\u003e. 2022;22(23):9102. doi:10.3390/s22239102\u003c/li\u003e\n\u003cli\u003eTong A, Sainsbury P, Craig J. 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Turkish surgical nurses\u0026apos; attitudes related to patient safety: A questionnaire study. \u003cem\u003eNiger J Clin Pract\u003c/em\u003e. 2020;23(4):470-475. doi:10.4103/njcp.njcp_677_18\u003c/li\u003e\n\u003cli\u003eZisberg A, Young HM, Schepp K, Zysberg L. A concept analysis of routine: Relevance to nursing. \u003cem\u003eJ Adv Nurs\u003c/em\u003e. 2007;57(4):442-453. doi:10.1111/j.1365-2648.2007.04103.x\u003c/li\u003e\n\u003cli\u003eBernburg M, Groneberg DA, Mache S. Mental Health Promotion Intervention for Nurses Working in German Psychiatric Hospital Departments: A Pilot Study. \u003cem\u003eIssues Ment Health Nurs\u003c/em\u003e. 2019;40(8):706-711. doi:10.1080/01612840.2019.1565878\u003c/li\u003e\n\u003cli\u003eLeonard M, Graham S, Bonacum D. The human factor: the critical importance of effective teamwork and communication in providing safe care. \u003cem\u003eQual Saf Health Care\u003c/em\u003e. 2004;13 Suppl 1(Suppl 1):i85-i90. doi:10.1136/qhc.13.suppl_1.i85\u003c/li\u003e\n\u003cli\u003eKumar H, Morad R, Sonsati M. Surgical team: improving teamwork, a review. \u003cem\u003ePostgrad Med J\u003c/em\u003e. 2019;95(1124):334-339. doi:10.1136/postgradmedj-2018-135943\u003c/li\u003e\n\u003cli\u003eWilkinson S, Hayward R. Band 5 nurses\u0026apos; perceptions and experiences of professional development. \u003cem\u003eNurs Manag (Harrow)\u003c/em\u003e. 2017;24(2):30-37. doi:10.7748/nm.2017.e1537\u003c/li\u003e\n\u003cli\u003eBoamah SA, Laschinger H. The influence of areas of worklife fit and work-life interference on burnout and turnover intentions among new graduate nurses. \u003cem\u003eJ Nurs Manag\u003c/em\u003e. 2016;24(2):E164-E174. doi:10.1111/jonm.12318\u003cbr\u003e \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Operating Room Nurses, Generative AI, Emotion Analysis, Sentiment Analysis, Perioperative Nursing, Burnout, Job Satisfaction","lastPublishedDoi":"10.21203/rs.3.rs-4505331/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4505331/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cb\u003eAim\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThis study aimed to elucidate the emotions of operating room nurses in Japan towards perioperative nursing using generative AI and identify factors contributing to burnout and turnover.\u003c/p\u003e\u003cp\u003e\u003cb\u003eMethods\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThis single-center cross-sectional study, conducted from February 2023 to February 2024, employed semi-structured interviews with 10 operating room nurses from a national hospital in Japan. The interviews were designed to capture detailed qualitative data about the nurses' emotional experiences. These interviews were transcribed verbatim and analyzed using thematic, sentiment, and subjectivity analysis with ChatGPT (OpenAI, San Francisco, CA). Data visualization techniques, including keyword co-occurrence networks and cluster analyses, were also employed to uncover patterns and relationships in the data.\u003c/p\u003e\u003cp\u003e\u003cb\u003eResults\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThematic analysis revealed key themes related to patient care, surgical safety, and nursing skills. The sentiment analysis showed a range of emotional tones, with high subjectivity scores indicating that the nurses' reflections were deeply personal and empathetic. Keyword co-occurrence networks highlighted the interconnectedness of various themes, such as the relationship between patient care and safety protocols. Cluster analysis identified distinct groups of emotional experiences, demonstrating the diverse emotional landscape of operating room nurses.\u003c/p\u003e\u003cp\u003e\u003cb\u003eConclusions\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThis study demonstrated the potential of generative AI to provide nuanced insights into the emotions of operating room nurses. The findings underscore the importance of emotional support, effective communication, and robust safety protocols in enhancing nurse well-being and job satisfaction. By leveraging AI technologies, healthcare institutions can better understand and address the emotional challenges faced by nurses, potentially reducing burnout and improving retention rates. Future research with larger and more diverse samples is needed to validate these findings and explore the broader applicability of AI in healthcare settings.\u003c/p\u003e","manuscriptTitle":"Sentiment Analysis of Operating Room Nurses in Acute Care Hospitals in Japan: Unveiling Passion for Perioperative Nursing Using ChatGPT","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-06-28 05:20:42","doi":"10.21203/rs.3.rs-4505331/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-07-15T05:31:36+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-07-13T07:52:53+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-07-12T13:29:22+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"261452635436508751046473480683149895447","date":"2024-07-01T23:18:37+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"200453122434341448180378261823357680240","date":"2024-07-01T18:19:55+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-07-01T15:26:49+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-06-07T05:39:29+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-06-07T05:17:12+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Nursing","date":"2024-05-30T23:10:11+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"e185e782-8b2a-4fad-80ec-f78744c2202b","owner":[],"postedDate":"June 28th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-01-13T16:09:13+00:00","versionOfRecord":{"articleIdentity":"rs-4505331","link":"https://doi.org/10.1186/s12912-024-02655-9","journal":{"identity":"bmc-nursing","isVorOnly":false,"title":"BMC Nursing"},"publishedOn":"2025-01-09 15:57:38","publishedOnDateReadable":"January 9th, 2025"},"versionCreatedAt":"2024-06-28 05:20:42","video":"","vorDoi":"10.1186/s12912-024-02655-9","vorDoiUrl":"https://doi.org/10.1186/s12912-024-02655-9","workflowStages":[]},"version":"v1","identity":"rs-4505331","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4505331","identity":"rs-4505331","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}