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An Exploration of Factors Associated with Intention to Practice Hand Hygiene among Healthcare Workers in Taiwan Using the Health Belief Model
Hand hygiene (HH),Healthcare workers (HCWs),Health Belief Model (HBM),Healthcare-associated infections (HAI),Taiwan,
|Publication Year :||2019|
目的：本研究係以健康信念模式 (Health Belief Model, HBM) 為架構，透過問卷調查，檢視臺灣醫護人員手部衛生意圖之相關因素，並將醫師與護理師分層進行分析，以供未來發展適性衛教或介入策略之實證參考依據。
結果：本研究之探索性因素分析共萃取出十個潛在因素，針對醫護人員整體而言，其中四因素與高洗手意圖具統計顯著關聯，分別為：較高之與預防感染相關之「自覺利益」(AOR=2.84)、較高之與工作相關之「自覺利益」(AOR=1.70)、較高之與時間相關之「自覺障礙」(AOR=0.36)，及較高之「行動線索」(AOR=1.89)。將醫護分層分析後發現，與醫師未來洗手意圖最相關之因素為，與預防感染相關之「自覺利益」(AOR=14.27)，反觀護理師，較認同執行手部衛生可以讓自己覺得是位稱職的醫護人員時 (AOR=2.99)，其未來具高洗手意圖之勝算比顯著較高。此外，本研究亦發現，當醫護人員工作之醫療場所有推行洗手政策時 (AOR=4.43)，對醫護人員整體之洗手意圖亦有正向影響。
Background: Healthcare-associated infection (HAI) is an important patient safety issue in public health. The World Health Organization (WHO) estimated that 10% of inpatients worldwide suffered from HAI each year, causing many adverse health consequences, and HAI was mostly transmitted through the hands of healthcare workers (HCWs), but their prevalence of hand hygiene (HH) practice was below 40%, which could be improved for infection control. Prior studies have confirmed that increasing the HH practice of HCWs was a cost-effective way to prevent HAI; however, little is known about HH intention and its associated factors among HCWs in Taiwan.
Objectives: This study aimed to systematically examine the HH intention and associated factors among physicians and nurses in Taiwan, using the Health Belief Model (HBM) as a theoretical framework. Analysis would also be performed separately for physicians and nurses for comparison.
Methods: An anonymous online survey was conducted between December 2018 and March 2019. Responses from 103 physicians and 602 nurses were received. Survey items were developed on the basis of the five constructs of HBM (perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action). Multivariate logistic regression was used to explore factors associated with HH intention, separately for physicians and nurses.
Results: Exploratory factor analysis extracted ten potential factors, four of which were significantly associated with high HH intention among HCWs, as follows: high “perceived benefits” about infection prevention (AOR=2.84), high “perceived benefits” about praise/respect at work (AOR=1.70), high “perceived barriers” about time (AOR=0.36), and high “cues to action” (AOR=1.89). The stratified analysis found that physicians’ HH intention was strongly related to “perceived benefits” about infection prevention (AOR=14.27). By contrast, nurses who believed HH can make them feel like a competent HCW (AOR=2.99) were more likely to have high HH intention. Notably, in hospitals with HH policy (AOR=4.43), HCWs also had greater HH intention.
Conclusions: This HBM-based study explored HH intention among HCWs in Taiwan and found different HBM factors associated with physicians’ and nurses’ HH intention. To increase physicians’ HH intention, empirical evidence could be provided to them via on-the-job training to strengthen their beliefs in the effectiveness of HH practice for HAI prevention. For nurses, praising their HH practice during departmental meetings might help enhance their beliefs in their professionalism if they practice HH as recommended. Finally, efforts should be made to further promote hospital-wide HH policy with proper incentives to improve the HH practice among HCWs.
|Appears in Collections:||健康行為與社區科學研究所|
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