Background

Although the hand hygiene (HH) procedure is simple, the related behaviour is complex and is not readily understood, explained or changed. There is a need for practical tools to provide data that can guide healthcare managers and practitioners not only on the ‘what’ (the standards that must be met), but also the ‘how’ (guidance on how to achieve the standards).

Aim

To develop a valid questionnaire to evaluate attitudes to the factors that influence engagement in HH behaviour that can be readily completed, administered and analysed by healthcare professionals to identify appropriate intervention strategies. Construct validity was assessed using confirmatory factor analysis, predictive validity was assessed through comparison with self-reported HH behaviour, and convergent validity was assessed through direct unit-level observation of HH behaviour.

Methods

The Capability, Opportunity, Motivation-Behaviour (COM-B) model was used to design a 25-item questionnaire that was distributed to intensive care unit (ICU) personnel in Ireland. Direct observation of HH behaviour was carried out at two ICUs.

Findings

In total, 292 responses to the survey (response rate 41.0%) were included in the analysis. Confirmatory factor analysis resulted in a 17-item questionnaire. Multiple regression revealed that a model including capability, opportunity and motivation was a significant predictor of self-reported behavioural intention [F(3,209)=22.58, P<0.001]. However, the opportunity factor was not found to make a significant contribution to the regression model.

Conclusion

The COM-B HH questionnaire is reliable and valid, and provides data to support the development and evaluation of HH interventions that meet the needs of specific healthcare units.

中文翻译：

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心理测量学评估影响手部卫生行为的因素以告知干预措施

背景

尽管手卫生（HH）程序很简单，但是相关行为却很复杂，并且不容易理解，解释或更改。需要一种实用的工具来提供数据，这些数据不仅可以指导“什么”（必须满足的标准），而且可以指导“如何”（如何达到标准的指南），以指导医疗保健管理人员和从业人员。

目的

制定有效的调查问卷以评估对影响参与HH行为的因素的态度，这些态度可由医疗保健专业人员轻松完成，管理和分析，以确定合适的干预策略。使用验证性因子分析评估构建体效度，通过与自我报告的HH行为进行比较评估预测效度，并通过直接单位水平的HH行为观察评估收敛效度。

方法

使用能力，机会，动机-行为（COM-B）模型设计了25个项目的问卷，分发给爱尔兰的重症监护病房（ICU）人员。在两个ICU上直接观察HH行为。

发现

分析中总共包括292份调查问卷答复（回应率为41.0％）。验证性因素分析得出了17个项目的问卷。多元回归显示，包括能力，机会和动机的模型是自我报告的行为意图的重要预测因子[ F（3,209）= 22.58，P <0.001]。但是，没有发现机会因素对回归模型有重大贡献。

结论

COM-B HH问卷是可靠和有效的，并提供数据来支持HH干预措施的开发和评估，以满足特定医疗部门的需求。