van Dijk MD, Nieboer D, Vos MC, van Beeck EF. Validity of self-reported compliance and behavioural determinants of observed compliance: an application of the COM-B hand hygiene questionnaire in nine Dutch hospitals.
J Hosp Infect 2023:S0195-6701(23)00136-6. [PMID:
37116660 DOI:
10.1016/j.jhin.2023.04.012]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 03/29/2023] [Accepted: 04/13/2023] [Indexed: 04/30/2023]
Abstract
BACKGROUND
Hand hygiene compliance (HHC) can be influenced by behavioural determinants, but knowledge on this is still scarce. The Capability, Opportunity, Motivation-Behaviour (COM-B) hand hygiene questionnaire was developed by Lydon et al. to gain insight in self-reported behavioural determinants and self-reported HHC.
AIM
To determine the validity of self-reported HHC, by using the COM-B questionnaire. To investigate the influence of self-reported behavioural determinants on observed HHC, while taking environmental determinants into account.
METHODS
Cross-sectional study, from September to November 2019, in nine hospitals in the Netherlands. Healthcare workers (HCW) filled in the COM-B questionnaire and direct hand hygiene observations were performed. In addition, information on environmental determinants (workload, ward category, type of hospital, infrastructure of a ward) was collected. Validity of self-reported HHC was determined by the intraclass correlation coefficient (ICC). Univariable and multivariable regression analyses were performed to investigate the relation between behavioural- and environmental determinants and observed HHC.
FINDINGS
The ICC showed no association between self-reported HHC and observed HHC (0.04 (-0.14, 0.21)). In the univariable regression analyses, ward category and the subscales opportunity and motivation were significantly associated with observed HHC. In the multivariable regression analysis, only ward category and motivation remained significant.
CONCLUSION
The self-reported HHC is not a valid substitute for direct hand hygiene observations. The behavioural determinant motivation was significantly associated with HCC, while almost none of the environmental determinants had an effect on observed HHC. In further development of hand hygiene interventions, increasing the intrinsic motivation of HCW should get extra attention.
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