社会认知理论对医务人员手卫生依从性干预效果分析

Analysis on intervention effect of social cognitive theory on hand hygiene compliance of medical workers

目的探索社会认知理论对医务人员手卫生依从性的干预效果。方法采用整群抽样的方法 ,将该院16个科室的医护人员作为研究对象。一院区的科室作为对照组,二院区的科室作为试验组(一院区与二院区相距2 km)。观察比较两组经过半年的干预后在手卫生知识的知晓率、手卫生依从性及手卫生正确率方面的差异。结果基线调查:医护人员对手卫生的知晓度仅为30%~40%;手卫生依从性仅为43%、手卫生正确率也仅为47%,说明医护人员的手卫生的意识、态度、行为甚至医院的政策环境等都有待提高。对照组干预后的情况变化比较,差异均无统计学意义(P>0.05);试验组在手卫生知识掌握、手卫生依从性、手卫生正确率方面的提高差异均有统计学意义(P<0.05)。经过多元回归分析发现,在认知方面、环境方面、行为方面的干预对手卫生依从性均有促进作用(P<0.05)。结论社会认知理论为基础的干预措施能有效地提高医护人员的手卫生依从性及正确率,值得临床推广应用。

Objective To investigate the effect of social cognitive theory intervention on the hand hygiene compliance of medical workers. Method Sixteen departments of our hospital served as the study objects by adopting the cluster sampling method. The departments in the first hospital area served as the control group and which in the second hospital area as the experi-mental group（2）. The difference in the hand hygiene awareness,hand hygiene compliance and hand hygiene accuracy rate after the half-year intervention between the two groups were observed. Result The baseline investigation：the awareness of hand hygiene knowledge of medical workers was only 30%~40%,the hand hygiene compliance was only 43% and the hand hygiene accuracy was only 47%,indicating that the medical workers′ hand hygiene consciousness,attitude,behavior and even hospital policy environment needed to be improved. After half-year intervention,the change of control group situation had no statistically significant difference（P〈0.05）; while the improvements of hand hygiene knowledge mastering,hand hygiene compliance and hand hygiene accuracy in the experimental group had statistically significant difference（P〈0.05）. The multivariate regression analysis found that the intervention in the aspects of cognition,environment and behavior had promoting effect on hand hygiene compliance（P≤0.05）. Conclusion The intervention measures based on social cognitive theory can effectively improve the hand hygiene compliance and hand hygiene accuracy of medical workers and is worth promotion.