基层医务人员手卫生行为现状及其影响因素

Current status of hand hygiene practices among primary healthcare workers and its influencing factors

【目的】了解基层医务人员手卫生现状及其影响因素,为提高基层医疗机构医务人员手卫生行为提供参考。【方法】采用自行设计的问卷,通过整群随机抽样方法对上海市嘉定区7家社区卫生服务中心医务人员进行问卷调查,对调查的数据进行描述性统计、信效度检验、相关性分析以及结构方程模型拟合。【结果】不同职业、不同教育水平医务人员的手卫生行为依从性差异有统计学意义(P<0.05),临床科室医务人员的手卫生行为依从性较高(P<0.05)。健康信念模型的核心变量中,医务人员在行为实施过程中的感知益处、感知障碍、自我效能对手卫生行为产生直接影响,直接效应值分别为0.341、-0.152、0.234;行动线索、新型冠状病毒感染感知严重性对手卫生行为产生间接影响,间接效应值分别为0.066、0.062。【结论】医务人员手卫生行为实施程度较高,但不同特征医务人员手卫生行为得分存在差异。通过提升医务人员感知益处、自我效能以及降低感知障碍,可以有效地提高医务人员手卫生行为。

[Objective]To investigate the current status and influencing factors of hand hygiene practices among primary healthcare workers,and to provide a reference for improving hand hygiene behavior in primary healthcare institutions.[Methods]A self-designed questionnaire was used to conduct a survey among medical staff of seven community health service centers in Jiading District,Shanghai,using a cluster random sampling method.The data collected were subjected to descriptive statistics,reliability and validity tests,correlation analysis,and structural equation model fitting.[Results]A statistical difference in hand hygiene compliance was found among medical staff with varying occupational types and educational levels(P<0.05),and medical staff in clinical departments exhibited higher levels of hand hygiene compliance(P<0.05).In the health belief model,among the core variables,healthcare workers’perceived benefits,perceived barriers,and self-efficacy had a direct impact on hand hygiene behavior,with direct effect values of 0.341,−0.152,and 0.234,respectively.Meanwhile,cues to action and perceived severity of COVID-19 infection indirectly affected hand hygiene behavior,with an indirect effect value of 0.066 and 0.062,respectively.[Conclusion]Healthcare workers generally exhibit a high degree of hand hygiene compliance,but there are variations in hand hygiene scores among healthcare workers with different characteristics.Enhancing healthcare worders’perception of benefits,action cues,and self-efficacy while reducing perceived barriers can effectively improve their hand hygiene behavior.