Capability, Opportunity, Motivation, and Hand Hygiene Behavior in Healthcare Workers: A Structural Equation Modeling

Abstract

Background Hand hygiene among healthcare workers is the leading measure to reduce healthcare-associated infections. However, hand hygiene behavior is complex and not readily understood. This study aimed to identify the determinants and the underlying mechanism of hand hygiene behavior based on the capability, opportunity, motivation-behavior model. Methods A self-constructed questionnaire survey was conducted among healthcare workers in Chongqing, China. Capability, opportunity, and motivation were designed as independent variables, and hand hygiene behavior was measured as a dependent variable. Internal consistency reliability analysis and confirmatory factor analysis were applied to examine the reliability and validity of the questionnaire. Structural equation modeling was performed to explore the relationships among capability, opportunity, motivation, and hand hygiene behavior. Results Four hundred and ninety-nine physicians and nurses were investigated. The Cronbach’s α coefficients were above 0.764. Confirmatory factor analysis was confirmed with good data fitness. The structural equation modeling had a good fit (root mean square error of approximation=0.070, comparative fit index=0.960, Tucker–Lewis index=0.956). Both opportunity ( β =0.265, p <0.05) and motivation ( β =0.333, p <0.05) directly affected hand hygiene behavior. Both capability ( β =0.194, p <0.001) and opportunity ( β =0.719, p <0.001) were indirectly linked to hand hygiene behavior through motivation. Conclusion To improve hand hygiene behavior, more efforts need to be focused on resource provision and motivation enhancement in the future compared to training.

Validity of self-reported compliance and behavioural determinants of observed compliance: an application of the COM-B hand hygiene questionnaire in nine Dutch hospitals

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Factors Affecting the Qualification Rate of Hand Disinfection Among Physicians: A Cross-Sectional Survey

“…This gender disparity aligns with previous research conducted by Chinese scholars in the same domain. 10 , 11 In terms of age groups, doctors aged 41–50 years exhibited the highest qualification rate for hand disinfection at 91.67%. Following closely were doctors aged 31–40 years, with a rate of 65.22%, and doctors aged ≤ 30 years, with a rate of 65.00%.…”

Health Science Students’ Perceptions of Hand Hygiene Education and Practice in a South African University: Introducing the University Hand Hygiene Improvement Model

“…Zheng and colleagues showed that the underlying mechanism of hand hygiene behavior among HCWs is based on the capability, opportunity, and motivation-behavior model. Their study found that to improve hand hygiene behavior, more efforts should focus on resource provision and hand hygiene motivation enhancement [ 39 , 66 ]. Therefore, to improve hand hygiene habits, we need strategies that not only increase knowledge but also positively affect attitudes and views.…”