Current situation and influencing factors of hand hygiene behavior among medical staff: a study based on the capability, opportunity, motivation, and behavior model

Objective To investigate the current situation and influencing factors of hand hygiene behavior among medical staff based on the capability, opportunity, motivation, and behavior(COM-B) model and to explore the influence paths of capability, opportunity, and motivation of hand hygiene on this behavior.

Methods A cross-sectional survey was conducted among medical staff in a tertiary comprehensive teaching hospital from May to June 2022 with the convenience sampling method, using the general information questionnaire, hand hygiene behavior scale, and hand hygiene status questionnaire.Pearson correlation analysis and multiple linear regression analysis were used to test the relationship between variables.Bootstrap method was used to analyze the mediating effect of influencing factors on hand hygiene behavior.

Results A total of 1 876 questionnaires were distributed, and 1 722 valid questionnaires were collected, with an effective recovery rate of 91.79%. The scores of hand hygiene capability, opportunity, motivation, and behavior of medical staff were(4.86 ± 0.32), (4.88 ± 0.32), (4.88 ± 0.32), and(4.91 ± 0.26), respectively. Hand hygiene capability, opportunity, motivation, and behavior of medical staff were positively correlated with each other(r=0.546-0.814, P < 0.01). For every one-point increase in hand hygiene opportunity and motivation scores, hand hygiene behavior scores increased by 0.220 and 0.284points, respectively(P < 0.001). The total effect of hand hygiene capability on the behavior of medical staff was 0.449(P < 0.001), and the direct effect was not significant, with a value of 0.019(P>0.05). Hand hygiene capability influenced hand hygiene behavior through path 1(hand hygiene capability→opportunity→behavior, path coefficient=0.206), path 2(hand hygiene capability→motivation→behavior, path coefficient=0.107), and path 3(hand hygiene capability→opportunity→ motivation→behavior, path coefficient=0.118)(P < 0.05 for all paths).

Conclusions Hand hygiene opportunity and motivation played multiple mediating roles between hand hygiene capability and hand hygiene behavior. The improvement of hand hygiene behavior should be based on the COM-B model, and a comprehensive improvement strategy for hand hygiene capability, opportunity, and motivation should be constructed to improve hand hygiene compliance and prevent hospital infection.