Hand hygiene determinants of informal caregivers in hospitals under Pender's perspective

ABSTRACT Objectives: to analyze hand hygiene determinants of informal caregivers in a hospital environment. Methods: qualitative study conducted with 55 caregivers at a university hospital in the Northeast of Brazil. A semi-structured instrument was used, adapted from Nola Pender's Health Promotion Model, from which the deductive categories were derived. Results: the general behavior included hand hygiene before meals and after using the bathroom. Sensitivity to the requirements for hand hygiene was observed, but the barriers and self-efficacy consisted of the availability of soap or alcohol-based hand sanitizers, the lack of knowledge on the importance of and forgetfulness of the practice. The reinforcement on the importance of the practice and being in a contaminated environment were influencers, and commitment, warnings, and training were indispensable. Conclusions: benefits related to protection from infections were seen as positive determinants for hand hygiene adherence. For non-adherence, factors such as lack of sanitizing supplies, ignorance towards the importance of the activity, and forgetfulness stood out.

摘要
研究目的：分析医院环境中非正式照护者手卫生行为的影响因素。
研究方法：本研究为质性研究，于巴西东北部某大学医院开展，共纳入55名照护者作为研究对象。采用基于诺拉·彭德（Nola Pender）健康促进模型（Health Promotion Model）改编的半结构化研究工具，由此衍生出演绎分析类别。
研究结果：照护者的整体手卫生行为涵盖餐前及如厕后洗手环节；其对手卫生相关要求具备一定敏感度，但手卫生实施的阻碍因素与自我效能相关要素包括：皂液或醇类手消毒剂的可及性不足、对该操作重要性认知缺失以及遗忘执行。此外，强化手卫生重要性宣教与处于污染环境均为行为影响因素，而履行承诺、警示提醒与专业培训则为不可或缺的保障条件。
研究结论：可预防感染这一获益被视为促进手卫生依从性的积极影响因素；而手卫生依从性不佳的相关因素则包括手消毒用品匮乏、对操作重要性认知不足以及遗忘执行。