A Study On The Construction And Preliminary Application Of The Questionnaire In Promoting Patient Participation Of Hand Hygiene In Medical Institution

Objective:1. Construct a questionnaire in promoting patient participation of hand hygiene in medical institution, providing a measuring tool for improving patient participation of hand hygiene in medical institution nationally.2. With applying the questionnaire to test its scientific assessment, evaluate patient and health care worker(HCW)’s hand hygiene perception, participation intention, participation way and current participation situation, analyze the relevant factors that influencing patient participation of hand hygiene in medical institution, explore the best ways for patient to participate in hand hygiene. Methods:1. The initial questionnaire was constructed with item pool developed by literature research and specialist panel discussion. By use of pilot study, two rounds Delphi, pre-investigation and item analysis to screen index, formed the questionnaire in promoting patient participation of hand hygiene in medical institution.2. By random sampling, 223 patients and 237 HCWs from 9 clinical departments in 3 medical institutions of Xi’an were investigated by the questionnaire constructed in the first section of this paper and “Chinese scale of doctor-patient relationship questionnaire” translated by Yang Hui. Tested the validity and reliability of this questionnaire and analyzed the hand hygiene perception, participation intention, participation way and current participation situation of patient and HCW according to the investigated data.Results:1. Constructed “the questionnaire in promoting patient participation of hand hygiene in medical institution”“The questionnaire in promoting patient participation of hand hygiene in medical institution” consisted of two sub-questionnaires, one for patient and the other for HCW. Each sub-questionnaire contained the contents of hand hygiene perception, participation intention, participation way and current participation situation. Each sub-questionnaire was composed by 17 indexes, 15 were closed questions scored with the definition of 5 indications by using 0-4 points, the other 2 indexes were open-ended questions.2. The questionnaire in promoting patient participation of hand hygiene in medical institution was more scientific.(1) Patient sub-questionnaire recovery rate was 97%, effective rate was 96%, HCWs sub-questionnaire recovery rate was 99%, effective rate was 100%. It took an average time of 8 ~ 10 minutes to fill in a form, indicated that the questionnaire had better feasibility.(2) The patient sub-questionnaire’s reliability: The Cronbach’s α was 0.845, split-half reliability was 0.603, retested reliability was 0.822; The patient sub-questionnaire’s validity: The coefficient of association(r) between index and total score was 0.403~0.751, contributing rate of cumulative sums of squares was 49.456%.(3) The HCW questionnaire’s reliability: The Cronbach’s α was 0.826,split-half reliability was 0.651, retested reliability was 0.756. The HCW questionnaire’s validity: The coefficient of association(r) between index and total score was 0.403~0.713, contributing rate of cumulative sums of squares was 48.221%.3. The investigation of current situation in promoting patient participation of hand hygiene in medical institution(1) The hand hygiene perception of both patient and HCW: 90.30% HCWs thought that hand hygiene was important, the perception scores were 22.10±1.75, It was the department that influenced HCW’s hand hygiene perception; 96.00% patients thought that hand hygiene was important, the perception scores were 27.78±3.50, Culture degree and work state were the factors influenced patient hand hygiene perception.(2) The participation intention of both patient and HCW: 91.60% HCWs were strongly willing to participate in with scores of 18.49±3.81, the HCW participation intention was influenced by factors including different departments, majors, years of working and education level; 69.50% patients were strongly willing to participate in with scores of 22.58±4.26, the patient participation intention was influenced by ages.(3) Patient preferred reminding doctors than nurses to execute hand hygiene.(4) Patient’s willingness of reminding hand hygiene was related with whether got HCW’s authorization. With doctor’s authorization, patient’s willingness to participate in was 49.80% compared with 65.00% oppositely.(5) It did have psychological effect for both HCW and patient by reminding hand hygiene to HCW. 50.20% patients were embarrassed to this while 49.40% HCWs were embarrassed to be reminded.(6) Patient preferred participation methods from high to low were as follows, using survey cards,directly proposing, showing reminder card and sticking reminder on patient’s clothes; HCW preferred participation methods from high to low were as follows, patient using survey cards, showing reminder card, sticking reminder on patient’s clothes and directly proposing.(7) The self-assessment of current situation in patient participation of hand hygiene in medical institution: 74.68% HCWs indicated that they had never been reminded by patients. Conclusions:1. Constructed a questionnaire in promoting patient participation of hand hygiene in medical institution, with preliminary application, it proved that this questionnaire was likely good in both validity and reliability, which could be used as a study tool for patient participation of hand hygiene in medical institution.2. Both investigated patients and HCWs agreed with the importance of hand hygiene, the attitudes of both for patients participation of hand hygiene in medical institution were active. However, patient’s actual participation of hand hygiene was less.3. The following should be noted for medical institution about promoting patient participation of hand hygiene. ①Patients should be authorized to participate in it by HCW. ②The medical institution should carry out patient participation education activity of hand hygiene, to help patient and HCW realize patient participation in hand hygiene correctly, improve hand hygiene perception of patient and HCW, guide patient to participate in properly.③The participation method of patient using a survey card preferred by both patient and HCW was more recommended.④The medical institution should assess the doctor-patient relationship before carrying out the patient participation in hand hygiene.