Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Aug 17:15:2219-2228.
doi: 10.2147/PRBM.S373287. eCollection 2022.

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

Shuangjiang Zheng  1   2 , Qiuxia Yang  3 , Xuemei Wang  4 , Xinping Zhang  1 , Qian Zhou  5
Affiliations

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

Shuangjiang Zheng et al. Psychol Res Behav Manag. .

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.

Keywords: COM-B model; behavior; hand hygiene; healthcare workers.

PubMed Disclaimer

Conflict of interest statement

The authors declare that there is no conflict of interests.

Figures

Figure 1
Figure 1
Hypotheses of the COM-B model of hand hygiene behavior of HCWs.
Figure 2
Figure 2
Final SEM model of hand hygiene behavior of HCWs.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Pittet D, Hugonnet S, Harbarth S, et al. Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Infection Control Programme. Lancet. 2000;356(9238):1307–1312. doi:10.1016/s0140-6736(00)02814-2 - DOI - PubMed
    1. World Health Organization. Patient Safety: Global Action on Patient Safety: Report by the Director-General. Geneva: World Health Organization; 2019.
    1. Schreiber PW, Sax H, Wolfensberger A, Clack L, Kuster SP. The preventable proportion of healthcare-associated infections 2005-2016: systematic review and meta-analysis. Infect Control Hosp Epidemiol. 2018;39(11):1277–1295. doi:10.1017/ice.2018.183 - DOI - PubMed
    1. Umscheid CA, Mitchell MD, Doshi JA, Agarwal R, Williams K, Brennan PJ. Estimating the Proportion of Healthcare-Associated Infections That Are Reasonably Preventable and the Related Mortality and Costs. Infect Control Hospital Epidemiol. 2011;32(2):101–114. doi:10.1086/657912 - DOI - PubMed
    1. Borg MA, Benbachir M, Cookson BD, et al. Health care worker perceptions of hand hygiene practices and obstacles in a developing region. Am J Infect Control. 2009;37(10):855–857. doi:10.1016/j.ajic.2009.06.003 - DOI - PubMed