DOI QR코드

DOI QR Code

Moderation and Mediation Effects of Self-efficacy and Perceived Behavioral Control on the Relationship between Knowledge of and Compliance with Handwashing in Nursing Students

간호대학생의 손씻기 지식과 수행의 관계에서 자기효능감과 지각된 행위통제의 조절 및 매개효과

  • Received : 2017.05.26
  • Accepted : 2017.08.15
  • Published : 2017.08.31

Abstract

Purpose: The aim of this study was to examine the relationship between handwashing knowledge and handwashing compliance in nursing students and to identify the moderation and mediation effects of self-efficacy and perceived behavioral control on the relationship. Methods: The participants were 172 nursing college students who completed the self-report measures. Data were analyzed using t-test, ANOVA, and Pearson correlation coefficient, Multiple regression analysis was used to test moderation and mediation effects. Results: The score for knowledge of handwashing was higher in participants who had completed fundamentals of nursing practicum (t=-6.54, p<.001) and the score for compliance with handwashing was higher in participants who had completed clinical practicum (t=-3.81, p<.001) or fundamentals of nursing practicum (t=-5.97, p<.001). Self-efficacy showed a significant moderation effect (z=2.21, p=.027) but not a mediation effect while perceived behavioral control had a significant mediation effect but not a moderation effect on the relationship between knowledge of handwashing and compliance. Conclusion: Findings indicate that clinical practicum and fundamentals of nursing practicum were helpful to nursing students in acquiring knowledge and in practicing proper handwashing technique. These findings suggest that continuing and repetitive education programs on handwashing need to be enhanced and strategies to strengthen self-efficacy and perceived behavioral control need to be included in education programs.

Keywords

References

  1. World Health Organization. WHO guidelines on hand hygiene in health care [Internet]. Geneva: World Health Organization; 2009 [cited 2017 March 10]. Available from: http://www.who.int/gpsc/5may/tools/9789241597906/en/
  2. Lee MS, Hong SJ, Kim YT. Handwashing with soap and national handwashing projects in Korea: Focus on the national handwashing survey, 2006-2014. Epidemiology and Health. 2015;37:1-9. https://doi.org/10.4178/epih/e2015039
  3. Freeman MC, Stocks ME, Cumming O, Jeandron A, Higgins JPT, Wolf J, et al. Hygiene and health: Systematic review of handwashing practices worldwide and update of health effects. Tropical Medicine and International Health. 2014;19(8): 906-916. https://doi.org/10.1111/tmi.12339
  4. Hovi T, Ollgren J, Savolainen-Kopra C. Intensified hand-hygiene campaign including soap-and-water wash may prevent acute infections in office workers, as shown by a recognizedexposure-adjusted analysis of a randomized trial. BMC Infectious Diseases. 2017;17(1):47. https://doi.org/10.1186/s12879-016-2157-z
  5. Kim YJ, Kwon HJ, Kim YJ, Sung SY. Knowledge, attitudes and practives of hand washing for patients in military hospitals. Journal of the Korea Contents Association. 2014;14(12):350-360.
  6. Yoon EJ, Kim MH. Knowledge and compliance with hand hygiene by nursing students in clinical practice. Journal of Korean Academic Society of Nursing Education. 2013;19(3):455-464. https://doi.org/10.5977/jkasne.2013.19.3.455
  7. Ryu SM, Lim YJ. Knowledge, attitude and performance on the hand washing by pre-practicum nursing students. Journal of the Korea Academia-Industrial cooperation Society. 2013; 14(11):5714-5722. https://doi.org/10.5762/kais.2013.14.11.5714
  8. Park KY. Influences of perceived behavior control and self-efficacy on proper hand cleansing and hand washing practices among pre-practicum nursing students. Journal of Korean Academy of Fundamentals of Nursing. 2012;19(3):313-321. https://doi.org/10.7739/jkafn.2012.19.3.313
  9. Burton M, Cobb E, Donachie P, Judah G, Curtis V, Schmidt WP. The effect of handwashing with water or soap on bacterial contamination of hands. International Journal of Environmental Research and Public Health. 2011;8(1):97-104. https://doi.org/10.3390/ijerph8010097
  10. Yang NY. Knowledge, self efficacy and self care behavior regarding foot care among elderly diabetes mellitus patients. Korean Journal of Adult Nursing. 2009;21(4):413-422.
  11. Ryu SM. Knowledge, attitude, and performance on the hand washing of health care related students. Journal of the Korea Academia-Industrial Cooperation Society. 2013;14(8):3916-3924. https://doi.org/10.5762/kais.2013.14.8.3916
  12. Kelcíkova S, Skodova Z, Straka S. Effectiveness of hand hygiene education in a basic nursing school curricula. Public Health Nursing. 2012;29(2):152-159. https://doi.org/10.1111/j.1525-1446.2011.00985.x
  13. De Wandel D, Maes L, Labeau S, Vereecken C, Blot S. Behavioral determinants of hand hygiene compliance in intensive care units. American Journal of Critical Care. 2010;19(3):230-239. https://doi.org/10.4037/ajcc2010892
  14. Jenner EA, Watson PWB, Miller L, Jones, F, Scott GM. Explaining hand hygiene practice: An extended application of the theory of planned behaviour. Psychology, Health and Medicine. 2002;7(3):311-326. https://doi.org/10.1080/13548500220139412
  15. Lee MR, So HY, Cho MK. Determinants of nurses' handwashing practice. Korean Journal of Adult Nursing. 2005;17(2):268-275.
  16. Jeong SY, Kim OS. The structural model of hand hygiene behavior for the prevention of healthcare-associated infection in hospital nurses. Korean Journal of Adult Nursing. 2012;24 (2):119-129. https://doi.org/10.7475/kjan.2012.24.2.119
  17. Montano DE, Kasprzyk D. Theory of reasoned action, theory of planned behavior, and the integrated behavioral model. In: Glanz K, Rimer BK, Viswanath K, editors. Health behavior: Theory, research and practice. San Francisco, CA: John Wiley & Sons; 2008. p. 77-81.
  18. Ryu SM, Kang SY. Effect of an infection prevention education program on knowledge of infection and hand washing performance for nursing students. Health Service Management Review. 2010;4(2):31-37. https://doi.org/10.18014/hsmr.2010.4.2.31
  19. Choi EH, Jang IS, Choi JY. The effect of an educational hand washing program on knowledge, attitude and performance of hand washing in undergraduates. Journal of the Korean Society of School Health. 2014;27(1):39-49. https://doi.org/10.15434/kssh.2014.27.1.039
  20. Lazarus RS, Folkman S. Stress, appraisal, and coping. NY: Springer Publishing Company; 1984.
  21. Muris P. Relationship between self-efficacy and symptoms of anxiety disorders and depression in a normal adolescent sample. Personality and Individual Differences. 2002;32(2):337-348. https://doi.org/10.1016/s0191-8869(01)00027-7
  22. Ajzen, I. From intention to actions: A theory of planned behavior. In: Kuhl J, Beckman J, Editors. Action control: From cognition to behavior. Heidelberg: Springer Publishing Company; 1985. p. 11-39.
  23. Sherer M, Maddux JE, Mercandante B, Prentice-Dunn S, Jacobs B, Rogers RW. The self-efficacy scale: Construction and validation. Psychological Reports. 1982;51(2):663-671. https://doi.org/10.2466/pr0.1982.51.2.663
  24. Jung JH, Park HS. A study on smoking factors and self-efficacy of vocational female high schoolers. Journal of Korean Academic Society of Nursing Education. 2002;8(2):271-283.
  25. Madden TJ, Ellen PS, Ajzen I. A comparison of the theory of planned behavior and the theory of reasoned action. Personality and Social Psychology Bulletin. 1992;18(1):3-9. https://doi.org/10.1177/0146167292181001
  26. Centers for Disease Control and Prevention. Proper hand washing [Internet]. Osong: Centers for Disease Control and Prevention; 2017 [cited 2017 May 16]. Available from: https://cdc.go.kr/CDC/notice/CdcKrIntro0506.jsp?menuIds=HOME001-MNU1154-MNU0005-MNU2572-MNU2492&cid=71215
  27. Elaziz KM, Bakr IM. Assessment of knowledge, attitude and practice of hand washing among health care workers in Ain Shams University hospitals in Cairo. Journal of Preventive Medicine and Hygiene. 2009;50(1):19-25.
  28. Whang SJ. The relationship between clinical stress, self-efficacy, and self-esteem of nursing college students. Journal of Korean Academic Society of Nursing Education. 2006;12(2): 205-213.
  29. Bae BR. Analyses of moderating and mediating effects with SPSS/Amos/LISREL/SmartPLS. Seoul: Chungram Publishing; 2015.

Cited by

  1. Mediation Effect of Self-Efficacy on the Relationship between Knowledge of and Compliance with Handwashing in Cosmetology Students vol.17, pp.2, 2019, https://doi.org/10.20402/ajbc.2019.0295
  2. Development and Application of an Infection Control Education Program in Long-Term Care Hospitals vol.23, pp.2, 2020, https://doi.org/10.7587/kjrehn.2020.158
  3. 간호대학생의 손씻기 실천에 영향을 미치는 요인: 건강신념, 자기효능감, 손씻기 태도를 중심으로 vol.27, pp.2, 2020, https://doi.org/10.5953/jmjh.2020.27.2.132