Authors
1 Behavioral Sciences Research Center, School of Nursing
2 Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
Abstract
Background: Health‑care acquired infections are significant given the risks and costs
they impose. All previous studies indicate a poor level of knowledge and performance
among the nurses in hospital infections; as such, educating nurses can play an important
role in infection control. This study aimed at evaluating the effects of the health belief
model (HBM) in making nurses adopting health‑care behaviors needed to control nosocomial
infections (Nis). Materials and Methods: The participants of the study were 135 nurses from
two hospitals in Mashhad, Iran. A self‑administered questionnaire was used to collect data.
The questionnaire consisted of seven parts. The intervention group received four 45 min
educational programs, both in individual and collective forms. After a 2‑month interval, a
post‑test was conducted to see whether any difference has been resulted. Results: There
was a significant relationship between knowledge (P = 0.001), perceived threat (P = 0.004),
perceived benefits (P = 0.001), and practices (P = 0.001) in comparing to control and
experimental groups after intervention. For the experimental and control groups, the most
frequent cues to action at the preintervention stage were, respectively, related to the period
of studying at university and in‑service classes. Conclusion: According to this study,
HBM‑based education can increase knowledge, perceived threat, and perceived benefits
of nurses. Additionally, it can reduce perceived barriers and improve the control of NIs
among nurses.
Keywords
multidrug‑resistant organisms in Germany: Epidemiological data
from KISS (the Hospital Infection Surveillance System. Dtsch
Arztebl Int 2011;108:87‑93.
2. Rosenthal VD, Guzman S, Migone O, Safdar N. The attributable
cost and length of hospital stay because of nosocomial pneumonia
in intensive care units in 3 hospitals in Argentina: A prospective,
matched analysis. Am J Infect Control 2005;33:157‑61.
3. Rosenthal VD, Richtmann R, Singh S, Apisarnthanarak A,
Kubler A, Viet‑Hung N, et al. Surgical site infections, International
Nosocomial Infection Control Consortium (INICC) report, data
summary of 30 countries, 2005‑2010. Infect Control Hosp Epidemiol
2013;34:597‑604.
4. Rosenthal VD, Bijie H, Maki DG, Mehta Y, Apisarnthanarak A,
Medeiros EA, et al. International Nosocomial Infection Control
Consortium (INICC) report, data summary of 36 countries, for
2004‑2009. Am J Infect Control 2012;40:396‑407.
5. Alaghehbandan R, Azimi L, Rastegar Lari A.Nosocomial infections
among burn patients in Teheran, Iran: A decade later. Ann Burns
Fire Disasters 2012;25:3‑7.
6. Lahsaeizadeh S, Jafari H, Askarian M. Healthcare‑associated
infection in Shiraz, Iran 2004‑2005. J Hosp Infect 2008;69:283‑7.
7. Ranjbar M, Mohammad Alizadeh AH, Pazhooh HK, Kashani KM,
Golmohammadi M, Nojomi M. Nosocomial infections and
antimicrobial resistance pattern in a tertiary referral hospital in
Hamedan, Iran. Int J Crit Illn Inj Sci 2012;2:46‑7.
8. AfhamiS, HadadiA, KhoramiE, SeifiA, BazazNE. Ventilator‑associated
pneumonia in a teaching hospital in Tehran and use of the Iranian
Nosocomial Infections Surveillance Software. East Mediterr Health
J 2013;19:883‑7.
9. Masoumi Asl H. The National Nosocomial Infections Surveillance
in Iran. A 4 years report. Proc. BMC Proceedings. International
Conference on Prevention and Infection Control (ICPIC 2011)
Switzerland BioMed Central Ltd 2011;5: p. 243.
10. Mulu W, Kibru G, Beyene G, Damtie M. Postoperative Nosocomial
Infections and Antimicrobial Resistance Pattern of Bacteria Isolates
among Patients Admitted at Felege Hiwot Referral Hospital,
Bahirdar, Ethiopia. Ethiop J Health Sci 2012;22:7‑18.
11. Huis A, van Achterberg T, de Bruin M, Grol R, Schoonhoven L,
Hulscher M. A systematic review of hand hygiene improvement
strategies: A behavioural approach. Implement Sci 2012;7:92.
12. Ataei B, Zahraei SM, Pezeshki Z, Babak A, Nokhodian Z,
Mobasherizadeh S, et al. Baseline evaluation of hand hygiene
compliance in three major hospitals, Isfahan, Iran. J Hosp Infect
2013;85:69‑72.
13. Santos LX, Souza Dias MB, Borrasca VL, Cavassin LT, Deso di Lobo R,
et al. Improving hand hygiene adherence in an endoscopy unit.
Endoscopy 2013;45:421‑5.
14. Fesharaki MG, Rahmati‑Najarkolaei F, Aghamiri Z, Mohamadian M.
Hand‑Washing Compliance Rate and the Influencing Factors. Arch
Clin Infect Dis 2014; 9: e17316.
15. Lucena A, Dalla Costa LM, Nogueira KS, Matos AP,
Gales AC, Paganini MC, et al. Nosocomial infections with
metallo‑beta‑lactamase‑producing Pseudomonas aeruginosa:
Molecular epidemiology, risk factors, clinical features and outcomes.
J Hosp Infect 2014;87:234‑40.
16. Stone PW, Hasan S, Quiros D, Larson EL. Effect of guideline
implementation on costs of hand hygiene. Nurs Econ 2007;25:279‑84.
17. Dawson SJ. The role of the infection control link nurse. J Hosp Infect
2003;54:251‑7.
18. Hinkin J, Cutter J. How do university education and clinical
experience influence pre‑registration nursing students’ infection
control practice? A descriptive, cross sectional survey. Nurse Educ
Today 2014;34:196‑201.
19. Payghan B, Kadam S, Kumar P, Sridevi BK. Knowledge and
perception of health care workers towards clean care practices in
a tertiary care hospital. J Evol Med Dent Sci 2013;2:1459‑65.
20. Ghanbari MK, Farazi AA, Shamsi M, Khorsandi M, Esharti B.
Measurement of the Health Belief Model (HBM) in Nurses Hand
Hygiene among the Hospitals. World Applied Sci J 2014;31:811‑8.
21. Yaghubi M, Seyed Sharifi SS. Knowledge, attitude, and practice
of intensive care units nurses about nosocomial infections control
in North Khorasan province hospitals of Bojnurd in 2012. J North
Khorasan Univ Med Sci 2013;5:943‑50.
22. Abdollahi AA, Rahmani H, Khodabakhshi B, Behnampour N.
Assessment of level of knowledge, attitude and practice of
employed nurses to nosocomial infection in teaching hospitals of
Golestan University of Medical Sciences (2000). J Gorgan Univ Med
Sci 2003;5:80‑6.
23. Kelcikova S, Skodova Z, Straka S. Effectiveness of hand hygiene
education in a basic nursing school curricula. Public Health Nurs
2012;29:152‑9.
24. Stretcher V, Rosenstock I. The Health Belief Model. In: Editors.
Health behavior and health education. San Francisco: Jossey‑Bass;
1997. p. 41‑59.
25. Jemmott JB 3rd, Heeren GA, Ngwane Z, Hewitt N, Jemmott LS,
Shell R, et al. Theory of planned behaviour predictors of intention
to use condoms among Xhosa adolescents in South Africa. AIDS
Care 2007;19:677‑84.
26. Sanaeinasab H, Tavakoli R, Karimizarchi A, Amini ZH, Farokhian A,
Najarkolaei FR. The effectiveness of education using the health belief
model in preventing osteoporosis among female students. Eastern
Mediterr Health J 2014;19(Suppl 3):S38‑44.
27. Zhao J, Song F, Ren S, Wang Y, Wang L, Liu W, et al. Predictors
of condom use behaviors based on the Health Belief Model (HBM)
among female sex workers: A cross‑sectional study in Hubei
Province, China. PLoS One 2012;7:e49542.
28. Coe AB, Gatewood SB, Moczygemba LR, Goode JV, Beckner JO.
The use of the health belief model to assess predictors of intent
to receive the novel (2009) H1N1 influenza vaccine. Inov Pharm
2012;3:1‑11.
29. Ma KH, Yam KL, Tsui KW, Yau FT. Internal consistency and
test‑retest reliability of the Chinese version of the self‑report
health‑related quality of life measure for children and adolescents
with epilepsy. Epilepsy Behav 2006;9:51‑7.
30. Suchitra JB, Lakshmi Devi N. Impact of education on knowledge,
attitudes and practices among various categories of health
care workers on nosocomial infections. Indian J Med Microbiol
2007;25:181‑7.
31. Ghaffari M, Tavassoli E, Esmaillzadeh A, Hassanzadeh A. Effect of
Health Belief Model based intervention on promoting nutritional
behaviors about osteoporosis prevention among students of female
middle schools in Isfahan, Iran. J Educ Health Promot 2012;1:14
32. Motamedi N, Hejazi SH, Hazavehei SM, Zamani Aaa R, Saberi S,
Rahimi E. Effect of education based on Health Belief Model on
promoting preventive behavior of coetaneous leishmaniasis.
J Military Med 2010;11:231‑6.
33. Gorman JR, Brewer NT, Wang JB, Chambers CD. Theory‑based
predictors of influenza vaccination among pregnant women. Vaccine
2012;31:213‑8.
34. Tehrani FJ, Nikpour S, Kazemi EAH, Sanaie N, Panahi SAS. The
Effect of Education Based on Health Belief Model on Health Beliefs
of Women with Urinary Tract Infection. Int J Community Based Nurs
Midwifery 2013;2:2‑11.
35. Hashemi PM, Shojaizade D, Dehdari T, Gohari MR. Design and
evaluation of educational interventions on the health belief model to
promote preventive behaviors of urinary tract infection in mothers
with children less than 6 years. Razi J Med Scie 2013;20:22‑8.
36. Rahimikian F, MirmohamadalieiM, Mehran A, Aboozari GhforoodiK,
Salmaani Barough N. Effect of Education Designed based
on Health Belief Model on Choosing Delivery Mode. Hayat
2009;14:25‑32.
37. Jeong HS, Lee DW, Youn CH, Lee MK, Lee SJ, Suh YS, et al.
Perception and Performance of Preventive Behaviors for the
Pandemic Influenza in Hospital Employees and Outpatients. Yonsei
Med J 2011;52:181‑7.38. Norouzi A, Ghofranipour F, Heydarnia A, Tahmasebi R. Determinants
of physical activity based on Health Promotion Model (HPM) in
diabetic women of Karaj diabetic institute. Iranian South Medical
Journal 2010;13:41‑51.
39. Karimy M, Hasani M, Khoram R, Ghaffari M, Niknami S. The
Effect of Education, Based on Health Belief Model on Breast
Self‑ Examination in Health Liaisons of Zarandieh City 2008. Zahedan
J Res Med Sci 2008;10:283‑91.
40. Anderson VE. The utility of health belief model constructs in
predicting dietary behaviors a among female university students:
A pilot investigation. USA: Georgia: Georgia Southern University;
2004.
41. Shalansky S, Ignaszewski I, Levy A, Linden W, Hoang P, Radulovic B.
Health beliefs as predictors of heart failure medication adherence.
Can J Cardiol 2003;19:164A.
42. Kaewchana S, Simmerman M, Somrongthong R, Suntarattiwong P,
Lertmaharit S, Chotipitayasunondh T. Effect of intensive hand
washing education on hand washing behaviors in thai households
with an influenza‑positive child in urban Thailand. Asia Pac J Public
Health 2012;24:577‑85.
43. Farzan M, Zerin I, Kabir M, Pavel M, Hossain M. Health Education
Intervention on Hand Washing in a selected Primary School
Children. Bangladesh J Dental Res Edu 2012;2:7‑11.
44. Chariyeva Z, Golin CE, Earp JA, Suchindran C. Does motivational
interviewing counseling time influence HIV‑positive persons’
self‑efficacy to practice safer sex? Patient Educ Couns 2012;87:101‑7.
)