Instituto de Ciências da Saúde, Universidade Paulista, São Paulo, SP, Brazil.
Rev Saude Publica. 2009 Dec;43(6):907-16. doi: 10.1590/s0034-89102009010700001. Epub 2009 Dec 4.
To analyze the influence of psychosocial and organizational factors relating to adherence to standard precautions for preventing exposure to biological material in hospitals.
A cross-sectional study was conducted among 270 medical and nursing professionals at a university hospital in the municipality of São Paulo, Southeastern Brazil, in 2002. After selection by means of simple random sampling, the participants answered a questionnaire on psychosocial variables in the form of a Likert scale. The construct validity was evaluated using factor analysis and the reliability, by means of Cronbach's alpha coefficient. The association between psychosocial factors and adherence to standard precautions were obtained by means of multiple logistic regression analysis, with backward elimination of nonsignificant variables.
The scales showed satisfactory validity and reliability (Cronbach's alpha between 0.67 and 0.82). Individual, work-related and organizational factors explained 38.5% of the overall rate of adherence to standard precautions. This overall rate of adherence was significantly associated with being a physician, receiving training in standard precautions at the hospital, downplaying the obstacles to following the standard precautions, taking the job more seriously, having feedback from safety practices and implementing managerial actions to support safety.
Individual, work-related and organizational factors together influenced the adherence to standard precautions. Programs for preventing occupational exposure to biological material need to take into account the obstacles to following standard precautions within clinical practice, and to emphasize organizational support policies for safety at work.
分析与遵守预防医院生物性物质暴露标准预防措施相关的社会心理和组织因素对其的影响。
2002 年，在巴西东南部圣保罗市的一所大学附属医院，对 270 名医疗和护理专业人员进行了横断面研究。采用简单随机抽样法选择参与者后，他们以李克特量表的形式回答了一份关于社会心理变量的问卷。采用因子分析评估结构效度，采用克朗巴赫α系数评估信度。采用多元逻辑回归分析，逐步排除无统计学意义的变量，得出社会心理因素与遵守标准预防措施之间的关联。
各量表的效度和信度均令人满意（克朗巴赫α系数介于 0.67 至 0.82 之间）。个体、工作相关和组织因素共同解释了遵守标准预防措施总比率的 38.5%。总体遵守率与以下因素显著相关：医生、在医院接受标准预防措施培训、对遵守标准预防措施的障碍轻描淡写、更认真地对待工作、从安全实践中获得反馈以及实施管理措施以支持安全。
个体、工作相关和组织因素共同影响遵守标准预防措施的情况。预防职业性生物性物质暴露的方案需要考虑临床实践中遵守标准预防措施的障碍，并强调工作安全的组织支持政策。
