a Specialty Internal Medicine Unit , Saudi Aramco Medica Services Organization , Saudi Aramco , Dharan , Saudi Arabia.
Teach Learn Med. 2013;25(4):374-82. doi: 10.1080/10401334.2013.827575.
Although hand hygiene is the most effective method for preventing healthcare-associated infections, hand hygiene practice falls short in many healthcare facilities. The compliance rate is mostly linked to system design and easily accessible hand hygiene products. System change, healthcare worker motivation, and complex behavioral considerations seem to play a significant role.
This article discusses the application of behavioral theories in hand hygiene promotion in a theoretical manner. The program relies on the transtheoretical model (TTM) of health behavior change, John Keller's (ARCS) Model of Motivational Design, and the theory of planned behavior (TPB). Thus, the program links attitudes and behavior to hand hygiene promotion.
The TTM of health behavior change helps to tailor interventions to predict and motivate individual movement across the pathway to change. A program could be based on this theory with multiple intercalations with John Keller's ARCS and the TPB. Such a program could be strengthened by linking attitudes and behavior to promote hand hygiene. The program could utilize different strategies such as organization cultural change that may increase the attention as well as fostering the movement in the ARCS stages. In addition, modeling TPB by creating peer pressure, ability to overcome obstacles, and increasing knowledge of the role of hand hygiene may lead to the desired outcome. The understanding and application of behavior change theories may result in an effective program to improve awareness and raise intention and thus may increase the potential for success of hand hygiene promotion programs.
尽管手部卫生是预防医源性感染最有效的方法，但在许多医疗机构中，手部卫生的实践并不理想。合规率主要与系统设计和易于获取的手部卫生产品有关。系统的改变、医护人员的积极性以及复杂的行为考虑因素似乎起着重要作用。
本文以理论的方式讨论了将行为理论应用于手部卫生促进的问题。该方案依赖于健康行为改变的跨理论模型（TTM）、约翰·凯勒（ARCS）动机设计模型和计划行为理论（TPB）。因此，该方案将态度和行为与手部卫生促进联系起来。
健康行为改变的跨理论模型有助于针对个人在改变途径上的移动进行预测和激励。可以基于该理论制定一个方案，与约翰·凯勒的 ARCS 和 TPB 进行多次穿插。通过组织文化变革等不同策略，该方案可以增强这种方案，从而增加关注度，并在 ARCS 阶段促进移动。此外，通过建立同伴压力、克服障碍的能力以及增加对手部卫生作用的认识来模拟 TPB，可能会带来预期的结果。理解和应用行为改变理论可能会产生一个有效的方案，以提高认识，提高意图，从而增加手部卫生促进方案成功的可能性。
