Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden.
Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
BMC Infect Dis. 2021 May 4;21(1):420. doi: 10.1186/s12879-021-06097-5.
The Hawthorne Effect is the change in behaviour by subjects due to their awareness of being observed and is evident in both research and clinical settings as a result of various forms of observation. When the Hawthorne effect exists, it is short-lived, and likely leads to increased productivity, compliance, or adherence to standard protocols. This study is a qualitative component of an ongoing multicentre study, examining the role of Incisional Negative Pressure Wound Therapy after vascular surgery (INVIPS Trial). Here we examine the factors that influence hygiene and the role of the Hawthorne effect on the adherence of healthcare professionals to standard hygiene precautions.
This is a qualitative interview study, investigating how healthcare professionals perceive the observation regarding hygiene routines and their compliance with them. Seven semi-structured focus group interviews were conducted, each interview included a different staff category and one individual interview with a nurse from the Department for Communicable Disease Control. Additionally, a structured questionnaire interview was performed with environmental services staff. The results were analysed based on the inductive qualitative content analysis approach.
The analysis revealed four themes and 12 subthemes. Communication and hindering hierarchy were found to be crucial. Healthcare professionals sought more personal and direct feedback. All participants believed that there were routines that should be adhered to but did not know where to find information on them. Staff in the operating theatre were most meticulous in adhering to standard hygiene precautions. The need to give observers a clear mandate and support their work was identified. The staff had different opinions concerning the patient's awareness of the importance of hygiene following surgery. The INVIPS Trial had mediated the Hawthorne effect.
The results of this study indicate that the themes identified, encompassing communication, behaviour, rules and routines, and work environment, influence the adherence of healthcare professionals to standard precautions to a considerable extent of which many factors could be mediated by a Hawthorne effect. It is important that managers within the healthcare system put into place an improved and sustainable hygiene care to reduce the rate of surgical site infections after vascular surgery.
霍桑效应是指由于被观察而导致的被试行为的变化，在研究和临床环境中，由于各种形式的观察，这种效应都很明显。当霍桑效应存在时，它是短暂的，并且可能导致生产力、依从性或对标准协议的依从性增加。本研究是一项正在进行的多中心研究的定性部分，该研究检查了血管手术后切口负压伤口治疗（INVIPS 试验）的作用。在这里，我们研究了影响卫生的因素以及霍桑效应对医疗保健专业人员遵守标准卫生预防措施的影响。
这是一项定性访谈研究，调查医疗保健专业人员如何看待关于卫生常规的观察以及他们对这些常规的遵守情况。进行了七次半结构化焦点小组访谈，每次访谈都包括不同的员工类别，以及传染病控制部门的一名护士的个人访谈。此外，还对环境服务人员进行了结构化问卷调查访谈。结果基于归纳定性内容分析方法进行分析。
分析揭示了四个主题和 12 个子主题。沟通和阻碍等级制度被发现是至关重要的。医疗保健专业人员寻求更个人化和直接的反馈。所有参与者都认为有一些应该遵守的常规，但不知道在哪里可以找到相关信息。手术室的工作人员在遵守标准卫生预防措施方面最为细致。需要给观察者一个明确的任务授权并支持他们的工作。工作人员对手术后患者对卫生重要性的意识持不同意见。INVIPS 试验对霍桑效应进行了调解。
本研究的结果表明，所确定的主题，包括沟通、行为、规则和常规以及工作环境，在很大程度上影响了医疗保健专业人员对标准预防措施的遵守，其中许多因素可能会受到霍桑效应的影响。医疗保健系统的管理人员应该建立一个改进和可持续的卫生保健系统，以降低血管手术后手术部位感染的发生率。
