The Finnish Institute for Health and Welfare, Helsinki, Finland.
Euro Surveill. 2022 Oct;27(40). doi: 10.2807/1560-7917.ES.2022.27.40.2100915.
BackgroundCompliance with infection prevention and control (IPC) measures is critical to preventing COVID-19 transmission in healthcare settings.AimTo identify and explain factors influencing compliance with COVID-19-specific IPC measures among healthcare workers (HCWs) in long-term care facilities (LTCF) in Finland.MethodsThe study included a web-based survey and qualitative study based on the Theoretical Domains Framework (TDF). The link to the anonymous survey was distributed via email to LTCFs through regional IPC experts in December 2020. Outcome was modelled using ordinary logistic regression and penalised ridge logistic regression using regrouped explanatory variables and an original, more correlated set of explanatory variables, respectively. In-depth interviews were conducted among survey participants who volunteered during January-March 2021. Data were analysed thematically using qualitative data analysis software (NVIVO12).ResultsA total of 422 HCWs from 17/20 regions responded to the survey. Three TDF domains were identified that negatively influenced IPC compliance: environmental context and resources, reinforcement and beliefs about capabilities. Twenty HCWs participated in interviews, which resulted in identification of several themes: changes in professional duties and lack of staff planning for emergencies (domain: environmental context and resources); management culture and physical absence of management (domain: reinforcement), knowledge of applying IPC measures, nature of tasks and infrastructure that supports implementation (domain: beliefs about capabilities), that explained how the domains negatively influenced their IPC behaviour.ConclusionsThis study provides insights into behavioural domains that can be used in developing evidence-based behaviour change interventions to support HCW compliance with pandemic-specific IPC measures in LTCFs.
在医疗保健环境中，遵守感染预防和控制（IPC）措施对于防止 COVID-19 传播至关重要。
确定并解释影响芬兰长期护理机构（LTCF）医护人员（HCW）遵守 COVID-19 特定 IPC 措施的因素。
该研究包括基于理论领域框架（TDF）的网络调查和定性研究。2020 年 12 月，通过区域 IPC 专家向 LTCF 通过电子邮件分发了匿名调查的链接。使用普通逻辑回归和惩罚岭逻辑回归分别对结果进行建模，使用重新分组的解释变量和原始、相关性更高的解释变量集。在 2021 年 1 月至 3 月期间，对自愿参加调查的调查参与者进行了深入访谈。使用定性数据分析软件（NVIVO12）对数据进行主题分析。
共有来自 20 个地区中的 17 个地区的 422 名 HCW 对调查做出了回应。确定了三个对 IPC 合规性产生负面影响的 TDF 领域：环境背景和资源、强化和对能力的信念。20 名 HCW 参加了访谈，确定了几个主题：专业职责的变化和应急人员规划的缺乏（领域：环境背景和资源）；管理文化和管理层的实际缺席（领域：强化）、IPC 措施应用知识、任务性质和支持实施的基础设施（领域：能力信念），这些主题解释了这些领域如何对他们的 IPC 行为产生负面影响。
本研究深入了解了行为领域，可以用于开发基于证据的行为改变干预措施，以支持 LTCF 中 HCW 遵守大流行特定的 IPC 措施。
