Browsing by Subject "Health Belief Model"
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Item Exploring self-reported hand hygiene among registered nurses in the inpatient hospital setting using the Health Belief Model(2013-12) Gillespie, Michelle Farci; Horner, Sharon D.Methicillin Resistant Staphylococcus aureus (MRSA) is the most commonly isolated multi-drug resistant organism in the hospital setting. MRSA can result in death among people who have no identified risk factors for infection. One-third of MRSA infections are cross-transmitted as Healthcare-Associated Infections (HAIs). It is well known that the single most effective means for decreasing the risk of HAIs is hand hygiene (HH), yet poor performance among registered nurses persists. The theoretical framework used to guide the study was the Health Belief Model (HBM). The purposes of the study were to: explore the RNs’ self-reported HH performance rate; explore the RNs’ knowledge related to MRSA; identify relationships between MRSA knowledge and HBM constructs; explore the RNs’ barriers to HH performance; identify relationships between barriers and self-reported HH performance; explore relationships among HH behaviors and constructs in the HBM; explore predictors of ‘overall HH’ performance; and identify if certain demographic characteristics are related to MRSA knowledge, self-reported HH, and HBM constructs. A cross sectional descriptive study was conducted with a sample of RNs who were randomly selected. The questionnaire mailing, which included the survey, consent, and the return-stamped envelope were distributed to 684 RNs. Completed surveys (n=120) from RNs who met the sample inclusion criteria were returned within four weeks. Self-reported HH were highest during times of increased perceived susceptibility for infection. In addition, nurses were more likely to overcome barriers to HH during ‘moments’ associated with the highest perceived susceptibility. Although MRSA knowledge did not correlate with ‘overall HH’ performance, there was a significant relationship identified with self-efficacy (r=.27, p<.01), which may influence HH behaviors. The most commonly identified barriers to HH performance were system factors (e.g. ‘a high workload’). Self-efficacy and barriers represented 26% of the variability in the regression model when applying significant correlations among HBM constructs and ‘overall HH.’ The phenomenon of the RN’s HH decision making is not completely understood. More research is needed to explain predictors for HH among registered nurses. This understanding will allow researchers to plan interventions aimed at increasing knowledge and understanding about perceived susceptibility, which may in turn improve self-efficacy behaviors for HH, which could decrease HAI rates.Item Qualitative descriptive study of Mexican Americans health-seeking experience during myocardial infarction(2013-12) Sanderson, Jennifer Dawn MaLyssa; Carter, Patricia A.Premature death due to cardiovascular disease, including myocardial infarction, is higher in Hispanics (23.5%) than non-Hispanic White (16.5%) adults. Delaying treatment over 60 minutes increases the risk of sudden death by 50%. The purpose of this study was to describe the perceived benefits and barriers to seeking cardiac emergency care including emergency medical services (EMS) activation during an acute myocardial infarction (MI) in Mexican American adults. A qualitative descriptive design was used wherein semi-structured interviews and sociodemographic questionnaire were conducted with 12 Mexican Americans who had experienced an MI in the last two years. Qualitative conventional content analysis was used to uncover unique perceptions of Mexican Americans seeking emergency care. The overall theme that arose was degree of perceived threat leads to action. This theme was comprised five categories: perceived susceptibility, perceived severity, perceived barriers, perceived benefits, and learned behavior. Perceived severity was closely intertwined with perceived susceptibility. Recent appointments with HCPs facilitated low perceived susceptibility to an MI and acted as a barrier leading to ix decreased initiation of emergency services for MI. Participants attempted self-treatment and evaluation which was a barrier to immediate emergency care. Perceived benefits to initiation of emergency care were using EMS to achieve rapid treatment of MI symptoms. Though several participants initially stated they would activate EMS, further inquiry revealed calling EMS was considered a last resort if the participant were alone. The findings suggest education of lay people and HCPs needs to emphasize that MIs can present in a variety of ways from slow-onset to fast-onset. A goal for nursing practice is to include regular screening on cardiac risk factors along with interventions and evaluation among patients and family. Future research should aim at finding the most successful format to provide public education to Mexican Americans on MI symptom and rapid initiation of EMS.