Exploring behavioral factors influencing COVID-19 specific infection prevention and control measures in Finland
Healthcare worker (HCW) compliance with infection prevention and control (IPC) measures plays a critical role in preventing SARS-CoV-2 spread in healthcare settings. To ensure optimal adherence to COVID-19specific IPC practices, there is a need to understand the factors that influence them.
This two-phased study aims to identify and explain factors that influence the compliance to COVID-19 specific IPC measures among nursing staff in long-term care facilities (LTCF) in Finland. The first phase focused on exploring IPC measures generally whereas the second study is focusing on the use of personal protective equipment.
Both phases include a web-based survey and a qualitative research study based on the Theoretical Domains Framework (TDF); a conceptual 14 domains that can explain behavior.
The questions in the surveys covered background information of the respondent and LTCF as well as behavioral factors. The link to the anonymous surveys is distributed to the LTCFs through regional IPC experts and authorities. The outcome is modeled using both ordinary logistic regression and penalized ridge logistic regression using regrouped explanatory variables and the
The original more correlated set of explanatory variables, respectively.
The in-depth interviews are conducted to explain factors that are identified in the survey as factors that influence compliance with IPC measures. A question guide is drafted with semi-structured questions. The subjects are recruited from those who participate in the survey. Interviews are phone-based lasting from 30 minutes to 60 minutes each. Data is analysed thematically using NVIVO.
Results of the phase one
A total of 422 HCWs from 17/20 regions responded to the survey. The study findings suggested that three TDF domains influence the compliance with COVID-19 specific IPC measures: environmental factors and resources (inadequate staffing), beliefs about capabilities, and reinforcement (follow up and feedback of the management). The qualitative study included 20 HCWs consisting of nurses and assistant nurses who provided care in LTCFs during the pandemic. The study identified two themes that explain environmental factors and resources; lack of planning for emergencies; changing work responsibilities. Beliefs in capabilities were linked with knowledge, resources, and responsibilities, and reinforcement was linked with management absence and culture.
The study provided insights into TDF domains that can be used to develop evidence-based behaviour change interventions and strategies to support HCW compliance with pandemic-specific IPC measures in LTCFs during future epidemics.
This is a two-phase study. The first phase was conducted from November 2020 to May 2021. The second one is being conducted from January 2022 to September 2022.
Project leader: Anna-Leena Lohiniva
Group members: Jaana-Marija Lehtinen, Saija Toura, Jukka Olgren, Dinah Arifulla, Outi Lyytikäinen