Tuberculosis infection control in a high drug-resistance setting in rural South Africa: Information, motivation, and behavioral skills
Summary: Background: Tuberculosis (TB) is transmitted in resource-limited facilities where TB infection control (IC) is poorly implemented. Theory-based behavioral models can potentially improve IC practices. Methods: The present study used an anonymous questionnaire to assess healthcare worker (HC...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2012-02-01
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| Series: | Journal of Infection and Public Health |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1876034111001353 |
| _version_ | 1818454080634224640 |
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| author | Z. Kanjee K.R. Amico F. Li K. Mbolekwa A.P. Moll G.H. Friedland |
| author_facet | Z. Kanjee K.R. Amico F. Li K. Mbolekwa A.P. Moll G.H. Friedland |
| author_sort | Z. Kanjee |
| collection | DOAJ |
| description | Summary: Background: Tuberculosis (TB) is transmitted in resource-limited facilities where TB infection control (IC) is poorly implemented. Theory-based behavioral models can potentially improve IC practices. Methods: The present study used an anonymous questionnaire to assess healthcare worker (HCW) TB IC information, motivation, and behavioral skills (IMB) and implementation in two resource-limited rural South African hospitals with prevalent drug-resistant TB. Results: Between June and August 2010, 198 surveys were completed. Although the respondents demonstrated information proficiency and positive motivation, 22.8% did not consider TB IC to be worthwhile. Most tasks were rated as easy by survey participants, but responding HCWs highlighted challenges in discrete behavioral skills. The majority of responding HCWs reported that they always wore respirators (54.3%), instructed patients on cough hygiene (63.0%), and ensured natural ventilation (67.4%) in high-risk areas. Most respondents (74.0%) knew their HIV status. Social support items correlated with the implementation of the first three aforementioned practices but not with the respondents’ knowledge of their HIV status. In most cases, motivation and behavioral skills, but not information, were associated with implementation. Conclusion: HCWs in rural South African hospitals with high drug-resistance demonstrated moderate IMB and implementation of TB IC. Improvement efforts should emphasize the development of HCW motivation and behavioral skills as well as social support from colleagues and supervisors. Such interventions should be informed by baseline IMB assessments. In the present study, a trimmed/modified IMB model helped characterize TB IC implementation. Keywords: Infection control, Tuberculosis, MDR/XDR-TB, South Africa, Information–motivation–behavioral skills |
| first_indexed | 2024-12-14T21:49:12Z |
| format | Article |
| id | doaj.art-889126e1bd7d48ea8920f7bbb105accf |
| institution | Directory Open Access Journal |
| issn | 1876-0341 |
| language | English |
| last_indexed | 2024-12-14T21:49:12Z |
| publishDate | 2012-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Infection and Public Health |
| spelling | doaj.art-889126e1bd7d48ea8920f7bbb105accf2022-12-21T22:46:17ZengElsevierJournal of Infection and Public Health1876-03412012-02-01516781Tuberculosis infection control in a high drug-resistance setting in rural South Africa: Information, motivation, and behavioral skillsZ. Kanjee0K.R. Amico1F. Li2K. Mbolekwa3A.P. Moll4G.H. Friedland5Office of Student Affairs, Yale University School of Medicine, New Haven, CT, USA; Corresponding author. Present address: Brigham and Women's Hospital, Internal Medicine Residency Office, 75 Francis Street, Boston, MA 02115, USA. Tel.: +1 617 732 5775; fax: +1 617 264 6346.Center for Health, Intervention and Prevention, University of Connecticut, Stors, CT, USAYale Center for Analytical Sciences, Yale University School of Public Health, New Haven, CT, USAChurch of Scotland Hospital, Tugela Ferry, KwaZulu-Natal, South AfricaChurch of Scotland Hospital, Tugela Ferry, KwaZulu-Natal, South AfricaYale AIDS Program, Yale University School of Medicine, New Haven, CT, USASummary: Background: Tuberculosis (TB) is transmitted in resource-limited facilities where TB infection control (IC) is poorly implemented. Theory-based behavioral models can potentially improve IC practices. Methods: The present study used an anonymous questionnaire to assess healthcare worker (HCW) TB IC information, motivation, and behavioral skills (IMB) and implementation in two resource-limited rural South African hospitals with prevalent drug-resistant TB. Results: Between June and August 2010, 198 surveys were completed. Although the respondents demonstrated information proficiency and positive motivation, 22.8% did not consider TB IC to be worthwhile. Most tasks were rated as easy by survey participants, but responding HCWs highlighted challenges in discrete behavioral skills. The majority of responding HCWs reported that they always wore respirators (54.3%), instructed patients on cough hygiene (63.0%), and ensured natural ventilation (67.4%) in high-risk areas. Most respondents (74.0%) knew their HIV status. Social support items correlated with the implementation of the first three aforementioned practices but not with the respondents’ knowledge of their HIV status. In most cases, motivation and behavioral skills, but not information, were associated with implementation. Conclusion: HCWs in rural South African hospitals with high drug-resistance demonstrated moderate IMB and implementation of TB IC. Improvement efforts should emphasize the development of HCW motivation and behavioral skills as well as social support from colleagues and supervisors. Such interventions should be informed by baseline IMB assessments. In the present study, a trimmed/modified IMB model helped characterize TB IC implementation. Keywords: Infection control, Tuberculosis, MDR/XDR-TB, South Africa, Information–motivation–behavioral skillshttp://www.sciencedirect.com/science/article/pii/S1876034111001353 |
| spellingShingle | Z. Kanjee K.R. Amico F. Li K. Mbolekwa A.P. Moll G.H. Friedland Tuberculosis infection control in a high drug-resistance setting in rural South Africa: Information, motivation, and behavioral skills Journal of Infection and Public Health |
| title | Tuberculosis infection control in a high drug-resistance setting in rural South Africa: Information, motivation, and behavioral skills |
| title_full | Tuberculosis infection control in a high drug-resistance setting in rural South Africa: Information, motivation, and behavioral skills |
| title_fullStr | Tuberculosis infection control in a high drug-resistance setting in rural South Africa: Information, motivation, and behavioral skills |
| title_full_unstemmed | Tuberculosis infection control in a high drug-resistance setting in rural South Africa: Information, motivation, and behavioral skills |
| title_short | Tuberculosis infection control in a high drug-resistance setting in rural South Africa: Information, motivation, and behavioral skills |
| title_sort | tuberculosis infection control in a high drug resistance setting in rural south africa information motivation and behavioral skills |
| url | http://www.sciencedirect.com/science/article/pii/S1876034111001353 |
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