Sociocognitive factors determining compliance with standard precautions by nursing professionals during the COVID-19 pandemic

Santos, Andressa Silva Torres dos; Silva, Ana Cristina de Oliveira e; Pereira-Ávila, Fernanda Maria Vieira; Coêlho, Hemílio Fernandes Campos; Sousa, Laelson Rochelle Milanês; Reis, Renata Karina; Gir, Elucir

doi:10.1590/0034-7167-2023-0301

Andressa Silva Torres dos Santos Corresponding author: Andressa Silva Torres dos Santos, E-mail: torresandressa@hotmail.com

conception or design of the study/research

analysis and/or interpretation of data

final review with critical

intellectual participation in the manuscript

Universidade de São Paulo. Ribeirão Preto, São Paulo, Brazil

https://orcid.org/0000-0001-7142-911X

Ana Cristina de Oliveira e Silva

conception or design of the study/research

analysis and/or interpretation of data

final review with critical

intellectual participation in the manuscript

Universidade Federal da Paraíba. João Pessoa, Paraíba, Brazil

https://orcid.org/0000-0001-8605-5229

Fernanda Maria Vieira Pereira-Ávila

conception or design of the study/research

analysis and/or interpretation of data

final review with critical

intellectual participation in the manuscript

Universidade Federal Fluminense. Rio das Ostras, Rio de Janeiro, Brazil

https://orcid.org/0000-0003-1060-6754

Hemílio Fernandes Campos Coêlho

conception or design of the study/research

analysis and/or interpretation of data

final review with critical

intellectual participation in the manuscript

Universidade Federal da Paraíba. João Pessoa, Paraíba, Brazil

https://orcid.org/0000-0002-7140-3590

Laelson Rochelle Milanês Sousa

conception or design of the study/research

analysis and/or interpretation of data

final review with critical

intellectual participation in the manuscript

Universidade de São Paulo. Ribeirão Preto, São Paulo, Brazil

https://orcid.org/0000-0001-6018-5439

Renata Karina Reis

conception or design of the study/research

analysis and/or interpretation of data

final review with critical

intellectual participation in the manuscript

Universidade de São Paulo. Ribeirão Preto, São Paulo, Brazil

https://orcid.org/0000-0002-0681-4721

Elucir Gir

conception or design of the study/research

analysis and/or interpretation of data

final review with critical

intellectual participation in the manuscript

Universidade de São Paulo. Ribeirão Preto, São Paulo, Brazil

https://orcid.org/0000-0002-3757-4900

Corresponding author:
Andressa Silva Torres dos Santos, E-mail: torresandressa@hotmail.com

EDITOR IN CHIEF:

Dulce Barbosa

ASSOCIATE EDITOR:

Priscilla Valladares Broca

Participant sociodemographic and occupational characteristics
Variables	n	%
Sex
Male	1,405	15.5%
Feale	7,634	84.5%
Region
Northeast	2,718	30.2%
Southeast	2,524	27.9%
Midwest	1,609	17.8%
North	1,376	15.2%
South	802	8.9%
Professional category
Nurse	5,890	65.2%
Nursing technician or assistant	3,149	34.8%
Time since graduation
0 to 5 years	4,295	47.5%
6 to 10 years	2,053	22.7%
11 years and over	2,691	29.8%
Length of professional experience
0 to 5 years	3,666	40.6%
6 to 10 years	2,280	25.2%
11 years and over	3,093	34.2%
Type of person providing assistance
With COVID (suspected or confirmed)	1,677	18.6%
General	3,552	39.3%
Both	3,810	42.2%
Type of institution where they work
Did not answer this item	7,245	80.2%
Private	1,794	19.8%
Type of institution where they work
Did not answer this item	2,090	23.1%
Public	6,949	76.9%
Sector(s) of activity
Did not answer this item	8,198	90.7%
Outpatient clinic	841	9.3%
Sector(s) of activity
Did not answer this item	6,966	77.1%
Intensive Care Unit	2,073	22.9%
Sector(s) of activity
Did not answer this item	6657	73.6%
Ward	2382	26.4%
Sector(s) of activity
Did not answer this item	8,435	93.3%
Operating Room	604	6.7%
Sector(s) of activity
Did not answer this item	7,719	85.4%
Emergency Care Unit	1,320	14.6%
Sector(s) of activity
Did not answer this item	7,491	82.9%
Emergency Unit	1,548	17.1%
Sector(s) of activity
Did not answer this item	7,481	82.8%
Basic Health Unit	1,558	17.2%
Sector(s) of activity
Did not answer this item	8,961	99.1%
Private office	78	0.9%
Sector(s) of activity
Did not answer this item	8,287	91.7%
Field hospital to assist patients with COVID-19	752	8.3%
Sector(s) of activity
Did not answer this item	7,821	86.5%
Other	1,218	13.5%
COVID diagnosis (clinical or laboratory)
No	5,983	66.2%
Yes	3,056	33.8%
Isolation for a period from the family
Yes	5,879	65.0%
No	3,035	33.6%
Not applicable	125	1.4%
Training or course on COVID-19
Yes	6,335	70.1%
No	2,704	29.9%
Institution working provided sufficient personal protective equipment
Yes	6,550	72.5%
No	457	5.1%
In part	2,032	22.5%
Institution working provided good quality personal protective equipment
Yes	4,808	53.2%
No	973	10.8%
In part	3,258	36.0%

		Answer options
Scale item		Not effective at all n (%)	Somewhat effective n (%)	More or less effective n (%)	Partially effective n (%)	Totally effective n (%)	Mean	Standard deviation
1	As precauções-padrão são medidas eficazes para reduzir as infecções hospitalares (Standard precautions are effective in reducing health care infection)	75 (0.8)	9 (0.1)	2,508 (27.7)	174 (1.9)	6,273 (69.4)	4.39	0.95
2	Se eu seguir as precauções-padrão, protegerei meus pacientes de uma infecção (If I follow the protocol of standard precautions, I will protect my patients from infection)	60 (0.7)	11 (0.1)	2,190 (24.2)	175 (1.9)	6,603 (73.1)	4.47	0.91
3	Seguir as medidas de precauções-padrão vai me proteger de uma infecção (Following the standard precautions protocol will protect me from infection)	^* * Missing.	^* * Missing.	^* * Missing.	^* * Missing.	^* * Missing.	^* * Missing.	^* * Missing.
4	A maioria dos meus colegas de trabalho pensa que é importante seguir às precauções-padrão (Most of my colleagues think it is important to adhere to standard precautions)	235 (2.6)	42 (0.5)	4,275 (47.3)	177 (2.0)	4,310 (47.7)	3.92	1.09
5	Corro o risco de receber advertências dos meus superiores, se não seguir às precauções-padrão (I will be reprimanded by the charge nurse if I do not adhere to standard precautions)	834 (9.2)	66 (0.7)	2,525 (27.9)	152 (1.7)	5,462 (60.4)	4.03	1.32
6	Corro o risco de receber advertências dos enfermeiros e auxiliares responsáveis pela higienização, se não seguir às precauções-padrão (I will be reprimanded by infection control link nurses if I do not adhere to standard precautions)	952 (10.5)	80 (0.9)	2,735 (30.3)	158 (1.7)	5,114 (56.6)	3.93	1.36
7	Corro o risco de receber advertências dos médicos, se não seguir às precauções-padrão (I will be reprimanded by the physicians if I do not adhere to standard precautions)	2,789 (30.9)	122 (1.3)	2,871 (31.8)	128 (1.4)	3,129 (34.6)	3.08	1.63
8	Ter material (qualidade, disponibilidade e acessibilidade) em todos os locais de trabalho (Having equipment available in the health care setting)	136 (1.5)	20 (0.2)	1,268 (14.0)	85 (0.9)	7,530 (83.3)	4.64	0.84
9	Estar capacitado no que se refere às precauções-padrão (To be trained in using standard precautions)	66 (0.7)	13 (0.1)	1,066 (11.8)	96 (1.1)	7,798 (86.3)	4.72	0.73
10	Ter capacitação quanto às precauções-padrão (To receive reminders about standard precautions)	78 (0.9)	15 (0.2)	1,069 (11.8)	101 (1.1)	7,776 (86.0)	4.71	0.74
11	Quando o profissional médico tem um comportamento exemplar em relação às precauções-padrão (The senior physician has exemplary behavior regarding adherence to standard precautions)	618 (6.8)	47 (0.5)	2,518 (27.9)	125 (1.4)	5,731 (63.4)	4.14	1.24
Scale item		Not an obstacle n (%)	A bit of an obstacle n (%)	More or less obstacle n (%)	Partially obstacle n (%)	An obstacle n (%)	Mean	Standard deviation
12	Quando meus colegas de trabalho têm um comportamento exemplar em relação às precauções-padrão (My colleagues have exemplary behavior regarding adherence to standard precautions)	154 (1.7)	34 (0.4)	2,192 (24.3)	153 (1.7)	6,506 (72.0)	4.42	0.98
13	Situações inesperadas que podem atrapalhar a realização de meu trabalho (urgência, solicitação de colegas, nova tarefa a cumprir) (The occurrence of unanticipated events that adversely affect my work)	1,998 (22.1)	63 (0.7)	4,610 (51.0)	90 (1.0)	2,278 (25.2)	3.07	1.38
14	Falta de tempo (Lack of time)	2,893 (32.0)	56 (0.6)	3,432 (38.0)	72 (0.8)	2,586 (28.6)	2.93	1.56
15	Carga de trabalho mais elevada que de costume (Increased worload)	1,863 (20.6)	54 (0.6)	2,887 (31.9)	96 (1.1)	4,139 (45.8)	3.51	1.55
16	Complexidade das medidas de precauções-padrão (The complexity of the standard precautions protocol)	3,564 (39.4)	76 (0.8)	3,596 (39.8)	80 (0.9)	1,723 (19.1)	2.59	1.48
17	Falta de conhecimento sobre as precauções-padrão (Lack of knowledge about standard precautions)	1,672 (18.5)	52 (0.6)	2,381 (26.3)	58 (0.6)	4,876 (53.9)	3.71	1.55
18	Rotina, hábitos e equipe de trabalho (Care team routine)	2,903 (32.1)	57 (0.6)	3,723 (41.2)	95 (1.1)	2,261 (25.0)	2.86	1.51
19	Crenças pessoais relacionadas às precauções-padrão (Personal beliefs about standard precautions)	3,725 (41.2)	75 (0.8)	2,768 (30.6)	55 (0.6)	2,416 (26.7)	2.71	1.63
Scale item		Never n (%)	Rarely n (%)	Sometimes n (%)	Often n (%)	Ever n (%)	Mean	Standard deviation
20	Problemas relacionados ao material (qualidade, disponibilidade e acessibilidade) (Problems related to use of equipment)	1,278 (14.1)	50 (0.6)	2,823 (31.2)	86 (1.0)	4,802 (53.1)	3.78	1.45
21	Mesmo quando o paciente for difícil (Even if the patient is difficult)	103 (1.1)	78 (0.9)	353 (3.9)	1,281 (14.2)	7,224 (79.9)	4.71	0.69
22	Mesmo quando houver pouco tempo (Even if I am pressed for time)	108 (1.2)	145 (1.6)	657 (7.3)	1,873 (20.7)	6,256 (69.2)	4.55	0.80
23	Mesmo quando minhas mãos estiverem doloridas ou machucadas (Even if my hands are damaged or painful)	207 (2.3)	219 (2.4)	728 (8.1)	1,653 (18.3)	6,232 (68.9)	4.49	0.91
24	Mesmo em uma situação de urgência (During an emergency situation)	125 (1.4)	208 (2.3)	818 (9.0)	1,979 (21.9)	5,909 (65.4)	4.48	0.86

Factors	Mean	Standard deviation
Atitudes (Attitude toward standard precautions)	4.19	0.81
Influência social (Social influence)	3.74	1.06
Organização (Facilitating organization)	4.69	0.68
Comportamento interpessoal (Exemplary behavior)	4.28	1.01
Restrições organizacionais (Organizational constraints)	3.03	1.19
Restrições individuais (Individual constraints)	3.27	1.16
Intenção de seguir as precauções-padrão (Intention to perform standard precautions)	4.56	0.70

Factors	Professional category
Factors	Nurse	Nursing assistant or technician	p value^* * Mann-Whitney test.
Atitudes (Attitude toward standard precautions)	4.17	4.24	< 0.01
Influência social (Social influence)	3.60	3.99	< 0.01
Organização (Facilitating organization)	4.72	4.63	< 0.01
Comportamento interpessoal (Exemplary behavior)	4.22	4.39	< 0.01
Restrições organizacionais (Organizational constraints)	3.04	3.00	0.250
Restrições individuais (Individual constraints)	3.35	3.11	< 0.01
Intenção de seguir as precauções-padrão (Intention to perform standard precautions)	4.58	4.52	< 0.01

[1] Corresponding author:
Andressa Silva Torres dos Santos, E-mail: torresandressa@hotmail.com

Brasil

Brasil

Sociocognitive factors determining compliance with standard precautions by nursing professionals during the COVID-19 pandemic

Factores sociocognitivos que determinan la adherencia a las precauciones estándar por parte de los profesionales de enfermería durante la pandemia de COVID-19

ABSTRACT

Objectives:

Methods:

Results:

Conclusions: