COM-B Hand Hygiene Behavior Questionnaire

Background:

Although the hand hygiene (HH) procedure is simple, the related behaviour is complex and is not readily understood, explained, or changed. Appropriate theories of behavioural change are often not considered in the design and use of assessment tools relating to HH behaviour. The COM-B HHB questionnaire is reliable and valid and has the potential to provide data to support the development, and evaluation, of HH interventions that meet the needs of specific healthcare units.

Psychometrics:

A total of 292 responses to the survey (response rate 41.0%) were included in the analysis. Confirmatory factor analysis resulted in a 17-item questionnaire. Multiple regression revealed that a model including Capability, Opportunity, and Motivation, was a significant predictor of self-reported Behavioural intention (F(3,209) =22.58, p<0.001). However, the Opportunity factor was not found to make a significant contribution to the regression model. Unit-level comparisons suggested that there may be an overestimation of HH behaviour when self-report is compared to direct observation of HH behaviour.
Conclusion. The COM-B HHB questionnaire is reliable and valid and has the potential to provide data to support the development, and evaluation, of HH interventions that meet the needs of specific healthcare units.

Author of Tool:

Paul O'Connor and Sinead Lydon

Key references:

Lydon, S., Greally, C., Tujjar, O., Reddy, K., Lambe, K. Madden, C., Walsh, C., Fox, S. O’Connor, P. (under review). Psychometric evaluation of a theory-based measure of factors influencing hand hygiene behaviour.

Primary use / Purpose:

To measure healthcare professional's attitudes to the factors influencing hand hygiene behaviour.

COM-B Hand Hygiene Behavior Questionnaire

Please read each item below and circle the number that best captures the extent to which you agree with each statement.

 

    5. Strongly agree
    4. Agree  
  3. Neither    
  2. Disagree      
1. Strongly disagree        

1.     Capability          
a)    I have received adequate training in hand hygiene practices in this unit 1 2 3 4 5
b)    I know the moments when hand hygiene is required 1 2 3 4 5
c)    I know how to conduct a complete hand wash or rub 1 2 3 4 5
d)    I engage in hand hygiene without thinking 1 2 3 4 5
e)    I find it easy to adhere to hand hygiene recommendations in this unit 1 2 3 4 5
2.     Opportunity          
a)    I have enough time to engage in hand hygiene 1 2 3 4 5
b)    This unit has adequate facilities for hand hygiene 1 2 3 4 5
c)    Nurses in this unit always engage in hand hygiene when required 1 2 3 4 5
d)    Doctors in this unit always engage in hand hygiene when required 1 2 3 4 5
e)    Healthcare providers visiting this unit always wash their hands when required 1 2 3 4 5
f)     The hand hygiene protocols for this unit are clear 1 2 3 4 5
g)    There are prompts to remind staff to engage in hand hygiene in this unit 1 2 3 4 5

3.     Motivation          
a)    Hand hygiene compliance is considered important by staff in this unit 1 2 3 4 5
b)    Hand hygiene compliance is considered important by my seniors in this unit 1 2 3 4 5
c)    I strive for complete compliance with the five moments of hand hygiene 1 2 3 4 5
d)    We remind each other to engage in hand hygiene in this unit 1 2 3 4 5
e)    Infection control audits encourage me to adhere to hand hygiene protocols in this unit Behaviour 1 2 3 4 5
4.     Behaviour          
I wash my hands:          
a)    Before patient contact 0 1 2 3 4
b)   Before aseptic technique 0 1 2 3 4
c)   After body fluid exposure risk 0 1 2 3 4
d)   After patient contact 0 1 2 3 4
e)   After contact with the patient surroundings 0 1 2 3 4

Scoring Key

For each of the four subscales, add the item responses within that subscale together and then divide by the number of items in the subscale order to obtain a mean subscale score. For example, for the Capability subscale, add the responses to the five items and then divide by five in order to obtain the mean subscale score