The Effect of Cognitive Behavioral Therapy

Official title

The Effect of Hand Hygiene Education With Cognitive Behavioral Therapy on Hospital Infection Awareness: a Randomized Controlled Trial

Overview

The aim of this study is to investigate the effect of hand hygiene training applied using cognitive behavioural therapy techniques on healthcare workers' attitudes and beliefs regarding nosocomial infections. Another aim is to increase the effectiveness of hand hygiene training and to instil correct hand hygiene behaviour by utilising cognitive behavioural therapy to raise awareness of nosocomial infections among healthcare workers. This is a single-centre, double-blind, randomised, controlled trial with a single parallel group. The hypothesis is that hand hygiene training using cognitive behavioural therapy techniques will influence healthcare workers' attitudes and beliefs regarding nosocomial infections.

Detailed description

Although hand hygiene is a significant factor contributing to nosocomial infections, the problem of failure to implement effective hand hygiene has not yet been fully resolved. Hospital infections are generally defined as infections that develop in a patient who has been admitted to hospital for reasons other than infection. If the patient is not in the incubation period when admitted to hospital or does not have the signs and symptoms of that infection, infections that occur in hospital are hospital-acquired infections. Supporting hand hygiene training with Cognitive Behavioural Therapy represents a relatively new approach in the literature. Like many health behaviour interventions developed based on Ajzen's Theory of Planned Behaviour, this study also aimed to achieve lasting behavioural change by targeting cognitive attitudes and norms. Similar interventions have been found to be effective particularly in areas such as diabetes management, smoking cessation, and increasing physical activity. Von Lengerke et al. observed hand hygiene behaviour in their randomised controlled trials. Boscart et al. also utilised psychological theories to promote hand hygiene behaviour. However, the number of studies employing a cognitive behavioural therapy-based approach specifically for hand hygiene is limited. In this respect, this study makes an important contribution to the literature. This study goes beyond classical education models and focuses on transforming healthcare workers' attitudes towards nosocomial infections through an education approach based on a cognitive behavioural foundation. Given the scarcity of hand hygiene training supported by Cognitive Behavioural Therapy in the current literature, this study presents a novel theoretical approach and proposes a robust strategy for preventing hospital infections in practice.

Interventions

• Behavioral Hand hygiene training using cognitive behavioural therapy techniques
  The intervention group will receive hand hygiene training using cognitive behavioural therapy techniques. Hand hygiene training using cognitive behavioural therapy techniques will be delivered by a specialist psychologist certified in cognitive behavioural therapy from among the researchers. The training consists of three 1-hour sessions. The information on hand hygiene included in the training has been obtained from data provided by the Turkish Ministry of Health and the World Health Organisati

Primary outcome measures

• Initial values obtained from the Nosocomial Infection Belief and Attitude Scale [Time frame: The first measurement will be taken on the same day following the training provided to healthcare workers.]

Secondary outcome measures (1)

• Three-month change following the Nosocomial Infection Belief and Attitude Scale measurement [Time frame: The second assessment will take place three months after the training provided to healthcare workers.]

Eligibility criteria

Inclusion criteria

• Being a healthcare worker
• To have been actively working in a hospital for at least 1 year
• Agreeing to participate in the research

Exclusion criteria

• Working on the infection control committee
• Refusing to participate in the research

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: Yes

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Double blind

Primary purpose

Other

Study locations

Turkey (Türkiye) · 1 center

• Kırşehir Ahi Evran University — Kırşehir

Publications

• von Lengerke T, Lutze B, Krauth C, Lange K, Stahmeyer JT, Chaberny IF. Promoting Hand Hygiene Compliance: PSYGIENE-a Cluster-Randomized Controlled Trial of Tailored Interventions. Dtsch Arztebl Int. 2017 Jan 20;114(3):29-36. doi: 10.3238/arztebl.2017.0029. PMID 28179049
• Michie S, Abraham C, Whittington C, McAteer J, Gupta S. Effective techniques in healthy eating and physical activity interventions: a meta-regression. Health Psychol. 2009 Nov;28(6):690-701. doi: 10.1037/a0016136. PMID 19916637
• Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007 May;39(2):175-91. doi: 10.3758/bf03193146. PMID 17695343
• Boscart VM, Fernie GR, Lee JH, Jaglal SB. Using psychological theory to inform methods to optimize the implementation of a hand hygiene intervention. Implement Sci. 2012 Aug 28;7:77. doi: 10.1186/1748-5908-7-77. PMID 22929925
• Ajzen I. The theory of planned behaviour: reactions and reflections. Psychol Health. 2011 Sep;26(9):1113-27. doi: 10.1080/08870446.2011.613995. PMID 21929476

Identifiers

NCT: NCT07506915 · AHIEVRAN-2025- HAND HYGIENE

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗