title: Intention to comply with post-exposure management among nurses exposed to blood and body fluids in Taiwan: application of the theory of planned behaviour.
abstract: Nurses are at significant risk from occupationally acquired bloodborne virus infections following a needlestick and sharps injury. This study aimed to apply the theory of planned behaviour (TPB) to predict nurses' intention to comply with occupational post-exposure management. A cross-sectional survey was applied to select registered nurses who worked in human immunodeficiency virus (HIV)-designated hospitals. An anonymous, self-administered questionnaire based on the TPB was distributed to 1630 nurses and 1134 (69.5%) questionnaires were returned. From these, a total of 802 nurses (71%) reported blood and body fluid exposure incidents during 2003-2005 and this group was used for analysis. Only 44.6% of the 121 exposed nurses who were prescribed post-exposure prophylaxis (PEP) by infectious disease doctors returned to the clinic for interim monitoring, and only 56.6% of exposed nurses confirmed their final serology status. Structural equation modelling was used to test the TPB indicating perceived behavioural control (the perception of the difficulty or ease of PEP management, β=0.58), subjective norm (the perception of social pressure to adhere to PEP, β=0.15), and attitudes (β=0.12) were significant direct effects on nurses' intention to comply with post-exposure management. The hypothesised model test indicated that the model fitted with the expected relationships and directions of theoretical constructs [χ(2) (14, N=802)=23.14, P=0.057, GFI=0.987, RMSEA=0.039]. The TPB model constructs accounted for 54% of the variance in nurses' intention to comply with post-exposure management. The TPB is an appropriate model for predicting nurses' intention to comply with post-exposure management. Healthcare facilities should have policies to decrease the inconvenience of follow-up to encourage nurses to comply with post-exposure management.
authors.affiliation: Department of Nursing, College of Medicine, National Cheng Kung University & Hospital, Taiwan. nyko@mail.ncku.edu.tw
authors.forename: N-Y
authors.initials: NY
authors.lastname: Ko
authors.forename: S-H
authors.initials: SH
authors.lastname: Yeh
authors.forename: S-L
authors.initials: SL
authors.lastname: Tsay
authors.forename: H-J
authors.initials: HJ
authors.lastname: Ma
authors.forename: C-H
authors.initials: CH
authors.lastname: Chen
authors.forename: S-M
authors.initials: SM
authors.lastname: Pan
authors.forename: M-C
authors.initials: MC
authors.lastname: Feng
authors.forename: M-C
authors.initials: MC
authors.lastname: Chiang
authors.forename: Y-W
authors.initials: YW
authors.lastname: Lee
authors.forename: L-H
authors.initials: LH
authors.lastname: Chang
authors.forename: J-F
authors.initials: JF
authors.lastname: Jang
mesh_terms: D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D001769:Blood / Q000821:virology; D017848:Blood-Borne Pathogens / Q000302:isolation & purification; D001826:Body Fluids / Q000821:virology; D003430:Cross-Sectional Studies; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009726:Nurses; D009784:Occupational Diseases / Q000517:prevention & control*; D056990:Post-Exposure Prophylaxis / Q000379:methods*; D011795:Surveys and Questionnaires; D013624:Taiwan; D014777:Virus Diseases / Q000517:prevention & control*; D055815:Young Adult