Barriers and motivators affecting tuberculosis infection control practices of Russian health care workers.
METHODS
Five in-patient and out-patient tuberculosis (TB) care facilities in two regions of Russia.


OBJECTIVE
To identify barriers and motivators to the use of infection control measures among Russian TB health care workers.


METHODS
In this qualitative study, a convenience sample  of 96 health care workers (HCWs) was used to generate 15 homogeneous focus groups, consisting of physicians, nurses, and laboratory or support staff.


RESULTS
Barriers and motivators related to knowledge, attitudes and beliefs, and practices were identified. The three main barriers were  1) knowledge deficits, including the belief that TB was transmitted by dust, linens and eating utensils; 2) negative attitudes related to the discomfort of respirators; and 3) practices with respect to quality and care of respirators. Education and training, fear of infecting loved ones, and  fear of punishment were the main motivators.


CONCLUSIONS
Our results point to the need for evaluation of current educational programs. Positive health promotion messages that appeal to fear might also be successful in promoting TB infection control. Individualized rewards based on personal  motivators or group rewards that build on collectivist theory could be explored.
Department of Nursing, Mennonite College of Nursing at Illinois State University, Normal, Illinois 61761, USA. wwoith1@uic.edu
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D000328:Adult; D000553:Ambulatory Care; D001291:Attitude of Health Personnel; D003466:Cultural Characteristics; D004866:Equipment Contamination; D005239:Fear; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000523:psychology*; D006293:Health Promotion; D006801:Humans; D017053:Infection Control / Q000379:methods*; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control*; D007297:Inpatients; D008297:Male; D009042:Motivation; D016273:Occupational Exposure; D010348:Patient Care Team; D036301:Qualitative Research; D012121:Respiration, Artificial / Q000295:instrumentation; D012426:Russia / Q000453:epidemiology; D014376:Tuberculosis / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control* / Q000635:transmission; D012122:Ventilators, Mechanical / Q000382:microbiology