title: Patient empowerment in a hand hygiene program: differing points of view between patients/family members and health care workers in Asian culture.
abstract: BACKGROUND
  "Patient empowerment" is an important component of World Health Organization hand hygiene program, but little is known about the intentions and attitude of patients/families and health care workers (HCWs) regarding this.
  
  
  METHODS
  A cross-sectional survey using questionnaires was conducted in a tertiary teaching hospital in Taiwan to assess hand hygiene knowledge and the attitudes and intentions regarding patient empowerment among patients/families and HCWs.
  
  
  RESULTS
  Among patients/families, 95.4% (329/345) had positive attitudes regarding patient empowerment; however, only 67.2% (232/345) had the positive intention to remind HCWs about hand hygiene (P < .001). Risk factors for negative intention were being female (odds ratio [OR], 1.82; 95% confidence interval [CI]: 1.08-3.03), illiteracy (OR, 3.18; 95% CI: 0.86-11.7), and being patients/families in the pediatric department (OR, 1.86; 95% CI: 0.93-3.64). Among HCWs, the difference between positive attitude (81.1%; 714/880) and positive intention regarding being reminded about hand hygiene (62.8%; 553/880) was significant (P < .001). Risk factors for negative intention were age > 25 years (OR, 3.20; 95% CI: 1.51-6.81) and a negative attitude toward patient empowerment (OR, 10.00; 95% CI: 5.88-16.67).
  
  
  CONCLUSIONS
  There were significant gaps between attitude and intention regarding patient empowerment both among patients/families and HCWs. Special strategies targeting women, the pediatric population, or illiterate people may help improve patient/family participation. Additionally, hand hygiene education should be incorporated into early-stage medical/nursing education to create a facilitating environment. Patients/families and HCWs cooperation is needed to promote the hand hygiene program further.
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Sung-Ching
authors.initials: SC
authors.lastname: Pan
authors.forename: Kuei-Lien
authors.initials: KL
authors.lastname: Tien
authors.forename: I-Chen
authors.initials: IC
authors.lastname: Hung
authors.forename: Yu-Jiun
authors.initials: YJ
authors.lastname: Lin
authors.forename: Ya-Ling
authors.initials: YL
authors.lastname: Yang
authors.forename: Ming-Chin
authors.initials: MC
authors.lastname: Yang
authors.forename: Ming-Jiuh
authors.initials: MJ
authors.lastname: Wang
authors.forename: Shan-Chwen
authors.initials: SC
authors.lastname: Chang
authors.forename: Yee-Chun
authors.initials: YC
authors.lastname: Chen
mesh_terms: D000328:Adult; D044466:Asian People; D001291:Attitude of Health Personnel; D003428:Cross Infection / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D005190:Family; D005260:Female; D019983:Guideline Adherence; D063373:Hand Hygiene / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D011795:Surveys and Questionnaires; D013624:Taiwan; D062606:Tertiary Care Centers
keywords: Hand hygiene; Infection control; Patient care; Patient participation