Gender Differences in Nurses' Knowledge, Practice, and Attitudes Towards Contact Isolation Precautions: A Measurement Invariance Study

Background: Contact isolation precautions are essential for infection prevention and control in healthcare settings. Nurses play a critical role in implementing these precautions to prevent the spread of infectious diseases. Objectives: This paper reviews nurses’ current knowledge, practice, and attitude toward contact isolation precautions using differential item functioning (DIF). Methods: This cross-sectional study used the contact isolation precautions questionnaire, completed by 676 nurses at Namazi Hospital, Shiraz, Iran, in May 2019. The Firth binary logistic regression (LR) was used to detect the DIF of the items. Results: A total of 676 nurses were included in this study. Five hundred eighty-nine were female (81.1%), and the rest were male. Seventy-four percent of females and 65.5% of males had attended training courses on isolation precautions, which showed evidence of a weak difference (P = 0.08). The DIF analysis demonstrated that none of the items had considerable DIF. However, before (P = 0.048) and after (P = 0.472) removing item 8 in the knowledge section, the test’s significance changed. The results showed that, except for item 8, nurses had good knowledge (> 81%), positive attitudes (> 77%), and relatively adequate practices (> 71%) related to contact isolation precautions. It was also observed that both males (6.6 ± 1.9) and females (6.9 ± 1.3) had high knowledge scores, but their practice scores were relatively low (males: 5.7 ± 2.4, females: 6.6 ± 1.6), especially for men, who had the lowest scores. Conclusions: Overall, our results suggest that nurses had different perceptions of item 8 concerning contact precautions. Therefore, the contact precautions questionnaire should be cautiously used to compare nurses’ knowledge, attitude, and practice (KAP) scores. We suggest that the analysis of DIF should be used in the validation of contact isolation precautions questionnaires across different groups of healthcare workers. This study highlights the importance of continuous education to ensure that nurses have the necessary knowledge and skills to implement effective infection prevention and control measures.