Factors influencing hand hygiene compliance among elderly caregivers: based on the theory of planned behavior

This study aimed to identify factors influencing hand hygiene compli-ance among long-term care workers in long-term care facilities based on the theory of planned behavior (TPB). A cross-sectional survey was conducted with 133 long-term care workers from four long-term care facilities in Daegu Metropolitan City and Gyeongsangbuk-do, South Ko-rea. Self-reported questionnaires assessed hand hygiene-related belief factors (behavioral, normative, and control beliefs), core TPB factors (attitude toward behavior, subjective norms, and perceived behavioral control), intention, and hand hygiene compliance. Descriptive statistics, t-tests, analysis of variance, Pearson correlation, and multiple regres-sion analysis were performed. The mean scores for hand hygiene atti-tude, subjective norms, and behavioral intention exceeded the scale midpoint, whereas the scores for control beliefs and perceived behav-ioral control were relatively lower. Hand hygiene compliance was sig-nificantly correlated with behavioral beliefs (r=0.23, P=0.008), control beliefs (r=0.26, P=0.002), attitude toward behavior (r=0.18, P=0.038), perceived behavioral control (r=0.41, P<0.001), and intention (r=0.31, P<0.001). Multiple regression analysis identified perceived behavioral control (β=0.33, P=0.002) and intention (β=0.23, P=0.006) as significant predictors of compliance, explaining 19.1% of the variance (Adjusted R2=0.191). Perceived behavioral control and intention were identified as significant predictors of hand hygiene compliance. Interventions should not only enhance knowledge but also address structural and or-ganizational factors to strengthen caregivers’ perceived control and translate intention into practice.