Exploring the Relationship between Knowledge and Attitudes, Adherence and Confidence on Hand Hygiene Practices Among Thai Nursing Students

Abstract

Background: Hand hygiene plays a crucial role in infection control in healthcare settings, but there is a concerning gap in compliance rates among healthcare workers globally. Nursing students, who will form a substantial part of the future healthcare workforce, are key to effective hand hygiene practices. A significant educational gap in hand hygiene exists globally, especially in Asia, including Thailand. Research on nursing students’ knowledge, attitude, adherence to, and confidence in hand hygiene is still limited, despite their frequent non-compliance with standard protocols. Therefore, this study aimed to examine the correlations and associated factors between knowledge, attitudes, adherence to, and confidence in hand hygiene practices among first-year nursing students at a Thai nursing college.Methods: A cross-sectional study was conducted with all 116 first-year nursing students from Boromarajonani College of Nursing, Thailand. Data were collected through a self-administered questionnaire and analyzed using Pearson’s correlation and multiple logistic regression analysis.Results: The results show that only 46.6% of students demonstrated good knowledge of hand hygiene, but a higher percentage showed positive attitudes (51.7%) and adherence (55.2%). A majority (76.7%) had good confidence in their hand hygiene practices. Positive correlations were observed between knowledge and attitude, attitude and adherence, and adherence and confidence. Male students generally had better knowledge, while those with lower GPAs tended to have higher confidence in hand hygiene. The findings of this study are in line with previous studies, indicating that knowledge does not always lead to positive attitudes or adherence to hand hygiene. Also, confidence is necessary for effective hand hygiene practices.Conclusions: This study highlights the factors related to hand hygiene practices among Thai nursing students and emphasizes the need for comprehensive, culturally sensitive educational strategies. Future research should consider various contextual factors, such as gender differences and academic performance, to enhance hand hygiene practices among nursing students.