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      Prediction of Preventive Behaviors of the Needlestick Injuries during Surgery among Operating Room Personnel: Application of the Health Belief Model


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          Operating room personnel are at high risk of needlestick injuries (NSIs) and exposure to blood and body fluids.


          To investigate the predictors of NSIs preventive behaviors during surgery among operating room personnel based on a health belief model (HBM).


          This cross-sectional study was conducted on 128 operating room personnel in Hamadan, western Iran. Participants were selected, by census sampling, from teaching hospitals, completed a self-reported questionnaire including demographic characteristics, knowledge and HBM constructs.


          The levels of knowledge and perceived self-efficacy for the NSIs preventive behaviors among operating room personnel were not satisfactory. However, the levels of perceived benefits, susceptibility and severity were reported to be relatively good. The results showed that the perceived susceptibility (β ‑0.627) and cues to action (β 0.695) were the most important predictors of the NSIs preventive behaviors.


          The framework of the HBM is useful to predict the NSIs preventive behaviors among operating room personnel.

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          Most cited references35

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          A meta-analysis of fear appeals: implications for effective public health campaigns.

          The fear appeal literature is examined in a comprehensive synthesis using meta-analytical techniques. The meta-analysis suggests that strong fear appeals produce high levels of perceived severity and susceptibility, and are more persuasive than low or weak fear appeals. The results also indicate that fear appeals motivate adaptive danger control actions such as message acceptance and maladaptive fear control actions such as defensive avoidance or reactance. It appears that strong fear appeals and high-efficacy messages produce the greatest behavior change, whereas strong fear appeals with low-efficacy messages produce the greatest levels of defensive responses. Future directions and practical implications are provided.
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            Towards an Effective Health Interventions Design: An Extension of the Health Belief Model

            Introduction The recent years have witnessed a continuous increase in lifestyle related health challenges around the world. As a result, researchers and health practitioners have focused on promoting healthy behavior using various behavior change interventions. The designs of most of these interventions are informed by health behavior models and theories adapted from various disciplines. Several health behavior theories have been used to inform health intervention designs, such as the Theory of Planned Behavior, the Transtheoretical Model, and the Health Belief Model (HBM). However, the Health Belief Model (HBM), developed in the 1950s to investigate why people fail to undertake preventive health measures, remains one of the most widely employed theories of health behavior. However, the effectiveness of this model is limited. The first limitation is the low predictive capacity (R2 < 0.21 on average) of existing HBM’s variables coupled with the small effect size of individual variables. The second is lack of clear rules of combination and relationship between the individual variables. In this paper, we propose a solution that aims at addressing these limitations as follows: (1) we extended the Health Belief Model by introducing four new variables: Self-identity, Perceived Importance, Consideration of Future Consequences, and Concern for Appearance as possible determinants of healthy behavior. (2) We exhaustively explored the relationships/interactions between the HBM variables and their effect size. (3) We tested the validity of both our proposed extended model and the original HBM on healthy eating behavior. Finally, we compared the predictive capacity of the original HBM model and our extended model. Methods: To achieve the objective of this paper, we conducted a quantitative study of 576 participants’ eating behavior. Data for this study were collected over a period of one year (from August 2011 to August 2012). The questionnaire consisted of validated scales assessing the HBM determinants – perceived benefit, barrier, susceptibility, severity, cue to action, and self-efficacy – using 7-point Likert scale. We also assessed other health determinants such as consideration of future consequences, self-identity, concern for appearance and perceived importance. To analyses our data, we employed factor analysis and Partial Least Square Structural Equation Model (PLS-SEM) to exhaustively explore the interaction/relationship between the determinants and healthy eating behavior. We tested for the validity of both our proposed extended model and the original HBM on healthy eating behavior. Finally, we compared the predictive capacity of the original HBM model and our extended model and investigated possible mediating effects. Results: The results show that the three newly added determinants are better predictors of healthy behavior. Our extended HBM model lead to approximately 78% increase (from 40 to 71%) in predictive capacity compared to the old model. This shows the suitability of our extended HBM for use in predicting healthy behavior and in informing health intervention design. The results from examining possible relationships between the determinants in our model lead to an interesting discovery of some mediating relationships between the HBM’s determinants, therefore, shedding light on some possible combinations of determinants that could be employed by intervention designers to increase the effectiveness of their design. Conclusion: Consideration of future consequences, self-identity, concern for appearance, perceived importance, self-efficacy, perceived susceptibility are significant determinants of healthy eating behavior that can be manipulated by healthy eating intervention design. Most importantly, the result from our model established the existence of some mediating relationships among the determinants. The knowledge of both the direct and indirect relationships sheds some light on the possible combination rules.
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              Occupational exposures in emergency medical service providers and knowledge of and compliance with universal precautions.

              Little is known about compliance with universal precautions (CUP) or occupational exposures to blood and body fluids among Emergency Medical Services (EMS) providers. The objective of this study was to obtain estimates of CUP and knowledge of universal precautions (KUP), occupational exposures, and needle and lancet sticks in the prehospital environment. A convenience sample of workers (n=311, 51% response) from 17 agencies in Virginia that provided emergency ground transportation (volunteer, commercial, government rescue squads, and fire departments) completed a questionnaire on certification and training, KUP, CUP, exposures and needlesticks, risk perceptions, and demographic variables. Nearly all EMS providers reported exposures and were concerned about risk of HIV and hepatitis. Providers reported inconsistent CUP when treating patients or using needles, including failure to wear gloves (17%) and to appropriately dispose of contaminated materials (79%), including needles (87%), at all times. Certification type (advanced and basic) was related to both KUP and CUP. Of those respondents reporting current sharps use, 40% recapped needles. A lancet stick was reported by 1.4% (n=5), and 4.5% reported a needlestick (n=14). EMS providers working in the prehospital environment experience significant exposures but are not consistently using universal precautions. 2010 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

                Author and article information

                Int J Occup Environ Med
                Int J Occup Environ Med
                Int J Occup Environ Med
                The International Journal of Occupational and Environmental Medicine
                Shiraz: NIOC Health Organization
                October 2017
                01 October 2017
                : 8
                : 4
                : 232-240
                1 Department of Public Health, School of Health, Hamadan University of Medical Sciences, Hamadan, Iran
                2 Research Center for Behavioral Disorders and Substances Abuse, Hamadan University of Medical Sciences, Hamadan, Iran
                3 Department of Operating Room, School of Para Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
                4 Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
                Author notes
                Correspondence to Mitra Zandiyeh, MSc, Department of Operating Room, School of Para-Medical Sciences, Hamadan University of Medical Sciences, Hamadan, Iran Tel/Fax: +98-81-3838-1017. E-mail: zandyeh@ 123456umsha.ac.ir
                Copyright @ 2017

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                : 16 March 2017
                : 22 August 2017
                Page count
                Figures: 1, Tables: 4, References: 40, Pages: 9
                Original Article

                attitude,health belief model,needlestick injuries,operating room nursing,occupational exposure


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