An Investigation On Knowledge, Attitudes And Intention To Refuse Care-Seekers Among Oral Care Professionals In Tianjin

Objective:Aiming at understanding the level of hospital infection-related knowledge of oral health care workers in Tianjin, as well as the hazard perception of engaging in oral diagnosis and treatment and discriminatory attitudes to patients with infectious diseases, we analyzed the effective factors on willingness of patients who refuse treatment or care infectious disease, for providing a theoretical basis for the further development of the hospital infection control in this population.Materials and Methods:Between March to April in2013, using a stratified random sampling method, we collected50oral health care professionals in each16districts in Tianjin for the survey. Trained personnel of surveillance performed anonymous survey using uniformly printed self-made questionnaire named oral health care workers hospital infection KAP questionnaire, which including general, oral professional infection control knowledge, the hazard perception and discriminatory attitude to infective patients, and the willingness of refusing to diagnose infectious disease. After the end of the survey, questionnaire was reviewed by quality control personnel at all levels and error correction in a timely manner. All data entered into an Excel database using the double entry method. All statistical analyses was carried out using the SPSS18.0statistical software. One way ANOVA and t-test were performed to compare means of normally distributed variables. Chi-square test was used to analyze the distribution of the willingness of refusing to diagnose infectious disease. Non-conditional logistic regression analysis was used to analyze the effective factors of refusing to diagnose infectious disease.Results:900questionnaires were distributed, of which867were valid and questionnaire effective rate was96.3%.There were633doctors and234nurses;402males and465females, with mean age of36.83±9.85years, college or higher education accounted for84.47%, with intermediate and above accounted for47.87%,10years and above accounted for50.64%. The total rate of27hospital infection control knowledge was (68.59±10.71)%, range from96.30%to25.93%; There were statistically significant in different education, occupation, work experience, unit level and nature of the survey total rate of difference (P<0.05).There were11single awareness of more than90%in all the27knowledge; have8single awareness rate of less than50%, including5of disinfection and sterilization knowledge,2knowledge of infectious diseases,1knowledge of hand hygiene and protection; the single awareness rate of less than20%respectively were "non-single-use probe and mouth mirror to achieve the level of disinfection can (4.04%)," Every time oral treatment operation should wear masks hat "(10.03%)," is not available under the exhaust pressure steam sterilizer headpiece sterilization (12.92%), with a fast card-pressure steam sterilizer bare sterilization validity shall not exceed2h (14.42%).In our survey,54.9%engaged in oral diagnosis and treatment of hazardous (i.e., hospital infection hazard perception score10to15points), age, academic qualifications and unit level and nature of the investigation object hazard perception is significantly different (P＜0.05); The significantly difference were found in the discriminatory attitudes, sex, education, occupation, and unit level survey discrimination (P＜0.05); There were37.14%of medical staff have the willingness of refusing to diagnose infectious disease, compare to grand2and3hospital, grand1hospital have a significantly higher willingness.(P<0.05). Multivariate unconditional logistic regression analysis showed that the unit level, knowledge of hospital infection awareness, hazard perception score and discriminatory attitudes score into the main effects model (P＜0.05), in which OR(95%CI) of the hospital infection awareness, hazard perception score, discriminatory attitudes score, were1.231(1.140-1.329)、1.246(1.169-1.329) respectively, suggesting that the lower the knowledge of hospital infection awareness, hazard perception the higher the score, the higher the score, the extent of discrimination, where the unit of a hospital staff refused to diagnosis easier to select.Conclusions:The knowledge and awareness of hospital infection control is low in oral health care workers in Tianjin. Oral health workers with old age, long work experience, low educational level and working in grade one hospital should be main objects of hospital infection knowledge training. Workers with low age, high educational level and working in specialist oral hospital were aware of the danger of work. Female and nurse tend to be easier to discriminate against patients with infectious diseases. Workers in grade one hospitals tend to be easier to refuse to diagnose than grade two and three hospital workers. The cognitive level of hospital infection, hazard perception and discriminatory attitudes will add to health care workers’refusing willingness. It is necessary to spread knowledge of hospital infection to health care workers, and reduce the risk perception, eliminate discriminatory attitudes to the infectious diseases patients at the same time.