Determinants Of Nurses’ Toileting Behavior:Application Of The Health Belief Model

Objectives:1.To describe female nurses’toileting behavior (TB) and beliefs related to toileting behavior (BTB).2.To investigate the factors of female nurses’toileting behavior based on Health Belief Model (HBM) to provide theoretical evidence to the interventions focusing on improving the status of female nurses’ toileting behavior and prevent the occurrence of lower urinary tract symptoms (LUTS).Methods:This is a cross-sectional study with401female nurses from three hospitals enrolled by multistage randomised sampling. Women’s toileting behavior scale (WTBS) and women’s belief of toileting behavior scale (WBTBS) were used to assess female nurses’toileting behavior and beliefs related to toileting behavior. Statistical analysis was implemented using SPSS16.0. Descriptive statistics were used to describe the nurses’ toileting behavior and beliefs related to toileting behavior, univariate analysis was conducted to analyze the influencing factors of nurses’ toileting behavior and beliefs related toileting behavior. AMOS19.0was used to build the structural equation model predicting nurses’toileting behavior based on HBM.Results:1.The total mean (SD) score of women’s toileting behavior was2.53(0.55); and the mean (SD) score of place preference for voiding domain, premature voiding domain, delay voiding domain, straining voiding domain, and position preference for voiding domain were2.50(1.09).2.90(0.85),2.31(0.93),3.14(0.76),1.83(0.78), respectively. Voiding place preference and delay voiding were the two biggest problems existing in female nurses’toileting behavior. As to the beliefs related to toileting behavior, the mean (SD) score of perceived susceptibility of LUTS domain, perceived severity of LUTS domain, perceived benefit of the healthy toileting behavior (HTB) domain, perceived barriers of HTB domain, self-efficacy of HTB domain were3.49(0.53),3.18(0.67),3.58(0.66),2.86(0.71),3.57(0.66), respectively. The weakest belief was perceived benefit of HTB, and the strongest beliefs were perceived severity of LUTS and perceived barriers of HTB.2. The fit index of the final model predicting the nurses’ toileting behavior, X2|df, GFI, AGFI, NFI, IFI, CFI, TLI, RMSEA, CN were1.303,0.967,0.945,0.901,0.972,0.971,0.957,0.028,386, respectively.3. The model predicting nurses’TB based on the HBM can explain46.2%of the variance of toileting behavior. Perceived barriers of HTB, perceived severity of LUTS and self-efficacy of HTB have direct effect on TB, while perceived susceptibility of LUTS and perceived benefit of HTB have small indirect influence on nurses’TB. Some modifying factors, including education, marital status, working years, BMI, volume of drinking water, urinary tract infection and the severity of LUTS can impact toileting behavior directly or indirectly through BTB.Conclusions:1. The current status of TB and BTB among nurses were not good. Nurses tend to have a bad place preference for voiding and delay voiding are prevalent among nurses. Nurses can perceive the severity of LUTS and barriers of HTB, however they have weak sense of the benefit of HTB.2. As a whole, the fit indices for the model built to predict nurses’ TB are all acceptable well, indicating the theoretical model proposed is fit the data well.3. HBM can well predict nurses’ TB. Interventions can be made to improve nurses’ TB based on the HBM. Related interventions should focus on the cognition education about LUTS and TB, and their close relationship, and improve their self-efficacy about HTB. Hospital managers should provide good conditions for voiding to improve nurses’ TB to prevent the occurrence of LUTS.