Background: Hand hygiene (HH) is one of the most effective practices to reduce healthcare-associated infection (HAI) transmission, though compliance remains inadequate among hospital personnel. The aim of this study was to explore perceived barriers and enablers of HH compliance in hospital care and healthcare workers’ (HCW) HAI risk and severity perceptions. Methods: Qualitative study using semi-structured interviews and observations. Interview recordings were transcribed verbatim and supplemented with transcribed observations and field notes. Data was aggregated and coded thematically using a qualitative data analysis software. Results: 65 interviews and 18 observations with HCWs were conducted in nine hospital centres in Quebec, Canada. Data analysis revealed several factors that may influence HCWs’ compliance with HH recommendations. These included clinical environment factors (e.g., lack of sinks), organizational factors (e.g., inadequate staffing, demanding workloads), and communication factors (e.g., dissemination of infection prevention and control [IPAC] information, feedback, and interpersonal professional relationships). At the individual level, knowledge of IPAC and HAI risk perceptions were associated with the adoption of HH. Conclusion: Understanding the determinants of HH adoption is crucial for improving current practices and reducing HAI rates in hospital care. Our findings suggest that environmental strategies (e.g., additional sinks and HH stations) and organizational and communication strategies (e.g., continuing education and training sessions, support from hospital management, positive feedback) could help raise HCWs’ awareness of HAI prevention and adoption of HH guidelines.

No abstract

There is limited research exploring the perceptions of people who gamble on the self-control strategies used to limit their gambling. This qualitative study examines self-control strategies used to limit money spent gambling, frequency of gambling, and time spent gambling. A total of 56 people who gamble (27 males and 29 females) participated in nine focus groups and five individual interviews in Montreal, Calgary, and Toronto (Canada). Self-control strategies used to limit their gambling expenditure were more common than frequency or time limiting strategies. Strategies to limit expenditure included: restricting access to money; keeping track of money allocated to gambling activities; and avoiding certain types of gambling activities. Various contextual factors were identified to influence those strategies, including social influences; winning or losing; using substances. Findings from this study emphasize the importance of communicating clear gambling limits to people who gamble, as well as the value of developing individual self-control strategies to limit frequency, time and money spent gambling.