Chulalongkorn Medical Journal


Background : Perception toward hand washing in relation to respiratory infection amongcaregivers has not received adequate attention. Caregivers’ perceptioncan help facilitate hand washing behavior in households and may reduceinfluenza transmission in communities.Objectives : To describe the perceptions toward hand washing, household’s barriersand to persuade hand washing in preventing respiratory infection amongcaregivers responsible for administering full-time care to influenzainfected children.Methods : A sampling technique was applied to select caregivers caring for aninfluenza infected child. An in-depth interview and observation wereconducted at each participant’s house between November 2008 andMay 2009. The methods elicited details on perception of benefits andbarriers of hand washing, educational approaches to promoting handwashing and availability of hand washing facilities. Content analysis wasapplied to analyze the data.Results : Twenty-five caregivers were interviewed. The majority (24/25) werefemale and ranged from 22 to 47 years of age. Half of the caregivers(13/25) work outside their home and contributes toward the household‘sincome. Findings supported caregivers’ knowledge that hands carrygerms and transmit diseases. They recognized that hand washing asthe most economical preventative practice in preventing diseases.However, they reported washing their hands only on occasions that arerelated to diarrheal disease prevention. Barriers in adherence to handwashing amounted to being busy, in a hurry, unaware, forgetfulness andinconvenient. Participants disclosed that their children aged 7-15 wereunaware of the benefits. They knew that hand washing promotion utilizingone-on-one demonstrations, poster reminder and positive reinforcementcould help to change this perception and promote frequent hand washingamong their children.Conclusion : This study demonstrated that caregivers are aware of the benefits ofgood hand washing practices but only when it is applied to preventinggastrointestinal tract infections. Children aged 7-15 years in thesehouseholds were unaware of the benefits and needed intensive handwashing education.


Faculty of Medicine, Chulalongkorn University

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