The Role of Powerlessness Among Health Care Workers in Tuberculosis Infection Control

Qual Health Res. 2017 Dec;27(14):2116-2127. doi: 10.1177/1049732317731317. Epub 2017 Sep 29.

Abstract

Due to their occupational exposure in health care settings, health care workers (HCW) have increased risk of Mycobacterium tuberculosis infection. They face challenges to remain up-to-date with evidence-based clinical practices and translate educational information into actions in infection control practices. Our purpose was to examine this "knowledge-action" gap about how HCWs understand their occupational M. tuberculosis risk and use recommended infection control measures in clinical practices in the Dominican Republic (DR). We conducted 10 focus groups with 40 physicians and nurses at two tertiary-level DR institutions. Using grounded theory methods, we developed a theoretical model to describe the decision-making process related to adherence to M. tuberculosis infection control measures in clinical practice. Findings highlight intrinsic and extrinsic factors that influenced the observed knowledge-action gap related to M. tuberculosis infection control practices in two DR health institutions.

Keywords: Dominican Republic; Mycobacterium tuberculosis; focus groups; grounded theory; health care providers; hospitals; infection control; infectious disease transmission; occupational exposure; qualitative; tuberculosis.

MeSH terms

  • Adult
  • Attitude of Health Personnel
  • Cross Infection / prevention & control*
  • Dominican Republic
  • Evidence-Based Medicine
  • Female
  • Focus Groups
  • Grounded Theory
  • Health Knowledge, Attitudes, Practice
  • Health Personnel / psychology*
  • Humans
  • Infection Control / organization & administration*
  • Male
  • Middle Aged
  • Occupational Exposure / prevention & control*
  • Practice Guidelines as Topic
  • Risk Factors
  • Tuberculosis / prevention & control*