First questionnaire with measurement equivalence between physicians and nurses to assess individual determinants of compliance with surgical site infection prevention: cross-sectional survey results from the WACH-study

Abstract

Abstract Background Compliance to prevent healthcare-associated infections varies between physicians and nurses. Understanding these differences is the key to adapt, i.e., tailor interventions to promote compliance. To measure determinants to be taken into account in tailoring processes, reliable and valid instruments with measurement equivalence (ME) across professional groups are needed. Aim To determine the reliability, validity, and ME of questionnaire scales to assess determinants of compliance to prevent surgical site infections (SSI) based on the Capability|Opportunity| Motivation–Behaviour model (COM-B), and explore their associations with self-reported compliance. Methods Self-reported SSI-preventive compliance and COM-B-determinants were assessed in a questionnaire survey of 90 physicians and 193 nurses working in nine departments in six German hospitals outside the university sector. Single- and multi-group confirmatory factor analyses, t-tests, and multiple linear regression analyses were performed. Findings: Scales for individual determinants (capability, motivation, planning) but not environmental determinants (opportunities) showed reliability and validity among both physicians and nurses, and ME across these groups. No group differences were found in compliance and determinants. Capability (β = .301) and planning (β = .201) showed theory-conform associations with self-reported compliance among nurses, not physicians. Additionally, both tended to mediate the association of motivation. Conclusion The scales for motivation, capability, and planning regarding SSI-preventive compliance rendered reliable and valid scores for physicians and nurses in surgery. Due to ME, they provide true comparisons between both groups in German hospitals. Such scales for environmental determinants (opportunities) have yet to be developed. Associations of individual determinants with self-reported compliance were in line with theory among nurses.