Why don't doctors wash their hands? A correlational study of thinking styles and hand hygiene.

Department of Palliative & Supportive Services, School of Medicine, Flinders University, Adelaide, Australia.
American journal of infection control (Impact Factor: 2.33). 09/2008; 36(6):399-406. DOI: 10.1016/j.ajic.2007.11.002
Source: PubMed

ABSTRACT The World Health Organization has identified cognitive determinants of hand hygiene as an outstanding research question. This study investigated whether doctors' preferences for a rational thinking style or an experiential thinking style are associated with hand hygiene compliance.
This was an observational study of hand hygiene practices of 32 doctors in 2 teaching hospitals in South Australia. Compliance rates were correlated with self-reported thinking styles. The doctors were observed by a trained observer during a ward round or outpatient clinic and were unaware that hand hygiene was under observation. The main outcome measures were hand hygiene compliance (hand hygiene compliance tool) and thinking style (Rational-Experiential Inventory).
An overall mean compliance rate of 7.6% (standard deviation +/- 7.2%) was found. Compliance was significantly positively correlated with experiential/automatic thinking (r = .46; P = .004) and the observational setting of ward rounds (vs clinics) (r = -.47; P = .003). No significant relationship was found between compliance and a rational/deliberate thinking style (r = -.01; P = .472).
Hand hygiene is more experiential than rational. Findings suggest that certain promotional strategies appealing to the experiential thinking mode may improve compliance, and that traditional approaches based on logic and reasoning alone probably will not work.


Available from: Malcolm James Bond, Jun 15, 2015
  • [Show abstract] [Hide abstract]
    ABSTRACT: Cognitive-Experiential Self Theory assumes that reasoning conforms to a parallel dual processing model (comprising rational and experiential systems), through which we make sense of the world. The Rational Experiential Inventory was developed to measure an individual's preference for rational (need for cognition) and experiential (faith in intuition) thinking, with individual differences proposed to influence the respective dominance of each. While small but consistent gender effects have been found previously, age effects have rarely been reported or investigated across the lifespan. We examine both age and gender differences in Rational Experiential Inventory scores, using combined data from five studies involving adult participants (n = 520, 61.9% male) with a mean age of 41.45 years (SD = 11.73, range 20-74 years). Results suggest a convergence of the rational and experiential systems in adulthood, although the timing may be different for women and men. In later adulthood, the relationship appears to diverge again.
    Personality and Individual Differences 12/2010; 49(8):907-911. DOI:10.1016/j.paid.2010.07.028 · 1.86 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Cognitive-Experiential Self-Theory (CEST) emphasizes the dual roles of rational and experiential thinking, with individuals having varying preferences for each style. This study explored the relationship between these constructs, illustrating the value of the derived model in addictive behavior, as illustrated by smoking. Data were extracted from a study of the predictors of men’s health behavior. Participants comprised 212 Australian men (aged 25–65 years) who completed a self-report questionnaire which assessed thinking styles and recorded smoking status. Rational and experiential data were subjected to cluster analysis and median splits to identify logical subgroups based on participants’ dual responses. The four derived clusters were more representative of smoking status than groups defined by median splits. In general, both smokers and ex-smokers preferred experiential thinking and non-smokers preferred rational thinking. There was a strong tendency for smokers to report both low rational and high experiential thinking. The use of cluster analysis advanced the evaluation of the interactive nature of rational and experiential thinking by allowing an empirical test of their potential relationship. The thinking profiles reported represent an advance in the assessment of CEST which may provide a useful model for applications in fields both related to, and beyond, addiction.
    Personality and Individual Differences 08/2015; 82. DOI:10.1016/j.paid.2015.03.009 · 1.86 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Patients could help to improve the hand hygiene (HH) compliance of healthcare professionals (HCPs) by reminding them to sanitize their hands. To review the effectiveness of strategies aimed at increasing patient involvement in reminding HCPs about their HH. A systematic review was conducted across Medline, EMBASE and PsycINFO between 1980 and 2013. Twenty-eight out of a possible 1956 articles were included. Of these, 23 articles evaluated the effectiveness of developed patient-focused strategies and five articles examined patients' attitudes towards hypothetical strategies. Sixteen articles evaluated single-component strategies (e.g. videos) and 12 articles evaluated multi-modal approaches (e.g. combination of video and leaflet). Overall, the strategies showed promise in helping to increase patients' intentions and/or involvement in reminding HCPs about their HH. HCP encouragement appeared to be the most effective strategy. However, the methodological quality of the articles in relation to addressing the specific aims of this review was generally weak. A number of strategies are available to encourage patients to question HCPs about their HH. Better controlled studies with more robust outcome measures will enhance understanding about which strategies may be most successful and why. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
    Journal of Hospital Infection 12/2014; 89(3). DOI:10.1016/j.jhin.2014.11.010 · 2.78 Impact Factor