Perception toward hand washing among caregivers in Thai household with influenza infected child, Bangkok, Thailand: A qualitative study

Abstract

Background : Perception toward hand washing in relation to respiratory infection among caregivers has not received adequate attention. Caregivers’ perception can help facilitate hand washing behavior in households and may reduce influenza transmission in communities.

Objectives : To describe the perceptions toward hand washing, household’s barriers and to persuade hand washing in preventing respiratory infection among caregivers responsible for administering full-time care to influenza infected children.

Methods : A sampling technique was applied to select caregivers caring for an influenza infected child. An in-depth interview and observation were conducted at each participant’s house between November 2008 and May 2009. The methods elicited details on perception of benefits and barriers of hand washing, educational approaches to promoting hand washing and availability of hand washing facilities. Content analysis was applied to analyze the data.

Results : Twenty-five caregivers were interviewed. The majority (24/25) were female and ranged from 22 to 47 years of age. Half of the caregivers (13/25) work outside their home and contributes toward the household‘s income. Findings supported caregivers’ knowledge that hands carry germs and transmit diseases. They recognized that hand washing as the most economical preventative practice in preventing diseases. However, they reported washing their hands only on occasions that are related to diarrheal disease prevention. Barriers in adherence to hand washing amounted to being busy, in a hurry, unaware, forgetfulness and inconvenient. Participants disclosed that their children aged 7-15 were unaware of the benefits. They knew that hand washing promotion utilizing one-on-one demonstrations, poster reminder and positive reinforcement could help to change this perception and promote frequent hand washing among their children.

Conclusion : This study demonstrated that caregivers are aware of the benefits of good hand washing practices but only when it is applied to preventing gastrointestinal tract infections. Children aged 7-15 years in these households were unaware of the benefits and needed intensive hand washing education.