Quite recently, the World Health Organization has already declared AH1N1 Flu as a Pandemic, with the rating of Classified Level 6 Alert (World Health Organization, 2009) that has to date, affected 33 countries and thousands of deaths. Cross-contamination, which is the transfer of bacteria from one source to food which is high-risk (Three Rivers District Council, 2009) has resulted to 2.4 million healthcare-acquired infections (HAIs) and 30,000 deaths per year (American Society for Microbiology Survey, 2009). Surprisingly, these diseases or infections that have ended lives may be prevented not only by costly medicine or treatment using sophisticated, state-of-the-art technology but something as basic and simple as this: Hand-washing.
With medical experts worldwide concurring on the immense benefits and the necessity of handwashing in the promotion of people’s health, there has been a clamor to increase awareness for people to make handwashing a part of their daily routine. This study aims to provide information on hand-washing behavior of people in public restrooms and the factors that may or may not influence frequency of hand-washing.
I. Statement of the Problem
Everyone knows the benefits of being clean as in hand-washing. However, there are still some who do not wash their hands after using the restroom. Are factors that may influence or may be linked with the human behavior of handwashing? If so, what are they? Do these factors induce or preclude handwashing behavior?
II. Theory Statement
In Smith’s study, she used Observation as one of the variables due to the Theory of Self-Awareness that states that self-awareness increases adherence to social norms. Thus, self-awareness of the people due to their knowledge of others watching them drives them to adhere to the social norm of hand-washing.
There is also a link between Gender and Ethnic differences to health-related beliefs and behaviors (Courtenay, McCreary and Merighi, 2002). There is a higher likelihood for men to engage in riskier health-related behaviors and fewer preventive behaviors in health (Courtenay, McCreary and Merighi, 2002).
The Theory of Planned Behavior, which believes that corresponding attitudes toward behavior, subjective norms and perceived behavioral control, coupled with personal responsibility may predict intention, in effect, the behavior of people, is used in justifying the Smith’s choice of Location as a variable in assessing the likelihood of handwashing. In a hospital setting, wherein people’s attitudes are focused on the maintenance of sanitary conditions as expected in hospitals, people become more conscious in being more responsible in following expected norms of sanitary habits in the hospital. In such as setting, behavior control in the people to wash their hands is greater then as compared to other places.
There are some variables that affect the frequency of handwashing (Smith 2005). These may be observation, gender and location. There is a higher incidence of hand-washing among participants that know their behavior is being observed, are females and are in a hospital-setting (versus other locations such as schools and the workplace, for example).
IV. Procedure or Methodology
Female and male observers, respectively, were situated in both women’s and men’s restrooms in the University of Colorado, Colorado Springs (USCCS) campus and hospital, to record the pre-determined participant behaviors and conditions, including handwashing (yes/no), whether the participant could see the observer (observed/not observed), gender (male/female), and location (college campus/hospital) of 179 participants. These were tallied and results were generated.
No significant differences were found in participants who knew that they were being observed and those who did not have the said knowledge. There were also no significant differences between handwashing behavior of males and females, as well as between those who are in the school or hospital setting.
None of the hypotheses were supported by the study. Observation, Gender and Location do not play a role in handwashing behavior as there were no significant differences between participants that were found in studying the above-mentioned variables.
VII. Statement of the Problem
May Observation and the Presence of Signages reminding people to wash their hands influence people to do so? What is the effect of people knowing that they are watched after they have read the signage recommending that they wash their hands after using the restroom?
VIII. Theory Statement of Relationship or cause and Effect
The study of Jenner et al. (2002) on predictive behaviors in hand hygiene or washing of hands in hospital health care workers state concludes that reminders such as signages are correlated to the higher tendency of people to wash their hands after they used the rest rooms.
With the spreading of various diseases, there is also an increase in public service announcements by the media, and reminders in all types of institutions to wash their hands. This norm of washing hands as acceptable behavior after using the restroom is displayed with the observers showing approval upon seeing that a person washed his or her hands, and disapproval when such is not done due to people’s belief in its importance. Such is largely due to efforts by media, the government and various institutions in the communities reminding people of the benefits of washing their hands.
This study, presupposes that observation may influence the frequency of hand-washing, as in Smith’s study. Also, the presence of a signage posted in the public restroom reminding people to wash their hands before they leave the restroom will also be examined as a factor affecting the incidence of hand-washing.
This study will then not only support Smith’s contention that there may be factors that explains Handwashing behavior in humans, but will also extend the point that these variables even work together, influencing people to wash their hands.
X. Procedure or Methodology
Observers were situated at a public restroom of a coffee shop right smack in the middle of a shopping mall. The rest room is for both men and women, with a small space that housed a couch and a handwashing station prior to the door leading to the rest room. In the lunch time hours, the first ten people who entered the rest room during this time, 7 women and 3 men were randomly selected to be participants in the study. The observers noted handwashing behavior upon participants’ reading of the huge signage reminding people to wash their hands. Such signage was conveniently placed in front of the door which they see upon exiting the rest room and after seeing that there is another person with them in the room observing their actions. Results were then tabulated on the participant’s washing of hands (yes/no) as reactions to reading the signage and noticing that they are under observation by another person in the room.
6 out of 10 participants washed their hands immediately washed their hands upon reading the signage and upon noting the presence of another person in the area. 3 participants barely noted the presence of the observer (they did not even as much as glance at the observer in the area), but washed their hands after reading the signage. Only one participant left the rest room without washing his hands, even if he has read the signage and knew of the presence of the observer (he had eye contact with the observer prior to leaving the area). The aforesaid participant appeared to be in a hurry.
Observation and the signage reminding people to wash their hands- that are conveniently placed in rest rooms may have an effect on people to wash their hands. Not only do the signage serve as reminders and the presence of an observer provide “pressure” for a person to wash their hands, the two in combination have effected handwashing behavior in a manner that the person washes his or her hands due to his or her possible avoidance of a situation wherein he will receive disapproval, not just because he failed to wash his hands, but because he did not do so after he had already seen the sign telling him of its benefits.
This gives the finding that the compulsion to handwashing may not only come from the person knowing and is being reminded of its importance- a community or societal belief, moreover, it is done out of the person’s fear of being perceived in a bad light- an idiot, or someone who blatantly defies commonly held belief. A person herein does not only wash his or her hand not only because he or she believes of its benefits to health, but because he or she did not want to be labeled as the person, who after reading the sign, still does not wash his or her hands- an unintelligent and/or openly defiant person who does not seem to understand the importance of handwashing even after he has been amply told.
The goal of many professionals who in their studies, have proved the benefits of handwashing, is to encourage people to do so after they use the rest rooms. Knowing the factors and understanding how they interrelate would provide the key to formulating solutions to make handwashing become widely practiced so as that they will become the necessary part of the routine of the people. Such must be done because however handwashing would seem basic and simple, doing such has a tremendous effect- it can even save lives.
Courtney from Study Moose
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