Application of PRECEDE-PROCEED Model to Study Protective Behavior among Health Care Workers

OBJECTIVES: Ways of reducing exposure of biological hazards in health care setting is an important issue, particularly when they face SARS, H1N1 and other infectious diseases. The purpose of this study is to investigate protective behavior of clinical nurses when they are exposed to biological hazards at work and relevant factors by PRECEDE-PROCEED model. METHODS: This study was approved by the IRBs of participated hospitals.1314 clinical nurses of five hospitals in Taipei, Taiwan completed the survey, with a response rate of 89.6%. To predict protective behavior of biological hazards at work, a hierarchical multiple regression was conducted by entering shift work and medical wards firstly, knowledge of biological hazards, health risk perception, self–efficacy when dealing the exposure of biological hazards, social support, and workplace safety climate secondly. RESULTS: The emergency room nurses exposed to biological hazards most among ten medical wards. While comparing the protective behavior of nurses when they were exposed to biological hazards with different medical wards, operating rooms, ICU and emergency room nurses performed better protective behaviors than others. According to the results of the hierarchical multiple regression, risk perception, self–efficacy, social support, and safety climate significantly predicted protective behavior of clinical nurses beyond shift work and medical wards (DeltaR2 = 0.191). CONCLUSION: PRECEDE-PROCEED model can effectively predict protective behavior of nurses when they are exposed to biological hazards. It is recommended to improve the protective behaviors via building workplace safety climate, reinforcing social support, and enhancing risk perception and self–efficacy of nurses.