Behavioural determinants shaping infection prevention and control behaviour among healthcare workers in Dutch general practices: a qualitative study reflecting on pre-, during and post-COVID-19 pandemic.

Publication date: Feb 28, 2024

Since the Coronavirus Disease 2019 (COVID-19) pandemic, awareness of infection prevention and control (IPC) has increased in primary care settings. This study aimed to examine behavioural determinants shaping IPC behaviour pre-, during, and post-pandemic among healthcare workers (HCWs) in general practices, to inform optimised IPC in primary care. For this qualitative study, semi-structured in-depth interviews were conducted during two study periods: (1) pre-COVID-19 pandemic: July 2019-February 2020, with 14 general practitioners (GPs) and medical assistants, and (2) during the COVID-19 pandemic: July 2022-February 2023, with 22 GPs and medical assistants. The design was informed by behaviour change theories. Data were analysed using thematic analysis. Main themes were: (1) risk perception and IPC awareness, (2) attitudes towards IPC and professional responsibility, (3) decision-making process and risk considerations for IPC adherence, (4) social norm and social influence in GP practice team, and (5) environmental context and resource availability in GP practice. During the pandemic, risk perception and awareness of the importance of IPC increased compared to the pre-pandemic period. A consistent belief emerged that IPC is part of professional responsibility, while needing to be balanced with other aspects of patient care. Decision-making is dependent on the individual GP and mainly influenced by risk assessments and sustainability considerations. The social context in the practice team can reinforce IPC behaviours. GP practice building and layout, and limited IPC resource and material availability were reported as main barriers. The theory-informed insights of this study can be used for targeted interventions to optimise IPC behaviour in general practices. Adopting multifaceted strategies to target the various determinants is recommended to sustain IPC, by implementing continuous education using tailored communication, integrating IPC in work routines and organisational workflows, refining existing IPC protocols by incorporating decision-making tools for HCWs, fostering a culture of IPC through knowledge-sharing and teamwork, and addressing GP practice physical environment and IPC resource barriers.

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Concepts Keywords
February Behavioural determinants
Healthcare Family medicine
July General practice
Pandemic Infection control
Primary health care
Qualitative research


Type Source Name
disease MESH infection
disease MESH COVID-19 pandemic
disease IDO process
pathway REACTOME Reproduction
drug DRUGBANK Trestolone
disease VO effectiveness
disease VO effective
disease VO report
drug DRUGBANK Methylergometrine
drug DRUGBANK Ademetionine
disease VO company
disease IDO susceptibility
disease VO population
disease MESH immunocompromised patients
drug DRUGBANK Etoperidone
disease VO Thing
disease VO Viruses
disease VO time
drug DRUGBANK Cysteamine
disease VO ineffective
disease MESH facial expressions
drug DRUGBANK Dimercaprol
drug DRUGBANK Coenzyme M
disease MESH tuberculosis
pathway KEGG Tuberculosis
disease VO mouth
disease IDO facility
disease VO Optaflu
drug DRUGBANK Isoxaflutole
disease MESH burnout
drug DRUGBANK Fenamole
disease MESH Infectious Diseases
disease MESH emergency
disease VO organization
disease VO organ
disease MESH healthcare associated infections
drug DRUGBANK Bismuth subgallate
disease VO Tax
disease IDO intervention
drug DRUGBANK Ribostamycin
drug DRUGBANK Sodium lauryl sulfate

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