J Korean Acad Fundam Nurs.  2025 Feb;32(1):149-158. 10.7739/jkafn.2025.32.1.149.

Factors Influencing Hand Hygiene Adherence among Hospitalized Adults in South Korea

• Kim S
• Choi J

• KMID: 2565334
• DOI: http://doi.org/10.7739/jkafn.2025.32.1.149

Abstract

Purpose
This study evaluated hospitalized patients’ knowledge, attitudes, and adherence to hand hygiene practices and aimed to identify the factors influencing adherence during hospitalization.
Methods
This cross-sectional correlational study was conducted using a structured questionnaire with 165 adult inpatients at a tertiary care hospital. Data collected between March 6 and 17, 2023, were analyzed using descriptive statistics, the t-test, one-way analysis of variance, Pearson correlations, multiple linear regression, and SPSS/WIN 27.0 software.
Results
The mean knowledge score was 9.02/12, and the attitude mean score was 1.68 on a -3 to +3 scale. The average adherence level was 3.83/5 before hospitalization but 3.36 during hospitalization. Adherence was highest after restroom use and before meals, and lowest before and after room transfers. Hand hygiene adherence was positively correlated with knowledge (r=.42, p<.001), attitude (r=.21, p=.008), and daily hand hygiene (r=.65, p<.001). Key predictors of hand hygiene adherence included daily hand hygiene (β=.58, p<.001), knowledge (β=.15, p=.021), caregiver’s hand hygiene (β=.14, p=.024), and other patients’ hand hygiene (β=.12, p=.049), explaining 50.0% of the variance.
Conclusion
Improving hand hygiene adherence among inpatients requires targeted education, supportive environments, and public awareness. Emphasizing factors such as daily hand hygiene adherence, knowledge, caregiver’s hand hygiene practices, and other patients’ behaviors can effectively reduce healthcare-associated infections and improve patient safety.

Keyword

Attitudes; Hand hygiene; Inpatients; Knowledge; Patient adherence