Quantitative analysis of infection prevention behaviors among patients receiving chemotherapy in Thailand: Predictors through the Bandura's Self-efficacy Theory

Abstract

Patients with advanced-stage cancer undergoing chemotherapy are highly susceptible to infections due to immunosuppression. Inappropriate behaviors further increase their risk of infection and severe complications such as not washing hands, consuming unsafe food, or exposure to contaminated environments. Consequently, nursing interventions are essential in promoting preventive behaviors and reducing infection risks. This study, therefore, examined the predictive power of infection prevention knowledge, distress, perceived self-efficacy, and social support on infection prevention behaviors in patients with advanced-stage cancer receiving chemotherapy. Bandura's Self-efficacy Theory was also integrated into the study's framework. This predictive study used a cross-sectional design that included 100 patients with advanced solid malignancy receiving outpatient chemotherapy at the King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Thailand. Participants were selected through purposive sampling. Data were collected using the Knowledge of Infection Prevention in Cancer Patients Receiving Chemotherapy Questionnaire, the Thai version of the Distress Thermometer, the Thai Version of the General Self-Efficacy Questionnaire, the Social Support Questionnaire, and the Infection Prevention Behaviors in Cancer Patients Receiving Chemotherapy Questionnaire. Descriptive and multiple regression statistics with the Enter method were used for data analysis. Notably, this study received Institutional Review Board approval from two university hospitals in Bangkok, Thailand. The participants showed a high mean infection prevention knowledge score of 17.09 (SD=2.49), low distress (M=3.17, SD=2.78), moderate self-efficacy (M=30.40, SD=6.99), high social support (M=56.24, SD=6.71), and high infection prevention behaviors (M=105.85, SD=7.89). Regression analysis indicated that self-efficacy (β=0.244, p<0.05), distress (β=-0.233, p<0.05), knowledge (β=0.212, p<0.05), and social support (β=0.192, p<0.05) significantly predicted infection prevention behaviors, explaining 30.6% of the variance (p<0.05). These findings underscore that infection prevention behaviors are influenced by self-efficacy, distress, knowledge, and social support. Specifically, higher self-efficacy improves adherence to prevention and greater knowledge equips patients for effective infection control. Additionally, strong social support reinforces healthy behaviors. Conversely, high distress negatively impacts compliance with preventive behaviors. These insights can guide nurses in promoting effective infection prevention strategies for reducing infection risks.

Keywords: Advanced-stage cancer, cancer care, chemotherapy, infection prevention behaviors, nursing care