Date of Award

1995

Document Type

Thesis

Publisher

Edith Cowan University

Degree Name

Bachelor of Nursing Honours

Faculty

Faculty of Health and Human Sciences

First Supervisor

Esme Kershaw

Second Supervisor

Lorrie Gray

Abstract

Hepatitis B is a major, largely undiagnosed disease in the community and nurses working in doctors' surgeries (practice nurses) undertake many clinical tasks which may expose them to the Hepatitis B virus. Using the Health Belief Model as the theoretical framework, the purpose of this correlational-descriptive study was to determine what actions are taken, by practice nurses in Western Australia to protect themselves against Hepatitis B, and to what extent their health beliefs contribute to those actions. A response rate of 59% (118) was obtained from an anonymous, confidential questionnaire sent to a random sample of 200 practice nurses in Western Australia. Data were analysed using descriptive analysis, t-tests, and one-way analysis of variance (ANOVA). Correlations using Pearson's correlation coefficient were done to discover relationships between components of the Health Belief Model. Results showed the rate of vaccination against Hepatitis B was high (80.5%), but compliance with universal precautions, measured in this study by glove usage, appears to be based on a subjective decision and needs improvement. A high proportion of practice nurses (61.9%) had sustained occupational exposure by needlestick or splash injury, but only 54.2% of the total sample were able to nominate appropriate post-exposure actions. Although 50% of respondents reported involvement in teaching about and/or administration of the vaccine, knowledge about transmission of the Hepatitis B virus was inadequate, and specific education was not associated with higher knowledge scores. These practice nurses believed there was only a low chance they would catch Hepatitis B, and that the disease, if caught, was moderately severe. Vaccination was significantly related (n < .05) to teaching about and/or administering the vaccine to others, knowledge of appropriate post-exposure actions, a low perceived barrier score, and a high belief in vaccine safety. High scores for glove usage were significantly related (p < .05) to Hepatitis D education in the previous 2 years and longer number of years as a practice nurse. Awareness of the disease in well known others, and sustaining a dirty needlestick injury were significantly related (p < .05) to higher perceived susceptibility. Low scores for glove usage, however, were significantly related (p < .05) to higher perceived severity and perceived threat scores. Health beliefs about Hepatitis B appear to have contributed little to practice nurses' actions to protect themselves against the disease. Recommendations include a targeted educational programme to include mode of transmission of the Hepatitis B virus and other bloodborne viruses, universal precautions guidelines, and a protocol for post-exposure management within a practice setting. A study of practice nurse's attitudes towards universal precautions is also advocated. Questionnaire changes are suggested for replication of the study.

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