Mindful attention awareness and attitudes toward social handwashing among nursing and midwifery students

Baran, Leyla; Öztürk, Huri; Mungan, Feride Doğru

doi:10.1590/1980-220X-REEUSP-2025-0095en

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ORIGINAL ARTICLE • Rev. esc. enferm. USP 59 • 2025 • https://doi.org/10.1590/1980-220X-REEUSP-2025-0095en linkcopy

Mindful attention awareness and attitudes toward social handwashing among nursing and midwifery students

Consciência plena e atitudes em relação à lavagem social das mãos entre estudantes de enfermagem e obstetrícia

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective: To explore the relationship between mindful attention awareness and attitudes toward social handwashing among undergraduate nursing and midwifery students.

Method: A cross–sectional and correlational study was conducted with 679 undergraduate nursing and midwifery students. Data were collected using two scales: (1) the Mindful Attention Awareness Scale (MAAS) and (2) the Attitude Scale toward Social Handwashing (ASSHW). Additionally, the participants provided data on their sociodemographic characteristics and responded to an inventory of handwashing practices. Relationships between scores were examined using Spearman’s rho.

Results: The students’ mindful attention levels (MAAS) averaged 44.97 ± 11.46, and their attitudes toward social handwashing (ASSHW) averaged 78.32 ± 13.67. While no direct correlation was found between overall ASSHW and MAAS scores, there were positive correlations between mindful attention levels and certain ASSHW sub-dimensions, as well as with specific handwashing behaviors such as frequency and duration.

Conclusion: These findings suggest that mindful attention may support better hand hygiene practices among nursing and midwifery students.

DESCRIPTORS
Hand Disinfection; Mindfulness; Students, Nursing

Sociodemographic features		Nursing		Midwifery		Total
Sociodemographic features		n	%	n	%	n	%
Gender	Female	252	72.4	331	100.0	583	85.9
Gender	Male	96	27.6	–––	–––	96	14.1
Year of Study	1st year	71	20.4	68	20.5	139	20.5
	2nd year	84	24.1	75	22.7	159	23.4
	3rd year	91	26.1	89	26.9	180	26.5
	4th year	102	29.3	99	29.9	201	29.6
Living Status	Family home	53	15.2	43	13.0	96	14.1
	Relatives Home	4	1.1	2	0.6	6	0.9
	Dormitory	236	67.8	273	82.5	509	75.0
	Student House	55	15.8	13	3.9	68	10.0
Total		348	100.0	331	100.0	679	100

Students’ handwashing habits	Nursing		Midwifery		Total
Students’ handwashing habits	n	%	n	%	n	%
Situations in which students feel the need to wash their hands
Before using the restroom	186	53.4	161	48.6	347	51.1
After using the restroom	287	82.5	289	87.3	576	84.8
After returning home from outside	274	78.7	259	78.2	533	78.5
Before eating	265	76.1	232	70.1	497	73.2
After eating	271	77.9	263	79.5	534	78.6
Whenever my hands feel dirty	316	90.8	290	87.6	606	89.2
Before hospital practices	214	61.5	193	58.3	407	59.9
After hospital practices	280	80.5	268	81.0	548	80.7
Materials Preferred by Students for Hand Hygiene
Only water	37	10.6	19	5.7	56	8.2
Water and bar soap	98	28.2	87	26.3	185	27.2
Water and liquid soap	316	90.8	301	90.9	617	90.9
Alcohol–based antiseptic	141	40.5	103	31.1	244	35.9
Frequency of Forgetting to Wash Hands During the Day
Always	16	4.6	14	4.2	30	4.4
Often	14	4.0	22	6.6	36	5.3
Sometimes	75	21.6	57	17.2	132	19.4
Rarely	170	48.9	156	47.1	326	48.0
Never	73	21.0	82	24.8	155	22.8
Situations affecting students’ handwashing frequency
Spending the day at home/outside	288	82.8	262	79.2	550	81.0
Participating in hospital practice	276	79.3	239	72.2	515	75.8
Experiencing a health issue	192	55.2	183	55.3	375	55.2
Being in crowded environments	223	64.1	214	64.7	437	64.4
Performing mechanically dirty tasks	226	64.9	209	63.1	435	64.1
Using public transportation	235	67.5	210	63.4	445	65.5
Situations preventing students’ handwashing during the day
Lack of access to hygiene products	137	39.4	131	39.6	268	39.5
Skin irritation, cracks, or allergic reactions caused by handwashing agents	109	31.3	102	30.8	211	31.1
Doubt about the cleanliness of handwashing products	108	31.0	96	29.0	204	30.0
Inadequate handwashing facilities	177	50.9	162	48.9	339	49.9
Absence of paper towels	95	27.3	78	23.6	173	25.5
Busy schedules or lack of time	112	32.2	117	35.3	229	33.7
Preference for using antiseptic solutions instead of washing	47	13.5	38	11.5	85	12.5
Students’ opinions on using proper handwashing techniques
Yes	91	26.1	100	30.2	191	28.1
Partially	205	58.9	196	59.2	401	59.1
No	37	10.6	28	8.5	65	9.6
No opinion	15	4.3	7	2.1	22	3.2

Scales	Item numbers	Nursing		Midwifery		Total
Scales	Item numbers	Mean ± SD	Min – Max	Mean ± SD	Min – Max	Mean ± SD	Min – Max
ASSHW	20	78.19 ± 13.67	35 – 100	78.45 ± 13.68	45 – 100	78.32 ± 13.67	35 – 100
IWI	11	43.05 ± 8.69	11 – 55	42.80 ± 8.54	11 – 55	42.93 ± 8.61	11 – 55
IHDI	5	20.14 ± 5.59	5 – 25	20.48 ± 5.25	5 – 25	20.31 ± 5.42	5 – 25
DHL	4	15.00 ± 3.91	4 – 20	15.17 ± 4.12	4 – 20	15.08 ± 4.01	4 – 20
MAAS	13	44.87 ± 10.83	13 – 73	45.08 ± 12.11	13 – 78	44.97 ± 11.46	13 – 78
HHPI	14	59.91 ± 13.37	14 – 70	61.34 ± 12.40	14 – 70	60.60 ± 12.91	14 – 70

Scales		ASSHW	IWI	IHDI	DLH	MAAS	HHPI	Frequency of HH	Duration of HH
ASSHW	r	1.000
ASSHW	p	–––
IWI	r	0.051	1.000
IWI	p	0.180	–––
IHDI	r	–0.064	0.037	1.000
IHDI	p	0.094	0.336	–––
DLH	r	–0.034	–0.019	0.392	1.000
DLH	p	0.378	0.627	0.000	––
MAAS	r	–0.036	–0.054	0.297	0.655	1.000
MAAS	p	0.350	0.160	0.000	0.000	–––
HHPI	r	–0.062	–0.002	0.799	0.777	0.708	1.000
HHPI	p	0.108	0.954	0.000	0.000	0.000	–––
Frequency of HH	r	–0.042	0.003	0.196	0.294	0.296	0.331	1.000
Frequency of HH	p	0.279	0.943	0.000	0.000	0.000	0.000	–––
Duration of HH	r	–0.004	0.000	0.459	0.532	0.482	0.592	0.223	1.000
Duration of HH	p	0.927	0.993	0.000	0.000	0.000	0.000	0.000	–––

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Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
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[T3FN1] ASSHW: The Attitude Scale towards Social Handwashing on Nursing Students, IWI: Impact of Work Intensity, IHDI: Impact of Handwashing on Development of Infection, DLH: Desire to Learn Handwashing, MAAS: Mindful Attention Awareness Scale, HHPI: Hand Hygiene Practice Inventory.