Study design and setting
Institution based cross sectional study design was implemented from April 01 to 30, 2019 at governmental hospitals in Addis Ababa. Addis Ababa is the capital city of Ethiopia where the African union is headquartered. The city has 51 hospitals of which 14 are governmental. Nurses participated in this study were selected from five randomly selected governmental hospitals namely Tikur Anbesa Specialized Hospital (TASH), Alert hospital, Zewditu memorial hospital, Yekatit 12 hospital and Minilik II hospital.
Study population and recruitment criteria
Nurses who had at least one-year clinical experience and selected randomly from selected governmental hospitals in Addis Ababa were participated in the study.
Sample size determination and sampling procedure
The sample size was determined using single population proportion formula. Based on the assumption 5% margin of error, 95% confidence interval (CI) and taking 42.6% good practice from a study done in Jimma (16), the actual sample size for the study was calculated as follows.
Where ni = the minimum sample size required
Z α/2 = standard normal deviation, set at 1.96, to correspond to the 95% confidence interval
P = 0.43
q = 1.0-p
d = margin of error/an absolute precision = 5% = 0.05
By adding 5% for non-responses the final sample size became 396.
Five governmental hospitals in Addis Ababa (TASH, Alert hospital, Zewditu memorial hospital, Menlik II hospital and Yekatit 12 hospital) were selected using simple random sampling technique. To determine the number of nurses to be participated in study from each of the selected hospitals proportional allocation was applied. Finally, study participants from each selected hospital were selected by simple random sampling technique.
Study variables
Dependent variables: Attitude and practice of nurses towards patients with hepatitis B and C viruses
Independent variables: age, sex, marital status, years of work experience, training on infection prevention, history of exposure to BBF and needle and sharp injuries from HBV and HCV infected patients, vaccination against HBV and attitude towards patients with HBV and HCV
Data collection tool and techniques
Data was collected from the study participants using semi structured self-administered questionnaire. The tool was adapted from published articles (14,16–18). Internal consistency of the tool was checked by Cronbach’s alpha which was 0.75 for attitude items, 0.73 for practice items and 0.79 for both.
Operational definitions
Attitude: intention and acceptance towards care of patients with hepatitis B and C viruses. Likert’s five-point scale was used in rating of attitude related items and were scored 1 to 5 (1-strongly disagree, 2-disagree, 3-neutral, 4-agree, 5-strongly agree for positive statements and the reverse for negative ones). The scores for each statement were added to give maximum of 45 and minimum of 9. Positive attitude was given for interviewee who scored 32 and above whereas; negative attitude was given for interviewee who scored below 32 (19).
Practice: Nurses way of care for patients with hepatitis B and C viruses. Rating of practice related items was from 0-4 (0-never, 1-seldom, 2-sometimes, 3-usually, 4-always for recommended practices and the reverse for non-recommended practices). The scores for each item were added giving maximum of 40 and minimum of 0. Nurses scored 28 and above were considered to have good practice and those who scored <28 were taken to have poor practice (19).
Data processing and analysis
The data was coded, cleaned, and entered into Epi info version 7.2 and then exported to SPSS window version 24 for analysis. Descriptive statistics, frequency, and proportion were computed. The association between each independent variable and the outcome variables was assessed by using binary logistic regression. All variables with P ≤ 0.25 in the binary logistic regression analysis were further taken to multivariable logistic regression analysis in order to control all possible confounders. Adjusted odds ratio along with 95% CI and P-value < 0.05 were considered to declare factors that have statistically significant association with nurse’s attitude and practice towards patients’ hepatitis B and C viruses.