Development and Validation of a Questionnaire on Healthcare-Associated Infections for Companions of Hospitalized Patients

Authors

  • Arielle Teixeira Silva Puc Minas
  • Rafaela Bergamini Resende Silveira Pontifícia Universidade Católica de Minas Gerais
  • Evelyn Lívia Miranda da Silva Pontifícia Universidade Católica de Minas Gerais
  • Fabrício Gomes Michel Pontifícia Universidade Católica de Minas Gerais
  • Tânia Elizabete Dias de Castro Hospital Infantil Padre Anchieta
  • Thaymara Ribeiro Leite de Castro Hospital Infantil Padre Anchieta
  • Sabrynna Brito Oliveira Professora do Departamento de Biomedicina da Pontifícia Universidade Católica de Minas Gerais.

DOI:

https://doi.org/10.17058/reci.v15i4.20457

Keywords:

Health education, Hospital infection, Public health

Abstract

Background and Objectives: Healthcare-Associated Infections (HAIs) represent a major challenge in hospital settings. Hospitalized patients, healthcare professionals, and patient companions are potential disseminators of pathogens, reinforcing the need for preventive and educational strategies. This study aimed to develop and validate a data collection instrument designed to assess the perceptions of companions of hospitalized patients regarding the transmission and prevention of HAIs. Methods: This was a qualitative–quantitative, descriptive, observational, and cross-sectional study conducted in four phases: (1) development of the data collection instrument; (2) content validation by experts using the Content Validity Index (CVI); (3) online validation; and (4) on-site validation in a hospital in the state of Minas Gerais, Brazil. Results: A questionnaire consisting of 30 objective items distributed across four thematic sections was developed. Expert evaluation demonstrated high CVI values (ranging from 0.76 to 1.0) for items related to hand hygiene, use of alcohol-based hand rub, respiratory etiquette, vaccination status, and understanding of contagious diseases. The online validation involved 83 participants from different regions of the country and resulted in suggestions for instrument improvement. The on-site validation, conducted with 140 companions in a hospital setting, allowed for adjustments in language, response time, and feasibility of questionnaire application. Conclusion: The instrument showed satisfactory evidence of content validity, clarity, and comprehension, indicating its suitability for subsequent phases of application and investigation of companions’ perceptions regarding HAIs.

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Author Biographies

  • Rafaela Bergamini Resende Silveira, Pontifícia Universidade Católica de Minas Gerais

    Scientific Initiation student in the Biomedical Sciences undergraduate program at Pontifical Catholic University of Minas Gerais – Lourdes Campus.

  • Evelyn Lívia Miranda da Silva, Pontifícia Universidade Católica de Minas Gerais

    Scientific Initiation student in the Biomedical Sciences undergraduate program at Pontifical Catholic University of Minas Gerais – Lourdes Betim

  • Fabrício Gomes Michel, Pontifícia Universidade Católica de Minas Gerais

    Scientific Initiation student in the Biomedical Sciences undergraduate program at Pontifical Catholic University of Minas Gerais – Lourdes Campus

  • Tânia Elizabete Dias de Castro, Hospital Infantil Padre Anchieta

    Medical doctor at Hospital Infantil Padre Anchieta – HIPA.

  • Thaymara Ribeiro Leite de Castro, Hospital Infantil Padre Anchieta

    Staff member at Hospital Infantil Padre Anchieta (HIPA).

  • Sabrynna Brito Oliveira, Professora do Departamento de Biomedicina da Pontifícia Universidade Católica de Minas Gerais.

    Biomedical Scientist, Ph.D. in Microbiology. Professor in the Department of Biomedical Science at the Pontifical Catholic University of Minas Gerais. Scientific Initiation Advisor.

References

1. Organização Mundial da Saúde (OMS). Guidelines on core components of infection prevention and control programmes at the national and acute health care facility level. Geneva: World Health Organization; 2016. Available from: https://iris.who.int/handle/10665/251730. Licença: CC BY-NC-SA 3.0 IGO

2. Centers for Disease Control and Prevention. National Healthcare Safety Network (NHSN) Patient Safety Component Manual. Atlanta: CDC; 2024. Available from: https://www.cdc.gov/nhsn/pdfs/pscmanual/pcsmanual_current.pdf

3. Magill SS, Edwards JR, Bamberg W, et al. Multistate point-prevalence survey of health care–associated infections. N Engl J Med. 2014;370(13):1198–1208. Available from: https://doi.org/10.1056/NEJMoa1306801

4. Kreitmann L, Helms J, Martin-Loeches I, et al. Infecções adquiridas na UTI em pacientes imunocomprometidos. Medicina de Terapia Intensiva. 2024 Mar;50(3):332-349. DOI: 10.1007/s00134-023-07295-2. PMID: 38197931.

5. World Health Organization. Global report on infection prevention and control. Geneva: WHO; 2022. Available from: https://www.who.int/publications/i/item/9789240051164

6. Organização Pan-Americana da Saúde (OPAS). Prevenção e controle de infecções relacionadas à assistência à saúde: recomendações básicas. Washington, D.C.: OPAS, 2017. 154 p. Available from: https://iris.paho.org/handle/10665.2/34115

7.Kollef MH, Torres A, Shorr AF, Martin-Loeches I, Micek ST. Nosocomial infection. Crit Care Med. 2021;49(2):169–87. Available from: https://doi.org/10.1097/CCM.0000000000004783

8. Kaya HN, Süslü B, Aydın R, et al. Compliance of patient companions and visitors with hand hygiene: an observational study. J Hosp Infect. 2023;136:85-89. doi: 10.1016/j.jhin.2023.04.008. Available from: https://doi.org/10.1016/j.jhin.2023.04.008

9. Ragusa R, Giorgianni G, Faro G, et al. Are visitors dangerous carriers of pathogens in the hospital? An observational study in a university hospital in Sicily. Environ Eng Sci. 2019;36(9):1027-1032. Available from: https://pubmed.ncbi.nlm.nih.gov/31124745/

10. Cavalcante GC, Souza MS, Torres AR, et al. Estratégias para quebra de cadeia de transmissão de microrganismos de precaução por contato em pacientes imunossuprimidos. Braz J Health Rev. 2021;4(4):17455–65. doi: 10.34119/bjhrv4n4-238. Available from: https://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/article/view/34514

11. Khalish G, Gautama MSN. Hand hygiene compliance among hospital visitors: A systematic review and meta-analysis of observational studies. J Infect Prev. 2025 Mar 2:17571774251324373. Available from: https://doi.org/10.1177/17571774251324373

12. Silva LN da, Silva JCA, Ribeiro MDA, Oliveira SB. Percepção dos acompanhantes de pacientes sobre mecanismo de transmissão de infecções hospitalares. Rev. Pesq. Saúde [Internet]. 19º de abril de 2021 [citado 1º de julho de 2025];21(2). Disponível em: https://periodicoseletronicos.ufma.br/index.php/revistahuufma/article/view/14141

13. Alves MM, Almeida DP, Fernandes EGV, Leal GS. Educação em saúde: conhecimento de profissionais de saúde sobre IRAS e higienização das mãos. Rev EDaPECI. 2019;19(3):73–84. doi: http://dx.doi.org/10.29276/redapeci.2019.19.312225.73-84

14. Soleimani M, Fakhr-Movahedi A, Yarahmadi S. Family engagement in the care of infectious patients in intensive care units: a hybrid concept analysis. Nurs Open. 2024 Mar;11(3):e2117. DOI: 10.1002/nop2.2117. PMID: 38429918; PMCID: PMC10907824..

15. Evans S, Agnew E, Vynnycky E, et al. The impact of testing and infection prevention and control strategies on within-hospital transmission dynamics of Covid-19 in English hospitals. Philos Trans R Soc Lond B Biol Sci. 2021 Jul 19;376(1829):20200268. DOI: 10.1098/rstb.2020.0268.

16. Brasil. Ministério da Saúde. Portaria GM/MS nº 529, de 1º de abril de 2013. Institui o Programa Nacional de Segurança do Paciente. Diário Oficial da União. 2 abr 2013; Seção 1:43. Available from: https://bvsms.saude.gov.br/bvs/saudelegis/gm/2013/prt0529_01_04_2013.html

17. Conway J, Wu AG, Lipner SR. Guidance on hand jewelry for prevention of Covid‑19 transmission in healthcare settings. Dermatol Ther. 2020 Nov;33(6):e14178. DOI: 10.1111/dth.14178

18. Banach DB, Bearman GM, Morgan DJ, Munoz-Price LS.Infection control precautions for visitors to healthcare facilities. Expert Review of Anti-Infective Therapy. 2015, 13(9), 1047–1050. https://doi.org/10.1586/14787210.2015.1068119

19. Santos AJ dos, Siqueira AC de, Almeida TB de, Moura JP de. Percepção do acompanhante do paciente hospitalizado acerca da infecção hospitalar/ Perception of the hospitalized patient’s companion about hospital infection. Braz. J. Hea. Rev. [Internet]. 31 de julho de 2021 [citado em 1 de julho de 2025];4(4):16075-87. Disponível em: https://doi.org/10.34119/bjhrv4n4-132.

20. Cheng B, Chan M, Abi-Farrage D, et al. Becoming hand hygiene heroes: implementation of an infection prevention and control campaign for patient and family hospital safety. American Journal of Infection Control, v. 53, n. 2, p. 181–187, 2025. DOI: 10.1016/j.ajic.2024.10.026

21. BRASIL. Agência Nacional de Vigilância Sanitária (ANVISA). Programa nacional de prevenção e controle de infecções relacionadas à assistência à saúde (PNPCIRAS) 2021 a 2025. Brasília: ANVISA; 2021. Available from: https://www.gov.br/anvisa/pt-br/centraisdeconteudo/publicacoes/servicosdesaude/publicacoes/pnpciras_2021_2025.pdf

22. Estados Unidos. Centers for disease control and prevention (CDC). Core infection prevention and control practices for safe healthcare delivery in all settings – recommendations of the Healthcare Infection Control Practices Advisory Committee. Atlanta, GA: CDC; 2022. Available from: https://www.cdc.gov/infection-control/hcp/core-practices/?CDC_AAref_Val=https://www.cdc.gov/infectioncontrol/guidelines/core-practices/index.html

23. Gerchow L, Burka LR, Miner S, Squires A. Language barriers between nurses and patients: A scoping review. Patient Educ Couns. 2020 Sep;104(3):534-553. Available from: https://doi.org/10.1016/j.pec.2020.09.017

24. Sharkiya, S.H. Quality communication can improve patient-centred health outcomes among older patients: a rapid review. BMC Health Serv Res. 2023;23:886. Available from: https://doi.org/10.1186/s12913-023-09869-8

Published

2026-02-17

Issue

Section

ORIGINAL ARTICLE

How to Cite

Teixeira Silva, A., Bergamini Resende Silveira, R. ., Lívia Miranda da Silva, E. ., Gomes Michel, F. ., Elizabete Dias de Castro, T. ., Ribeiro Leite de Castro, T. ., & Brito Oliveira, S. . (2026). Development and Validation of a Questionnaire on Healthcare-Associated Infections for Companions of Hospitalized Patients. Revista De Epidemiologia E Controle De Infecção, 15(4). https://doi.org/10.17058/reci.v15i4.20457