Patients’ Behavioral Intentions to Remind Providers About Hand Hygiene and Report Missing Identification Bracelets: A Theory of Planned Behavior Study in a Saudi Tertiary Hospital

Sarah Alotaibi,1 Hissah Almutairi,2 Kholoud Alharbi31Performance & Outcome Administration, King Saud Medical City, Riyadh, Saudi Arabia; 2Quality and Output Monitoring, Branch of Ministry of Health, Riyadh, Saudi Arabia; 3Department of Nursing Administration and Education, Nursing College, King Saud University, Riyadh, Saudi ArabiaCorrespondence: Kholoud Alharbi, Department of Nursing Administration and Education, Nursing College, King Saud University, Riyadh, Saudi Arabia, Email Kalharbi1@ksu.edu.saBackground: Patient engagement is a cornerstone of safe healthcare delivery. Understanding the factors that influence patients’ willingness to participate in safety practices is essential for developing effective patient-centered safety interventions. This study explores the determinants influencing patients’ intentions to engage in safety practices, using the Theory of Planned Behavior (TPB).Objective: To assess the impact of attitudes, subjective norms, perceived behavioral control, and risk perception on patients’ behavioral intentions to remind healthcare providers about hand hygiene and report missing identification bracelets.Methods: A single-center cross-sectional correlational study was conducted at King Saud Medical City, Riyadh. Using convenience sampling, a structured Arabic questionnaire based on TPB was administered to 465 hospitalized patients. Data were analyzed using SPSS v24 with descriptive, Spearman correlation, and multiple linear regression analyses.Results: Perceived behavioral control was the strongest predictor of behavioral intention for both hand hygiene (β = 0.612, p < 0.001) and identification-related practices (β = 0.563, p < 0.001). For hand hygiene, subjective norms (β = 0.277, p < 0.001) and attitude (β = 0.162, p = 0.001) were positively associated with intention, whereas risk perception showed a small negative association (β = − 0.114, p = 0.014). For identification, risk perception (β = 0.252, p < 0.001) and attitude (β = 0.105, p < 0.001) were positively associated with intention; subjective norms were not significant. The models explained 81.1% and 84.3% of the variance, respectively.Conclusion: TPB-related factors were strongly associated with patients’ behavioral intentions to engage in the two safety practices studied. Higher perceived behavioral control showed the most consistent association with intention. These findings may inform the development and future testing of patient empowerment, education, and communication interventions; however, the cross-sectional design does not establish that such interventions improve actual patient behavior.Keywords: patient engagement, patient safety, theory of planned behavior, perceived behavioral control, hand hygiene, patient identification