Impact of Hand Rub Placement on Patient Trust and Disease Stigma
Trial statusNot yet recruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18+
SponsorHuashan Hospital
About this trial
This study aims to investigate how the physical placement of hand sanitizer in consultation rooms affects patient trust and feelings of disease stigma. While hand hygiene is an essential infection control measure in healthcare, performing it immediately in front of patients with visible, non-communicable conditions (such as psoriasis) might inadvertently make patients feel rejected or stigmatized.This study uses a randomized controlled design to evaluate if a simple environmental modification-changing the spatial location of the hand sanitizer-can naturally nudge physicians to alter their hand hygiene timing without compromising safety. Researchers will discreetly observe the hand hygiene behavior of outpatient dermatologists and ask participating psoriasis patients to complete a brief, anonymous questionnaire regarding their trust in the physician, feelings of stigma, and overall satisfaction with the consultation. The goal is to provide evidence for patient-centered hospital space designs that protect patient psychological well-being while maintaining hygiene standards.
Eligibility criteria
This trial accepts healthy volunteersQualifiers
Aged 18 years or older.
Diagnosed with psoriasis and receiving treatment at the designated psoriasis specialty outpatient clinic during the study period.
Legally capable of signing the informed consent form and cognitively able to understand and complete the questionnaire (independently or with assistance from family members).
Hold a registered practicing qualification in the Dermatology Department of Huashan Hospital Pudong Branch and are qualified for independent outpatient consultations.
Disqualifiers
Severe visual, hearing, or speech impairments leading to basic doctor-patient communication barriers.
Diagnosed with psychiatric disorders (e.g., schizophrenia, severe depression) that, as assessed by a specialist, may interfere with the authenticity of the questionnaire responses.
Presenting with a clinical state requiring emergency treatment during the visit, such as acute infection of skin lesions or generalized pustules.
Non-permanent practicing staff of the hospital, such as visiting physicians or rotating medical students.
Trial design
Design model
Parallel
Treatments tested in this trial
Distant placement of hand rub
Other interventionThe alcohol-based hand rub dispenser is relocated to a distant position in the consultation room, greater than 1 meter (approx. 3.3 feet) away from the physician (e.g., on a sink). This environmental modification is designed to prompt physicians to perform hand hygiene after the patient departs ("invisible hand hygiene"), aiming to improve patient trust and reduce perceived disease-related stigma.
Conventional placement of hand rub
Other interventionThe alcohol-based hand rub dispenser is placed in the conventional, standard position in the consultation room, which is less than or equal to 0.3 meters (approx. 1 foot) away from the physician (e.g., to the left of the computer). This facilitates standard hand hygiene immediately after patient contact ("visible hand hygiene").
Treatment groups
250 Participants
are divided into 2 treatment groupsGroup A: Distant Placement GroupExperimental treatment 1 intervention
Group B: Conventional Placement GroupActive comparator 1 intervention
Trial outcomes
Primary outcomes
1
Proportion of Invisible Hand Hygiene Events
Hand hygiene behavior was observed and categorized into "visible hand hygiene" (immediate post-contact cleansing before patient departure) and "invisible hand hygiene" (cleansing after patient departure). A positive outcome is defined as handwashing occurring after the patient leaves (invisible hand hygiene). The outcome is reported as the proportion of consultations where invisible hand hygiene occurred.
Time frame
Assessed during the outpatient consultation (average 10-15 minutes per consultation).2
Patient Trust in Physician Scale (TPS) Score
Patient trust was measured using the 10-item Trust in Physician Scale (TPS), a validated tool using a 5-point Likert scale to assess trust in the physician's competence, communication, and prioritization of patient interests. Results are expressed as percentages of total possible scores (range 0-100%). Higher scores indicate a higher level of trust in the physician.
Time frame
Assessed immediately after the outpatient consultation.3
Feelings of Stigma Questionnaire (FSQ) Score
Perceived disease stigma was measured using the 28-item modified Feelings of Stigma Questionnaire (FSQ), which uses a 6-point scale to assess subjective experiences of stigma across domains including self-stigma, social exclusion, privacy management, and emotional impact. Results are expressed as percentages of total possible scores (range 0-100%). Higher scores indicate higher levels of perceived disease stigma.
Time frame
Assessed immediately after the outpatient consultation.Secondary outcomes
1
Patient Satisfaction Score
Exploratory outcome evaluating patient satisfaction with the consultation process. This covers domains including private consultations, service attitude, disease/treatment explanations, follow-up arrangements, and privacy protection. Assessed via 5-point Likert scales, where higher scores indicate greater patient satisfaction.
Time frame
Assessed immediately after the outpatient consultation.Locations
Sponsors and contacts
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Source ClinicalTrials.gov
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