INTRODUCTION
Hygiene is a health science and its main concern is the protection and maintenance of health. Cleaning contributes positively to human health by protecting the body from polluting factors. It has been stated that many health problems today are related to an unhealthy lifestyle. Hospitals not only have many disease factors, but they are also an environment where many people are together. Therefore, it is a place where significant attention should be paid to hygiene (1).
Hygiene, which is a science teaching the healthy living conditions, is also a science complex that applies efficient health-related information in synthesis for the protection and development of human health and long-term continuance of life at a healthy level as an individual and society. According to the areas, hygiene can be divided into many branches, including social hygiene, work hygiene, school hygiene, environmental hygiene and personal hygiene (2).
Personal hygiene can be defined as all practices an individual makes to keep his/her body clean and healthy. It covers health and healthy behaviors together (3).
Personal hygiene is the practice developed by a person in accordance with his/her beliefs, values and habits. Therefore, personal hygiene practices are affected by cultural, social, familial factors as well as the information level and needs of the person about health and hygiene (4).
This study aimed to evaluate the knowledge and practices of nursing students about personal hygiene and the effectiveness of personal hygiene training given to the students.
METHODS
The study was planned in February 2019 upon the request of the nursing students. This intervention study was conducted to compare the knowledge levels of students in the Nursing Department of Bingöl University Faculty of Health Sciences regarding the personal hygiene practices. All procedures performed in the current study were in accordance with the ethical standards of the Institutional Ethics Committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was approved by the Bingol University Ethics Committee (approval date and number: 15.04.2019; 92342550/044-E.8057). While the population of the study was composed of 283 students studying in the Nursing Department of Bingöl University Faculty of Health Sciences during 2018-2019 academic year, the sample the study was composed of n=277 students who were present at the university during the data collection process and responded the questionnaires before and after the training. The rate of participation in this study was 97.8%.
In data collection, a “questionnaire” with 42 questions prepared by the researchers was used. In the questionnaire prepared after the literature review, there were questions measuring the students’ socio-demographic characteristics, definition of hygiene, the use of personal hygienic products and their knowledge level about their practices for personal hygiene. The questions in the questionnaire consist of open ended and multiple-choice questions with “yes-no,” “right-wrong” answers.
The necessary permission and official correspondence from the relevant institution were completed for the application of questionnaires before training and about the planned training process and the appropriate day and time for the training was determined and necessary announcements were then made to the nursing students. After the necessary explanations and information were given to the students before starting the training, they students were asked not to write their names on the questionnaires and to mark the answers as close to their responses as possible with the aim of obtaining more realistic answers. The training program prepared for the students was then presented and the post-training part of the same questionnaire was also applied after the training.
Statistical Analysis
The data obtained in the study were evaluated using the Statistical Program for Social Sciences (SPSS) for the Windows 22 program. In data analysis, descriptive statistics were given as number, percentage, minimum and maximum values, mean and standard deviation. Significance was evaluated by taking p<0.05.
RESULTS
This study was applied to 277 nursing students. Two hundred thirty (83.0%) of the students were female and forty-seven (17.0%) were male. The mean age of the students was 21+/-2 years. Of the students, 74 (27.0%) were 1st-year students, 72 (26.1%) were 2nd-year students, 65 (23.1%) were 3rd-year students, and 66 (23.8%) were 4th-year students.
To the question “the place where you have lived for the longest time,” 66 (23.8%) of the students stated a village, 17 (6.2%) as town, 53 (19.1%) as districts, and 141 (50.9%) as provinces. When their parents’ education levels were questioned, 141 (50.9%) of the mothers were illiterate, 89 (32.1%) were primary school level, 12 (4.3%) were secondary school level, 3 (1.1%) were high school level and 3 (1.1%) were university and higher education level. When their fathers’ education levels were questioned, 32 (11.6%) of the fathers were illiterate, 19 (6.9%) were literate, 127 (45.8%) were primary school, 38 (13.7%) were secondary school, 44 (15.9%) were high school, and 17 (6.1%) were university and higher education level. It was determined that 214 (77.3%) had a nuclear family type, 61 (22.0%) had extended families and 2 (0.7%) had a broken family structure (Table 1).
Table 2 shows the questions asked the students about the use of personal hygiene products and their answers.
Before providing the training to the students to get information about personal hygiene practices, various questions were asked to them. Table 3 shows personal hygiene practices before and after training.
Post-training responses of the students who responded negatively to the questions before training were evaluated again and the students whose negative practices turned to positive practices were examined again. Table 4 shows the contribution rates of training for personal hygiene practices.
DISCUSSION
Personal hygiene is the most important factor for people to lead a trouble-free life away from diseases. Personal hygiene activities are conducted to prevent most diseases, particularly epidemics. These activities include washing the hands and face, having a proper bath, washing the hands with soap and clean water after the toilet, washing the hands when cooking, before and after eating, keeping the nails clean, brushing the teeth, washing the feet, hair cleaning and care, and keeping the personal shoes, towel, laundry, brushes, and slippers clean (5,6). When all personal hygiene practices are examined, not only the body cleaning but also cleaning the environment and items used in hygiene practices and their personal use are important. According to the results of the study by Aydın (7), 94.7% of the primary school students had their own toothbrushes. In a study by Irmak (8), 91.6% of the patients had a personal toothbrush, whereas 8.4% did not. In the study by Kaya et al. (9), to determine the behaviors of students from a high school in Ankara about personal hygiene, 100% of the students stated that they had their own underwear and toothbrushes and 43.2% had their own nail clippers.
Personal hygiene is obtained in accordance with the person’s beliefs, value judgments and habits. Thus, personal hygiene applications are affected by not only cultural, familial and social factors, but also by the person’s need for health and hygiene and their personal training (10). Before the training was given to the students to get information about their personal hygiene practices, various questions were asked to them. Their responses before and after the training were then compared. Washing hands after the toilet was found to be 98.9% in the study by Şahin et al. (11). In the study by Thumma et al. (12) with the students staying in student dormitories, 84% of the students stated that they washed their hands every time after using the toilet. In another question, while 50.5% of the participants selected the “always” option to the item “I should brush my teeth at least twice a day” before training, 69.3% selected “always” after training. In the study performed by Sefit (13), 29.9% of the university students brushed their teeth twice a day. In the study by Silva et al. (14), entitled as “oral health of quilombola and quilombola rural adolescents: Investigation of hygiene habits and related factors,” 33.3% of the adolescents were seen brush their teeth three times a day.
Responses of the students who responded negatively to the questions before training were evaluated again after training and the students whose negative practices turned into positive practices were examined again. When the contribution rates of training for personal hygiene practices were examined, the first three of them were seen to be the item “I change my clothes every day” with a rate of 35.7%, the item “I use cotton clothes” with a rate of 30.0% and the item “I may forget to wash my hands when I get home” with a rate of 28.9%, which contributed to the nursing students. In the studies conducted with university students in Turkey, 38-47% of the participants changed their underwear daily (15-19). Considering these findings, it is possible to state that students are not adequately aware of the necessity of changing their underwear daily. The color, type, washing, drying and changing frequency of and storage conditions of underwear are crucial. It must choose white underwear made of cotton so that it is appropriate for boiling or washing at a higher temperature (17,20). In the study by Türkmen and Bakır (21) to evaluate the hand-washing applications of health technician candidates, 91.4% of the students stated that they washed their hands when they got home.
CONCLUSION
It was observed that all students included in the study had mistakes and deficiencies in their attitudes and behaviors toward personal hygiene in the pre-training period. Positive changes occurred in students in the post-training period compared with the pre-training period and the participants’ rates of practicing personal hygiene increased.
In accordance with the results obtained from the study, to increase the correct information and behavior of the students, benefits and results of providing hygiene training with the right sources, such as healthcare professionals or specialists who have special training in this field in a more planned and widespread manner, will be effective and efficient and it is recommended to add them to the curriculum. It may be useful to inform individuals through the mass media. Additionally, without ignoring the effect of families on personal hygiene practices, families should also be trained to hygiene.
Ethics
Ethics Committee Approval: This study was approved by the Bingol University Ethics Committee (approval date and number: 15.04.2019; 92342550/044-E.8057).
Informed Consent: All participants were informed and consents forms were obtained.
Peer-review: Externally peer-reviewed.
Authorship Contributions
Surgical and Medical Practices: A.B., M.Ö., Concept: A.B., Design: A.B., M.Ö., Data Collection or Processing: A.B., M.Ö., Analysis or Interpretation: A.B., M.Ö., Literature Search: A.B., M.Ö., Writing: A.B., M.Ö.
Conflict of Interest: No conflict of interest was declared by the authors.
Financial Disclosure: The authors declared that this study received no financial support.