Assessment of Hand Hygiene Knowledge, Attitude, and Practice Among Health Sciences Students in Herat, Afghanistan: A Cross-Sectional Study [Response to Letter]
Notice bibliographique
Résumé
Among Health Sciences Students in Herat, Afghanistan", and for their insightful comments that foster a critical academic debate. 1 The opportunity to clarify our methodological decisions and elaborate on the unique context of our research is one we welcome.Our study's primary objective was to establish a crucial baseline understanding of hand hygiene (HH) knowledge, attitudes, and practices (KAP) among the next generation of healthcare professionals in Afghanistan. 2 In a nation grappling with a fragile health system, such foundational data are indispensable for developing targeted educational curricula and effective, context-specific infection prevention and control policies.While we appreciate the methodological ideals raised, which represent the gold standard in well-resourced environments, we remain confident that our research design was a deliberate and ethically necessary adaptation to the severe realities of conducting research in a conflict-affected setting. 3he correspondents rightly note the limitations of our multi-site convenience sampling strategy.However, a rigid insistence on probability sampling in a setting such as Herat would be both impractical and ethically untenable.The prerequisites for such methods, namely a comprehensive and accurate sampling frame, are nonexistent due to decades of conflict and population displacement. 4Additionally, attempting to create one would have posed unacceptable security risks to both our research team and the participants. 5Consequently, our approach was not a shortcut but the only feasible and ethical pathway to gather vital preliminary data in a constrained setting.Similarly, while we acknowledge that our reliance on self-reported data likely inflated adherence rates due to social desirability bias (SDB)-a limitation we explicitly noted in our manuscript-we argue the finding is still valuable. 6The high score indicates that students have successfully internalized professional norms; the critical challenge, therefore, is addressing the systemic barriers that prevent the translation of knowledge into practice, such as inconsistent supply access and overwhelming workloads. 7The critique regarding our instrument validation is also appreciated.Our multi-step process, involving review by local experts and a pilot study yielding strong reliability, represented the most rigorous approach feasible where large-scale psychometric studies are not possible.Regarding our analytical choices, the use of a median split to categorize KAP scores was a deliberate decision appropriate for this exploratory study, as no universal benchmarks exist for this population; this method enhances interpretability by identifying predictors of relatively better or worse performance within our specific cohort. 8We must also respectfully correct
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,007 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,003 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».