Development and validation of the discomfort of cloth Masks-12 (DCM-12) scale.

During the COVID-19 pandemic, the use of face masks by the public has helped to slow the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the community. Cloth masks have been recommended because of their effectiveness, availability, and reusability. Like other types of face masks, however, user discomfort while wearing cloth masks is thought to engender behaviors that limit the effectiveness of cloth masks as source control (e.g., adjusting or removing one's mask temporarily while in public). To design cloth masks that are more tolerable, a measurement instrument for assessing subjective user discomfort is needed. Across two studies, we identified and confirmed a two-dimensional factor structure underlying the discomfort of cloth masks - discomfort related to the breathability and discomfort related to the tightness of the mask against the face and head. Additionally, we provide replicable evidence that both factor-subscales predict the self-reported frequencies of problematic mask-wearing behaviors.

Healthcare worker mental models of patient care tasks in the context of infection prevention and control.

OBJECTIVE: Understanding the cognitive determinants of healthcare worker (HCW) behavior is important for improving the use of infection prevention and control (IPC) practices. Given a patient requiring only standard precautions, we examined the dimensions along which different populations of HCWs cognitively organize patient care tasks (ie, their mental models). DESIGN: HCWs read a description of a patient and then rated the similarities of 25 patient care tasks from an infection prevention perspective. Using multidimensional scaling, we identified the dimensions (ie, characteristics of tasks) underlying these ratings and the salience of each dimension to HCWs. SETTING: Adult inpatient hospitals across an academic hospital network. PARTICIPANTS: In total, 40 HCWs, comprising infection preventionists and nurses from intensive care units, emergency departments, and medical-surgical floors rated the similarity of tasks. To identify the meaning of each dimension, another 6 nurses rated each task in terms of specific characteristics of tasks. RESULTS: Each HCW population perceived patient care tasks to vary along 3 common dimensions; most salient was the perceived magnitude of infection risk to the patient in a task, followed by the perceived dirtiness and risk of HCW exposure to body fluids, and lastly, the relative importance of a task for preventing versus controlling an infection in a patient. CONCLUSIONS: For a patient requiring only standard precautions, different populations of HCWs have similar mental models of how various patient care tasks relate to IPC. Techniques for eliciting mental models open new avenues for understanding and ultimately modifying the cognitive determinants of IPC behaviors.