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Noncommunicable DiseaseNCT07552792

Impact of Hand Rub Placement on Patient Trust and Disease Stigma

A study testing Distant placement of hand rub and Conventional placement of hand rub in people with Noncommunicable Disease and Psoriasis, run by Huashan Hospital.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

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… Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
Noncommunicable Disease, Psoriasis
What is being tested?
Distant placement of hand rub and Conventional placement of hand rub
Could I receive a placebo?
No, everyone receives an active treatment
How many people
250 participants
Where
No sites listed yet
Study dates
1 May 2026to Jun 2026
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • For Patients:
  • 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).
  • For Physicians:
  • Hold a registered practicing qualification in the Dermatology Department of Huashan Hospital Pudong Branch and are qualified for independent outpatient consultations.
  • Scheduled to continuously undertake outpatient work in the designated consultation rooms during the study period.
  • Voluntarily sign the informed consent form for behavioral observation.

Who cannot join

  • For Patients:
  • 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.
  • For Physicians:
  • Non-permanent practicing staff of the hospital, such as visiting physicians or rotating medical students.
  • Unable to independently perform hand hygiene procedures due to physical/limb dysfunction.

Trial locations and contacts

No sites are listed yet. Contact the study team or a site near you to ask about taking part.

About this study

Official title: The Impact of Hand Rub Placement on Hand Hygiene Sequence, Patient Trust, and Disease Stigma: A Randomised Controlled 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.

Read the detailed description

Background and Rationale:

Patients with visible non-communicable diseases, such as psoriasis, often experience high levels of disease-related stigma and are highly sensitive to physician behaviors. Although hand hygiene is a cornerstone of infection control, executing it in certain clinical scenarios may be misinterpreted by patients as the physician's "fear" or "disgust" toward their condition. This misinterpretation can exacerbate their psychological burden and impair the doctor-patient relationship. Environmental engineering theories suggest that micro-modifications to physical hospital spaces can significantly alter medical behavior patterns (such as sitting versus standing during consultations) without relying on resource-intensive training or administrative supervision.Study Design and Methodology:

This is a single-center, double-blind, randomized controlled deception trial conducted in an outpatient dermatology setting. The core intervention involves manipulating the spatial location of the hand sanitizer in the consultation room through randomized assignment to determine its causal effect on physician behavior and subsequent patient psychological outcomes. To minimize the Hawthorne effect and behavioral bias, a double-blind deception mechanism is employed. Physicians are informed that the study is simply for medical students to observe general consultation workflows, while patients are told they are participating in a routine outpatient service satisfaction survey. The true nature of the environmental intervention and its behavioral focus is concealed until a debriefing session at the conclusion of the study.Observations and Assessments:

During the study, trained observers will discreetly record the physicians' hand hygiene patterns in the consultation room. After the consultation concludes, participating psoriasis patients will be guided to an independent area to complete an anonymous electronic questionnaire (taking approximately 10 minutes).The primary psychological outcomes assessed include:Doctor-patient trust, measured by the 11-item Trust in Physician Scale (TPS).Intensity of disease stigma, measured by the 27-item Chinese version of the Feelings of Stigma Questionnaire (FSQ).Secondary outcomes include overall patient satisfaction evaluated across five dimensions, and the documentation of physician hand hygiene timing patterns under different environmental layouts.Statistical Analysis:

Analyses will utilize a prospectively defined dataset framework. Multivariate linear regression will be used to analyze the psychological impact pathways on trust and stigma, adjusting for demographic variables. Generalized estimating equations (GEE) and mixed linear models will be applied for sensitivity analyses to account for the correlation of multiple observations from the same physician.

Being tested
Distant placement of hand rub, Conventional placement of hand rub
Medical subject headings
Noncommunicable Diseases, Psoriasis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Distant placement of hand rubOther

    The 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 rubOther

    The 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").

Study groups in NCT07552792
Study groupRoleWhat they receive
Distant Placement GroupExperimentalIn this experimental arm, the hand rub dispenser is placed at a distant position, greater than 1 meter (approx. 3.3 feet) away from the physician (e.g., on a sink), before the outpatient consultation begins.
Receives: Other: Distant placement of hand rub
Conventional Placement GroupActive comparatorIn this active comparator arm, the hand rub dispenser is placed in the conventional position, less than or equal to 0.3 meters (approx. 1 foot) away from the physician (e.g., to the left of the computer), before the outpatient consultation begins.
Receives: Other: Conventional placement of hand rub

What is being measured

The primary outcome is the main question the study is designed to answer.

  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.

    Measured: 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.

    Measured: 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.

    Measured: Assessed immediately after the outpatient consultation.

Secondary outcomes (1)
  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.

    Measured: Assessed immediately after the outpatient consultation.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted27 Apr 2026
  2. Study start1 May 2026 (estimated)
  3. Primary completion1 Jun 2026 (estimated)
  4. Study completionJun 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Health services research
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
250 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07552792
Sponsor's protocol ID
KY2025-1371
Other IDs
24ZR1407800, C2025212, HSWH202403, HSWH202505, HSWH202513
Status last verified
Apr 2026
First submitted
20 Apr 2026
Last updated
27 Apr 2026
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Ginsburg IH, Link BG. Feelings of stigmatization in patients with psoriasis. J Am Acad Dermatol. 1989 Jan;20(1):53-63. doi: 10.1016/s0190-9622(89)70007-4.

    PubMed 2913081
  • Anderson LA, Dedrick RF. Development of the Trust in Physician scale: a measure to assess interpersonal trust in patient-physician relationships. Psychol Rep. 1990 Dec;67(3 Pt 2):1091-100. doi: 10.2466/pr0.1990.67.3f.1091.

    PubMed 2084735
  • Reid H, Smith R, Williamson W, Baldock J, Caterson J, Kluzek S, Jones N, Copeland R. Use of the behaviour change wheel to improve everyday person-centred conversations on physical activity across healthcare. BMC Public Health. 2022 Sep 20;22(1):1784. doi: 10.1186/s12889-022-14178-6.

    PubMed 36127688
  • Speight J, Holmes-Truscott E, Garza M, Scibilia R, Wagner S, Kato A, Pedrero V, Deschenes S, Guzman SJ, Joiner KL, Liu S, Willaing I, Babbott KM, Cleal B, Dickinson JK, Halliday JA, Morrissey EC, Nefs G, O'Donnell S, Serlachius A, Winterdijk P, Alzubaidi H, Arifin B, Cambron-Kopco L, Santa Ana C, Davidsen E, de Groot M, de Wit M, Deroze P, Haack S, Holt RIG, Jensen W, Khunti K, Kragelund Nielsen K, Lathia T, Lee CJ, McNulty B, Naranjo D, Pearl RL, Prinjha S, Puhl RM, Sabidi A, Selvan C, Sethi J, Seyam M, Sturt J, Subramaniam M, Terkildsen Maindal H, Valentine V, Vallis M, Skinner TC. Bringing an end to diabetes stigma and discrimination: an international consensus statement on evidence and recommendations. Lancet Diabetes Endocrinol. 2024 Jan;12(1):61-82. doi: 10.1016/S2213-8587(23)00347-9.

    PubMed 38128969
  • Sant'Anna A, Vilhelmsson A, Wolf A. Nudging healthcare professionals in clinical settings: a scoping review of the literature. BMC Health Serv Res. 2021 Jun 2;21(1):543. doi: 10.1186/s12913-021-06496-z.

    PubMed 34078358
  • Iyer R, Park D, Kim J, Newman C, Young A, Sumarsono A. Effect of chair placement on physicians' behavior and patients' satisfaction: randomized deception trial. BMJ. 2023 Dec 15;383:e076309. doi: 10.1136/bmj-2023-076309.

    PubMed 38101923
  • Anderson J, Fenton K. HIV related stigma: a dangerous roadblock. BMJ. 2022 Dec 12;379:o2989. doi: 10.1136/bmj.o2989. No abstract available.

    PubMed 36523179
  • Kahn MW. Etiquette-based medicine. N Engl J Med. 2008 May 8;358(19):1988-9. doi: 10.1056/NEJMp0801863. No abstract available.

    PubMed 18463374
  • Puhl R, Suh Y. Health Consequences of Weight Stigma: Implications for Obesity Prevention and Treatment. Curr Obes Rep. 2015 Jun;4(2):182-90. doi: 10.1007/s13679-015-0153-z.

    PubMed 26627213

Questions about this trial

What is this clinical trial studying?

A study testing Distant placement of hand rub and Conventional placement of hand rub in people with Noncommunicable Disease and Psoriasis, run by Huashan Hospital.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 27 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Juan Du, MD (+86-13601821207, dujuan@huashan.org.cn), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Proportion of Invisible Hand Hygiene Events (time frame: Assessed during the outpatient consultation (average 10-15 minutes per consultation).). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07552792, which also lists 9 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Apr 2026.

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