Patient perceptions of physician attire and perceived infection risk associated with attire and grooming in outpatient care at a tertiary care hospital in Central Sri Lanka

Abstract

Physicians’ attire is a visible aspect of clinical care and may influence patients’ trust, confidence, and perceived safety. Evidence from outpatient settings in low- and middle-income countries remains limited. To describe patients’ perceptions of physicians’ attire, grooming and perceived infection risk related to attire and grooming and to identify factors associated with these perceptions. A descriptive cross-sectional study was conducted among adult visitors attending the outpatient department of a tertiary care hospital in Sri Lanka. Consecutive eligible participants were recruited using convenience sampling. A structured self-administered questionnaire assessed perceptions of physicians’ attire, grooming practices, and infection-related risks associated with attire. Associations between participants’ perceptions and sociodemographic characteristics were analysed using Pearson’s chi-square test or Fisher’s exact test, with statistical significance set at p < 0.05. A total of 351 participants were included. Scrubs were the most preferred attire for male [200 (57.0%)] and female doctors [194 (55.3%)]. Preference for scrubs for male doctors differed significantly by age [young adults: 108 (65.5%); middle-aged adults: 77 (54.2%); older adults: 15 (34.1%); p < 0.001]. A similar pattern was observed for female doctors [young: 104 (63.0%); middle-aged: 75 (52.8%); older: 15 (34.1%); p = 0.002]. Preference for traditional attire increased with age, with saree preferred by 30 (18.2%) young adults, 51 (35.9%) middle-aged adults, and 24 (54.5%) older adults ( p < 0.001). Overall, 283 (80.6%) participants were aware that microorganisms could survive on clothing, while 192 (54.7%) perceived physicians’ attire as a potential source of infection. Among these participants, scrubs were perceived as carrying the lowest infection risk for both male [136 (70.8%)] and female physicians [135 (70.3%)], and 164 (85.4%) considered short-sleeved attire more favourable for effective hand hygiene. Patients’ perceptions of physicians’ attire vary according to age, education, and sociocultural context. Physicians’ appearance is perceived not only as a marker of professionalism but also as an indicator of safety in outpatient care.