SEM-PLS Model of Healthcare Workers’ Knowledge, Attitudes And Practices in Solid Medical Waste Management

Article Sidebar

PDF
Issue
Vol. 23 No. 2 (2026): Jurnal Kesehatan Lingkungan Volume 23 No. 2, Juli 2026
Published: Jul 31, 2026
Keywords:
Environmental healt,
Medical waste management,
SEM-PLS,
Occupational safety,
Healthcare workers

Main Article Content

Misbach Umar
Department of Environmental Science, Institut Teknologi Yogyakarta
Radjali Amin
Department of Environmental Science, Institut Teknologi Yogyakarta
Triyono Triyono
Department of Environmental Science, Institut Teknologi Yogyakarta
Rukmini Rukmini
Department of Environmental Science, Institut Teknologi Yogyakarta
Agus Suyanto
Department of Environmental Science, Institut Teknologi Yogyakarta

Abstract

Solid medical waste management in hospitals continues to face a gap between operational standards and on-site practices, thereby posing potential health and environmental risks. This study aimed to develop a SEM-PLS model of solid medical waste management based on healthcare workers’ knowledge, attitudes, and practices at Subang District General Hospital. An analytic correlational quantitative study with a cross-sectional design was conducted among 251 healthcare workers selected using proportional sampling with purposive eligibility criteria. Data were collected using a Knowledge–Attitude–Practice (KAP) questionnaire and analyzed with SmartPLS to assess construct validity, reliability, and direct and indirect inter-construct relationships. The results showed that knowledge had a significant effect on attitude (T = 22.48, p < 0.001), but did not directly affect practice/behavior (T = 0.20, p = 0.838). Attitude significantly influenced practice (T = 10.75, p < 0.001) and served as a mediating variable between knowledge and practice (T = 9.51, p < 0.001). These findings indicate that knowledge becomes practically meaningful when it is internalized as a positive attitude toward safety and compliance. Strengthening attitudes and fostering a workplace safety culture are therefore essential to improving compliance with solid medical waste management. Recommended interventions include applied, practice-oriented training, enhanced supervision, and strong managerial support to promote safe and sustainable practices.

Article Details

Section
Articles
Creative Commons License

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Authors who publish with Jurnal Kesehatan Lingkungan agree to the following terms:

  • Authors retain copyright and grant the journal the right of first publication.
  • The work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License, which permits others to share (copy and redistribute the material in any medium or format) and adapt (remix, transform, and build upon the material) for any purpose, even commercially, provided that appropriate credit is given to the original author(s) and the source, a link to the license is provided, and any changes made are indicated. Any adaptations, modifications, or derivative works must be distributed under the same license (CC BY-SA 4.0), and no additional restrictions may be applied that would limit the rights granted under this license.
  • Authors are permitted to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal’s published version of the work (e.g., posting it to an institutional repository or including it in a book), with acknowledgment of its initial publication in this journal.
Author Biographies

Radjali Amin, Department of Environmental Science, Institut Teknologi Yogyakarta

Environmental Science

Triyono Triyono, Department of Environmental Science, Institut Teknologi Yogyakarta

Environmental Engineering

Rukmini Rukmini, Department of Environmental Science, Institut Teknologi Yogyakarta

Environmental Science

Agus Suyanto, Department of Environmental Science, Institut Teknologi Yogyakarta

Environmental science

References

Kementrian Kesehatan Republik Indonesia. Peraturan Menteri Kesehatan republik Indonesia Nomor 3. 2020.

Kaposi A, Orosz N, Nagy A, Gomori G, Kocsis D. A comprehensive study on the factors influencing the generation of infectious healthcare waste in inpatient healthcare institutions in Hungary. J Air Waste Manag Assoc. 2024;74(11):828–41. Available from: https://doi.org/10.1080/10962247.2024.2408011

Lattanzio S, Stefanizzi P, D’ambrosio M, Cuscianna E, Riformato G, Migliore G, et al. Waste Management and the Perspective of a Green Hospital—A Systematic Narrative Review. Int J Environ Res Public Health. 2022;19(23).

Hasiu TS, Asrianto LO, Emianti. Faktor-Faktor yang Berhubungan Dengan Tindakan Petugas Kesehatan dalam upaya Pengelolaan Sampah Medis di Rumah Sakit umum Daerah Kabupaten Buton Utara. J Ilm Obs. 2024;

Sipayung TH, Dewi O. Pengelolaan Limbah Medis Padat di RSUD Kota Dumai Tahun 2023. J Ensiklopedia. 2024;2:274–5.

Rangkuti DSR, Tarigan AM, Amelia T. NoFactors Influencing Nurses Behavior in Sorting Medical Weste in the Inpatient Room of Sundari Medan General Hospital. J Pharm Sci. 2023;6(1).

Bambang, Setiawan, Marlik. Hubungan Pengetahuan, Sikap dengan Tindakan Perawat dalam Pemilahan Limbah Padat Medis dan Limbah Padat. J Keperawatan Prof. 2020;8(1):20–36.

Kementrian Kesehatan Republik Indonesia. Peraturan Menteri Kesehatan Republik Indonesia Nomor 7 Tahun 2019 Tentang Kesehatan Lingkungan Rumah Sakit. 2019.

Wulandari N, Marita Y. Hubungan Pengetahuan, Sikap, dan Masa Kerja Dengan Perilaku Petugas Kesehatan Dalam Pengelolaan Limbah Medis Di Puskesmas. Medsains. 2023;9(2).

RSUD Kabupaten Subang. Profil RSUD Kabupaten Subang. 2023.

Merdeka EKP, Tosepu R, Salma WO. Analisis Pengetahuan, Sikap, dan Tindakan Tenaga Kesehatan Terhadap Pengelolaan Limbah Medis Padat di Puskesmas Kabupaten Konawe Utara. MPPKI. 2021;4(2).

Sudiharti, Solikhah. Hubungan Pengetahuan dan Sikap Dengan Perilaku Perawat Dalam Pembuangan Sampah Medis di rumah Sakit PKU Muhammadiyah Yogyakarta. J Fak Kesehat Masy Univ Ahmad Daulan. 2012;6(1).

Riyanto S, Setyorini W. Metode Penelitian Kuantitatif Dengan Pendekatan SmartPLS 4.0. Deepublish Digital; 2024.

Ghozali I, Latan B. Partial Least Squares: Konsep, Teknik dan Aplikasi SmartPLS 3.0 untuk Penelitian Empiris (edisi revisi). Semarang: BP Undip; 2015.

Conti A, Viottini E, Comoretto RI, Piovan C, Martin B, Albanesi B, et al. The Effectiveness of Educational Interventions in Improving Waste Management Knowledge, Attitudes, and Practices among Healthcare Workers: A Systematic Review and Meta-Analysis. Sustain . 2024;16(9).

Wang J, Liu M, Wang D. Study on the relationship between medical staff’s knowledge, attitudes, and practices regarding medical waste classification and personality traits. Front Heal Serv. 2025;5(September):1–9.

Heriwati, Meliyanti F, Yudi Budianto. Pengelolaan Limbah Medis di Rumah Sakit Berdasarkan Pengetahuan dan Sikap Perawat. J Ilm Multi Sci Kesehat. 2023;15.

Nurhayati T, Maharani AF, Afriandi I. Pengetahuan dan Sikap Tenaga Kesehatan Terhadap Pengelolaan Limbah Medis Padat pada Salah Satu Rumah Sakit di Kota Bandung. J Sist Kesehat. 2017;3.

Akkajit P, Romin H, Assawadithalerd M. Assessment of Knowledge, Attitude, and Practice in respect of Medical Waste Management among Healthcare Workers in Clinics. J Environ Public Health. 2020;2020.

Azizah AM, Musyarofah S, Ainul Maghfiroh. Hubungan Pengetahuan dan Sikap Tenaga Kesehatan Terhadap Praktik Pemisahan Limbah Medis Padat. J Ilm Permas J Ilmilah STIKES Kendal. 2022;12(2).

Olaifa A, Govender RD, Ross AJ. Knowledge, attitudes and practices of healthcare workers about healthcare waste management at a district hospital in KwaZulu-Natal. South African Fam Pract. 2018;60(5):137–45. http://doi.org/10.1080/20786190.2018.1432137

Das, A.K. I, M.N., Billah, M.M., & Sarker A. COVID -19 pandemic and healthcare solid waste management strategy-A mini-review. Sci Total Environ. 2021; https://doi.org/10.1016/j.scitotenv.2021.146220

Ulandari N, Marita Y. Hubungan Pengetahuan, Sikap, dan Masa Kerja Dengan Perilaku Petugas Kesehatan Dalam Pengelolaan Limbah Medis di Puskesmas. Medsains. 2023;9(2).

Kartika Dewi G, Saryono S, Muslihudin M. Health Workers’ Attitude Mediates the Relation of Knowledge and Interest in Medical Waste Management Practice. J Indones Sos Teknol. 2024;5(5):2337–54.

Akıncı Ekinci N, Yazar MA, Kozanhan B, Uyar S. A different training model in providing effective medical waste management in the operating room: peer education. Eur Res J. 2025;11(1):34–42.

Khashaba E, El-Gilany AH, Denewar K. Effect of a waste management intervention program on knowledge, attitude, and practice (KAP) of nurses and housekeepers: a quasi-experimental study, Egypt. J Egypt Public Health Assoc. 2023;98(1). https://doi.org/10.1186/s42506-023-00140-w