Faculty of Health & Life Sciences, Oxford Institute of Nursing, Midwifery & Allied Health Research (OxINMAHR), Oxford Brookes University, Oxford, UK.
NIHR Oxford Cognitive Health Clinical Research Facility, Oxford Health NHS Foundation Trust, Oxford, UK.
J Clin Nurs. 2018 Mar;27(5-6):892-905. doi: 10.1111/jocn.14073. Epub 2017 Oct 27.
To understand the factors influencing parental attitudes towards antibiotic prescribing.
Overuse of antibiotics and inappropriate prescribing has resulted in rapid development of antimicrobial resistance (AMR) and is a significant global threat to patient safety. In primary care settings, substantial numbers of antibiotics are prescribed for young children, despite viral nature of illness for which antibiotics are ineffective. Parents play a vital role in decision-making regarding accessing healthcare services and requesting treatment for their children.
A systematic review was conducted in alignment with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement (Moher et al., Systematic Reviews, 4, 2015, p. 1).
The CINAHL, MEDLINE, PsycINFO, The Cochrane Library, BRITISH NURSING INDEX, EMBASE and PUBMED databases were searched for primary research published between 2006-2016. All types of primary research were searched and screened against inclusion criteria. The Critical Appraisal Skills Programme tool was used to appraise identified publications. Quantitative data were summarised descriptively, and qualitative data were thematically analysed.
A total of 515 publications were initially screened, and 55 full-text articles were eligibility assessed. Twenty papers met inclusion criteria. Four main themes were identified: the quality of relationships with healthcare providers, dealing with conflicting messages, rationalising antibiotic use and parental practices informed by past experience.
Parents wanted reassurance and advice regarding children's illnesses, had poor antibiotic knowledge and were influenced by personal past experiences. More accessible education, including simple information leaflets, is required. Further research on the influence of culture, ethnicity and socio-economic factors would be beneficial.
Healthcare professionals must provide adequate time for reassurance and explanations of decision-making. Easy-to-read information regarding appropriate antibiotic usage should be easily accessible for parents.
了解影响父母对抗生素处方态度的因素。
抗生素的过度使用和不当处方导致了抗菌药物耐药性（AMR）的迅速发展，这对患者安全构成了重大的全球威胁。在初级保健环境中，尽管抗生素对疾病无效，但仍有大量抗生素被开给幼儿。父母在决定是否使用医疗服务和为孩子治疗方面起着至关重要的作用。
按照《系统评价和荟萃分析的首选报告项目》（PRISMA）声明（Moher 等人，系统评价，4，2015，第 1 页）进行了系统评价。
在 2006-2016 年期间，对 CINAHL、MEDLINE、PsycINFO、Cochrane 图书馆、英国护理索引、EMBASE 和 PUBMED 数据库进行了初级研究的搜索。搜索了所有类型的初级研究，并根据纳入标准进行了筛选。使用批判性评估技能计划工具对确定的出版物进行评估。定量数据进行描述性总结，定性数据进行主题分析。
最初筛选出 515 篇出版物，对 55 篇全文文章进行了资格评估。有 20 篇文章符合纳入标准。确定了四个主要主题：与医疗保健提供者关系的质量、处理冲突的信息、合理化抗生素的使用以及基于过去经验的父母做法。
父母希望在孩子生病时得到安慰和建议，对抗生素知识了解甚少，并且受到个人过去经验的影响。需要提供更便捷的教育，包括简单的信息传单。进一步研究文化、种族和社会经济因素的影响将是有益的。
医疗保健专业人员必须提供足够的时间来保证和解释决策。应方便父母获得有关适当使用抗生素的易于理解的信息。
