实施国家政策以遏制瑞典医疗保健领域抗生素耐药性的挑战——医疗保健专业人员认知的定性研究。
The challenges of implementing national policies to contain antibiotic resistance in Swedish healthcare-A qualitative study of perceptions among healthcare professionals.
机构信息
Department of Public Health and Caring Sciences, Health Services Research, Uppsala University, Uppsala, Sweden.
Department of Global Public Health-Health Systems and Policy (HSP): Improving the Use of Medicines, Karolinska Institutet, Stockholm, Sweden.
出版信息
PLoS One. 2020 May 20;15(5):e0233236. doi: 10.1371/journal.pone.0233236. eCollection 2020.
OBJECTIVE
To explore and describe how healthcare policymakers and healthcare practitioners from different levels of Swedish healthcare perceived the everyday practice of putting national policies to contain antibiotic resistance into effect.
METHOD
A strategic sample of four healthcare policymakers, three healthcare practitioners working in hospital care, and six working in primary care were recruited and interviewed in person. A manifest and latent content analysis was carried out on the transcribed interview data.
RESULTS
Analysis revealed how the everyday practice of containing antibiotic resistance in different healthcare levels could be perceived as successful, difficult, or a dilemma. The informants' perceptions are presented in three categories which describe first; informants' perceptions of antibiotic use and antibiotic resistance in Sweden; secondly, informants' perceptions of definable efforts in containing antibiotic resistance in Sweden, most notably responsible use of antibiotics, prevention of infection, improving public knowledge of antibiotic resistance, and international collaboration; and thirdly, informants' perceptions of problem areas in containing antibiotic resistance in Sweden, such as behavior, attitudes and knowledge among healthcare practitioners and the public, work environment, and resources. Reflection on the underlying meaning of these perceptions led to identification of the latent theme, labelled "A sense of relative success, and many challenges yet to overcome".
CONCLUSION
This study has given in-depth insight into how a group of healthcare policymakers and practitioners perceived the everyday practice of containing antibiotic resistance, and revealed their perceptions of successful efforts to combat antibiotic resistance so far. It has identified problem areas in different healthcare levels, bringing to light challenges yet to overcome, and areas to focus on in future policies, most notably more emphasis on attitude and behavior change, and increasing awareness of antibiotic resistance among both healthcare practitioners and patients.
目的
探索并描述来自瑞典不同级别医疗保健的医疗保健政策制定者和医疗保健从业者如何看待将国家遏制抗生素耐药性政策付诸实施的日常实践。
方法
从医疗机构中选取了 4 名医疗保健政策制定者、3 名从事医院护理的医疗保健从业者和 6 名从事初级保健的医疗保健从业者作为战略样本，并对其进行了面对面访谈。对转录的访谈数据进行了明显和潜在内容分析。
结果
分析揭示了在不同医疗保健水平下实施遏制抗生素耐药性的日常实践如何被视为成功、困难或困境。这些信息提供者的看法分为三个类别：首先，信息提供者对瑞典抗生素使用和抗生素耐药性的看法；其次，信息提供者对瑞典遏制抗生素耐药性的可定义努力的看法，特别是负责任地使用抗生素、预防感染、提高公众对抗生素耐药性的认识以及国际合作；最后，信息提供者对瑞典遏制抗生素耐药性的问题领域的看法，如医疗保健从业者和公众的行为、态度和知识、工作环境和资源。对这些看法的潜在意义进行反思，得出了隐含的主题，即“相对成功的感觉，但仍有许多挑战需要克服”。
结论
本研究深入了解了一组医疗保健政策制定者和从业者如何看待遏制抗生素耐药性的日常实践，并揭示了他们对迄今为止对抗生素耐药性的成功努力的看法。它确定了不同医疗保健水平的问题领域，揭示了尚未克服的挑战和未来政策需要关注的领域，特别是更加强调态度和行为改变，以及提高医疗保健从业者和患者对抗生素耐药性的认识。
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