南非医生、药剂师和护士在抗菌药物、抗菌药物耐药性及抗菌药物管理方面的知识、态度和做法。
The knowledge, attitudes and practices of doctors, pharmacists and nurses on antimicrobials, antimicrobial resistance and antimicrobial stewardship in South Africa.
作者信息
Balliram Reshma, Sibanda Wilbert, Essack Sabiha Y
机构信息
Antimicrobial Research Unit, Faculty of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
Department of Public Health, Faculty of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
出版信息
S Afr J Infect Dis. 2021 Apr 21;36(1):262. doi: 10.4102/sajid.v36i1.262. eCollection 2021.
BACKGROUND
Sustained injudicious and indiscriminate use of antimicrobials has exerted selection pressure for developing antimicrobial resistance (AMR), requiring behaviour change from healthcare professionals (HCPs) based on their knowledge, attitudes and practices (KAP) on antimicrobials, AMR and antimicrobial stewardship (AMS).
METHODS
A cross-sectional online questionnaire-based survey was conducted nationally amongst doctors, pharmacists and nurses from November 2017 to January 2018. The questionnaire comprised demographic information and KAP questions.
RESULTS
Respondents comprised of 1120 doctors, 744 pharmacists and 659 nurses. Antimicrobial resistance was considered a severe problem globally and nationally by majority of HCPs. Self-assessment of knowledge revealed gaps in understanding of antimicrobials, AMR and AMS. Confidence scores in prescribing by doctors, pharmacists and nurses were 57.82%, 32.88% and 45.28%, respectively. Doctors, 441 (45.2%) indicated no confidence in using combination therapy. Prescribing correctly showed a confidence level of 33.99% from 436 doctors, 41.88% from nine pharmacists and 35.23% from 107 nurses. Healthcare professionals (1600 [91.22%]) stated educational campaigns would combat AMR. Only 842 (40.13%) HCPs attended training on these topics and 1712 (81.60%) requesting more education and training.
CONCLUSION
This is the first comparative survey on KAP of practising doctors, pharmacists and nurses in South Africa. Doctors had the highest knowledge score followed by nurses and pharmacists. Practice scores did not corroborate knowledge and the higher attitude scores. Gaps in KAP were evident. Healthcare professionals indicated the need for more education and training, thus requiring a review of pre-service and in-service education and training in addition to continued professional development programmes for practising HCPs.
背景
持续不合理且不加区分地使用抗菌药物对抗菌药物耐药性（AMR）的产生施加了选择压力，这就要求医疗保健专业人员（HCPs）基于其对抗菌药物、AMR及抗菌药物管理（AMS）的知识、态度和行为（KAP）做出行为改变。
方法
2017年11月至2018年1月在全国范围内对医生、药剂师和护士开展了一项基于在线问卷的横断面调查。问卷包括人口统计学信息和KAP问题。
结果
受访者包括1120名医生、744名药剂师和659名护士。大多数HCPs认为AMR在全球和国内都是一个严重问题。知识的自我评估显示在对抗菌药物、AMR和AMS的理解上存在差距。医生、药剂师和护士在处方方面的信心得分分别为57.82%、32.88%和45.28%。441名（45.2%）医生表示对联合治疗没有信心。436名医生正确处方的信心水平为33.99%，9名药剂师为41.88%，107名护士为35.23%。医疗保健专业人员（1600名[91.22%]）表示教育活动将对抗AMR。只有842名（40.13%）HCPs参加过这些主题的培训，1712名（81.60%）要求更多的教育和培训。
结论
这是南非首次对在职医生、药剂师和护士的KAP进行的比较性调查。医生的知识得分最高，其次是护士和药剂师。实践得分与知识和较高的态度得分不相符。KAP方面的差距很明显。医疗保健专业人员表示需要更多的教育和培训，因此除了为在职HCPs开展持续专业发展项目外，还需要对职前和在职教育与培训进行审查。
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