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沙特阿拉伯初级保健医生对抗生素处方的认知:基于计划行为理论模型

Perceptions of primary health care physicians about the prescription of antibiotics in Saudi Arabia: Based on the model of Theory of planned behaviour.

作者信息

Alradini Faten, Bepari Asmatanzeem, AlNasser Bashayer Hussain, AlGheshem Ethar Fahad, AlGhamdi Waad Khalid

机构信息

Clinical Sciences Department, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia.

Department of Basic Health Sciences, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia.

出版信息

Saudi Pharm J. 2021 Dec;29(12):1416-1425. doi: 10.1016/j.jsps.2021.10.011. Epub 2021 Nov 8.

Abstract

INTRODUCTION

Knowledge of different factors that influence physician decision-making in general practice for prescribing antibiotics is vital for successfully implementing antimicrobial stewardship interventions. The Theory of planned behaviour (TPB) is an established model that describes how cognitions drive human behaviour.

OBJECTIVES

The present study was performed to identify the socio-cultural and behavioural determinants that affect antibiotics prescription behaviour among primary care physicians and estimate the awareness about antibiotic resistance of public health importance.

METHODOLOGY

The questionnaire was divided into three sections: Section-I, which contained demographic content. Section-II contained 21 question items measuring attitudes, subjective norms, perceived behavioural control, and behavioural intentions of the prescribers. Section III had 12 questions related to knowledge about antibiotic resistance. As determined by Cronbach's α for each set of measured constructs of questionnaire scale, the internal consistency was good (α ≥ 0.7). The participants' socio-cultural and behavioural determinants were graded in 3 categories depending upon the mean score, while frequencies were used to estimate antibiotic resistance awareness. The data was analyzed by calculating the one-way ANOVA and by post-hoc Tukey-Kramer HSD multiple comparison test.

RESULTS

Four hundred thirty-four primary health care physicians responded to the questionnaire, and data was statistically investigated. Participants' knowledge of antibiotic-resistant bacteria was poor with greater behavioural intentions to prescribe antibiotics, but a positive attitude and acceptable perceived social pressure towards antibiotics.

CONCLUSION

Our study showed that awareness towards antibiotic-resistant bacteria among primary care physicians of Saudi Arabia stands insufficient but favourable attitude and satisfactory social pressure towards antibiotics with greater behavioural intentions to prescribe antibiotics. The continued medical education (CME) and frequent training interventions can increase these parameters of rational prescribing practice for antibiotics.

摘要

引言

了解影响全科医生开具抗生素决策的不同因素,对于成功实施抗菌药物管理干预措施至关重要。计划行为理论(TPB)是一个既定模型,描述了认知如何驱动人类行为。

目的

本研究旨在确定影响基层医疗医生抗生素处方行为的社会文化和行为决定因素,并评估对具有公共卫生重要性的抗生素耐药性的认识。

方法

问卷分为三个部分:第一部分包含人口统计学内容。第二部分包含21个问题项目,用于测量处方者的态度、主观规范、感知行为控制和行为意图。第三部分有12个与抗生素耐药性知识相关的问题。根据问卷量表每组测量结构的Cronbach's α确定,内部一致性良好(α≥0.7)。参与者的社会文化和行为决定因素根据平均得分分为3类,同时使用频率来评估抗生素耐药性意识。通过计算单因素方差分析和事后Tukey-Kramer HSD多重比较检验对数据进行分析。

结果

434名基层医疗医生回复了问卷,并对数据进行了统计调查。参与者对抗生素耐药菌的了解较差,开具抗生素的行为意图较强,但对抗生素持积极态度且感知到的社会压力可接受。

结论

我们的研究表明,沙特阿拉伯基层医疗医生对抗生素耐药菌的认识不足,但对抗生素持积极态度且社会压力令人满意,开具抗生素的行为意图较强。继续医学教育(CME)和频繁的培训干预可以提高抗生素合理处方实践的这些参数。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e9c7/8720812/3aa5626feaed/gr1.jpg

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