Wanat Marta, Santillo Marta, Borek Aleksandra J, Butler Christopher C, Anthierens Sibyl, Tonkin-Crine Sarah
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium.
JAC Antimicrob Resist. 2022 Mar 16;4(2):dlac026. doi: 10.1093/jacamr/dlac026. eCollection 2022 Apr.
In order to design appropriate antimicrobial stewardship (AMS) programmes, it is crucial to understand challenges to tackling antibiotic resistance (AMR) specific to each healthcare setting. Antibiotic prescribing in primary care accounts for most prescriptions with a significant proportion considered clinically inappropriate. Qualitative research has a long history in social sciences, but its value and contribution are still contested in medical journals including in the AMR/AMS field. However, through its focus on understanding, meaning making and explaining, qualitative research can offer insights in how to improve AMS efforts in primary care. This paper provides an overview of unique considerations, contributions and challenges related to using qualitative research in AMS to help the AMS community new to qualitative research to utilize its potential most fully. First, we discuss specific considerations for AMS in relation to the stages of conducting a qualitative study, including identifying a research question and choosing a suitable methodology; sampling appropriate participants; planning a recruitment strategy; choosing a method of data collection; and conducting data analysis. These are illustrated with examples of qualitative AMS studies in primary care. Second, we highlight the importance of patient and public involvement throughout all stages of the project and ensuring quality in qualitative AMS research. Finally, drawing on these considerations, we make a further case for the value and contribution of qualitative methodologies in AMS/AMR research while outlining future directions for both AMS and qualitative research, including the need for studies with diverse actors; interdisciplinary collaborations; and complex decisions on methodologies and timelines.
为了设计合适的抗菌药物管理（AMS）计划，了解每个医疗环境中应对抗生素耐药性（AMR）的挑战至关重要。初级保健中的抗生素处方占大多数处方，其中很大一部分被认为在临床上是不适当的。定性研究在社会科学领域有着悠久的历史，但其价值和贡献在包括AMR/AMS领域在内的医学期刊中仍存在争议。然而，通过关注理解、意义构建和解释，定性研究可以为如何改善初级保健中的AMS工作提供见解。本文概述了在AMS中使用定性研究的独特考量、贡献和挑战，以帮助刚接触定性研究的AMS社区充分发挥其潜力。首先，我们讨论与进行定性研究的阶段相关的AMS具体考量，包括确定研究问题和选择合适的方法；对合适的参与者进行抽样；规划招募策略；选择数据收集方法；以及进行数据分析。初级保健中定性AMS研究的例子说明了这些内容。其次，我们强调在项目的所有阶段患者和公众参与的重要性，以及确保定性AMS研究的质量。最后，基于这些考量，我们进一步阐述定性方法在AMS/AMR研究中的价值和贡献，同时概述AMS和定性研究的未来方向，包括对涉及不同行为者的研究的需求；跨学科合作；以及关于方法和时间线的复杂决策。
