《足够勇敢》：关于兽医决定对宠物 withholding 或延迟抗菌治疗的定性研究 。（注：“withholding”此处结合语境理解为“ withholding treatment”，即“ withholding”有“ withhold”的动名词形式，意为“ withholding treatment”，可理解为“ withholding”为“ withholding treatment”的动名词形式，意为“ withholding treatment”，即“ withholding treatment”，可理解为“ withholding”为“ withholding treatment”的动名词形式，意为“ withholding treatment”，即“ withholding treatment”，可理解为“ withholding”为“ withholding treatment”的动名 词形式，意为“ withholding treatment”，即“ withholding treatment”，可理解为“ withholding”为“ withholding treatment”的动名词形式，意为“ withholding treatment”，即“ withholding treatment”，可理解为“ withholding”为“ withholding treatment”的动名词形式，意为“ withholding treatment”，即“ withholding treatment”，可理解为“ withholding”为“ withholding treatment”的动名词形式，意为“ withholding treatment”，即“ withholding treatment”，可理解为“ withholding”为“ withholding treatment”的动名词形式，意为“ withholding treatment”，即“ withholding treatment”，可理解为“ withholding”为“ withholding treatment”动名词形式，意为“ withholding treatment”，即“ withholding treatment”，可理解为“ withholding”为“ 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'Brave Enough': A Qualitative Study of Veterinary Decisions to Withhold or Delay Antimicrobial Treatment in Pets.
作者信息
Scarborough Ri O, Sri Anna E, Browning Glenn F, Hardefeldt Laura Y, Bailey Kirsten E
机构信息
Asia-Pacific Centre for Animal Health, Melbourne Veterinary School, University of Melbourne, Parkville, VIC 3010, Australia.
National Centre for Antimicrobial Stewardship, Peter Doherty Institute, Parkville, VIC 3052, Australia.
出版信息
Antibiotics (Basel). 2023 Mar 8;12(3):540. doi: 10.3390/antibiotics12030540.
Abstract
Veterinarians sometimes prescribe antimicrobials even when they know or suspect that they are unnecessary. The drivers of this behaviour must be understood to design effective antimicrobial stewardship interventions. Semi-structured interviews were conducted with 22 veterinarians who treated companion animals in Australia. The Theory of Planned Behaviour was used to organise interview themes, focusing on a decision to withhold antimicrobial therapy in the absence of a clear indication. Many background factors influenced antimicrobial-withholding decisions, including the veterinarian's communication skills, general attitudes towards antimicrobial resistance (AMR), habits and energy levels. Client awareness of AMR and the veterinarian-client relationship were also important. Beliefs about the consequences of withholding antimicrobials (behavioural beliefs) were dominated by fears of the animal's condition deteriorating and of failing to meet client expectations. These fears, weighed against the seemingly distant consequences of AMR, were major barriers to withholding antimicrobials. Normative beliefs were primarily focused on the expected approval (or disapproval) of the client and of other veterinarians. Control beliefs about the difficulty of withholding antimicrobials centred around client factors, most importantly, their capacity to adequately monitor their animal, to pay for further investigations, or to undertake non-antimicrobial management, such as wound care, at home. The use of antimicrobials by companion animal veterinarians in the absence of a clear indication is often powerfully driven by behavioural beliefs, chiefly, fears of clinical deterioration and of failing to meet client expectations.
摘要
兽医有时即使知道或怀疑不必要也会开具抗菌药物。必须了解这种行为的驱动因素，以便设计有效的抗菌药物管理干预措施。对22名在澳大利亚治疗伴侣动物的兽医进行了半结构化访谈。计划行为理论被用于组织访谈主题，重点是在没有明确指征的情况下决定停用抗菌治疗。许多背景因素影响了停用抗菌药物的决定，包括兽医的沟通技巧、对抗菌药物耐药性（AMR）的总体态度、习惯和精力水平。客户对抗菌药物耐药性的认识以及兽医与客户的关系也很重要。关于停用抗菌药物后果的信念（行为信念）主要是担心动物病情恶化和未能达到客户期望。这些担忧，与抗菌药物耐药性看似遥远的后果相比，是停用抗菌药物的主要障碍。规范性信念主要集中在客户和其他兽医的预期认可（或不认可）上。关于停用抗菌药物困难的控制信念围绕着客户因素，最重要的是，他们充分监测动物、支付进一步检查费用或在家中进行非抗菌管理（如伤口护理）的能力。在没有明确指征的情况下，伴侣动物兽医使用抗菌药物往往受到行为信念的强烈驱动，主要是担心临床病情恶化和未能达到客户期望。
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