Wojcik Gosha, Afseth Janyne, Fagan Ross, Thomson Fiona, Ring Nicola
School of Health and Social Care, Edinburgh Napier University, 9 Sighthill Court, Edinburgh, EH11 4BN, UK.
School of Nursing, Midwifery and Paramedic Practice, Robert Gordon University, Aberdeen, Garthdee House Garthdee Road, Aberdeen, AB10 7QG, UK.
JAC Antimicrob Resist. 2024 Aug 7;6(4):dlae117. doi: 10.1093/jacamr/dlae117. eCollection 2024 Aug.
To further develop an understanding of laypeople's (adult patients and public) beliefs and attitudes toward antimicrobial resistance (AMR) by developing a conceptual model derived from identifying and synthesizing primary qualitative research.
A systematic search of 12 electronic databases, including CINAHL, MEDLINE, PsycINFO, PubMed and Web of Science to identify qualitative primary studies exploring patient and public understanding of AMR published between 2012 and 2022. Included studies were quality appraised and synthesized using Noblit and Hare's meta-ethnographic approach and reported using eMERGe guidance.
Thirteen papers reporting 12 qualitative studies were synthesized. Studies reported data from 466 participants aged 18-90 years. Five themes were identified from these original studies: the responsible patient; when words become meaningless; patient-prescriber relationship; past experience drives antibiotic use; and reframing public perception. These themes supported the development of a conceptual model that illustrates the tension between two different assumptions, that is, how can antibiotics be used for the collective good whilst balancing the immediate needs of individual patients.
Findings suggest that AMR is a distinct ethical issue and should not be viewed purely as a prescribing problem. The meta-ethnography-generated conceptual model illustrates many factors affecting the public's perception of AMR. These include laypeople's own knowledge, beliefs and attitudes around antibiotic use, the relationship with the healthcare provider and the wider context, including the overwhelming influence of the media and public health campaigns. Future research is needed to explore effective health messaging strategies to increase laypeople's baseline awareness of AMR as a public threat.
通过开发一个从识别和综合主要定性研究中得出的概念模型，进一步了解非专业人士（成年患者和公众）对抗菌药物耐药性（AMR）的信念和态度。
系统检索12个电子数据库，包括CINAHL、MEDLINE、PsycINFO、PubMed和Web of Science，以识别2012年至2022年间发表的探索患者和公众对AMR理解的定性初级研究。纳入的研究采用诺布利特和黑尔的元民族志方法进行质量评估和综合，并按照eMERGe指南进行报告。
综合了13篇报告12项定性研究的论文。这些研究报告了466名年龄在18至90岁之间参与者的数据。从这些原始研究中确定了五个主题：负责任的患者；当词语变得毫无意义时；患者与开处方者的关系；过去的经历驱动抗生素使用；以及重塑公众认知。这些主题支持了一个概念模型的开发，该模型说明了两种不同假设之间的紧张关系，即如何在平衡个体患者即时需求的同时，将抗生素用于集体利益。
研究结果表明，AMR是一个独特的伦理问题，不应仅仅被视为一个处方问题。元民族志生成的概念模型说明了许多影响公众对AMR认知的因素。这些因素包括非专业人士自身关于抗生素使用的知识、信念和态度、与医疗保健提供者的关系以及更广泛的背景，包括媒体和公共卫生运动的压倒性影响。未来需要开展研究，以探索有效的健康信息传播策略，提高非专业人士将AMR视为公共威胁的基线意识。
