School of Psychology, University of Wollongong, Wollongong, NSW, Australia.
Discipline of Psychology, School of Arts and Sciences, The University of Notre Dame Australia, Sydney, NSW, Australia.
Antimicrob Resist Infect Control. 2024 Sep 19;13(1):105. doi: 10.1186/s13756-024-01409-1.
The emergence and growth in antibiotic resistant bacteria is a critical public health problem exacerbated by the misuse of antibiotics. Children frequently succumb to illness and are often treated with antibiotic medicines which may be used improperly by the parent. There is limited evidence of the factors influencing parental decision-making about the use of antibiotics in low-resource contexts. The aim of this systematic review was to understand and describe how parents living in rural and remote locations make choices about their children's antibiotic use.
The CINAHL, Web of Science, Medline, Scopus and Academic Search Premier databases were systematically searched from 31 January until 28 June in 2023. No date restrictions were applied and additional search methods were utilised to identify further studies that met inclusion criteria. Eligibility criteria included studies which reported on factors contributing to parental decisions about their children's use of antibiotics in rural and remote settings. The Joanna Briggs Institute Critical Appraisal Checklists were employed to evaluate studies. Characteristics and findings were extracted from studies, and data was synthesised descriptively and presented in summary tables.
A total of 3827 articles were screened and 25 worldwide studies comprising of quantitative, qualitative and prospective designs were included in the review. Studies that reported the number of rural caregivers consisted of 12 143 participants. Data analysis produced six broad themes representing the mechanisms that influenced parents in their access and use of antibiotics: the child's symptoms; external advice and influences; parent-related determinants; barriers to healthcare; access to antibiotics; and socio-demographic characteristics.
A number of factors that influence parents' prudent use of antibiotics in rural contexts were identified. In seeking to enhance appropriate use of antibiotics by parents in rural and remote settings, these determinants can serve to inform interventions. However, the identified studies all relied upon parental self-reports and not all studies reviewed reported survey validation. Further research incorporating validated measures and intervention strategies is required.
Should my child be given antibiotics? A systematic review of parental decision making in rural and remote locations; CRD42023382169; 29 January 2023 (date of registration). Available from PROSPERO.
抗生素耐药菌的出现和增长是一个严重的公共卫生问题，而抗生素的滥用则加剧了这一问题。儿童经常患病，并且经常接受抗生素治疗，但家长可能会不正确地使用这些药物。在资源有限的情况下，关于影响父母决定使用抗生素的因素的证据有限。本系统评价的目的是了解和描述生活在农村和偏远地区的父母如何做出关于子女使用抗生素的选择。
系统检索了 CINAHL、Web of Science、Medline、Scopus 和 Academic Search Premier 数据库，检索时间为 2023 年 1 月 31 日至 6 月 28 日。没有对日期进行限制，并利用了其他搜索方法来确定符合纳入标准的进一步研究。纳入标准包括报告了在农村和偏远地区父母对子女使用抗生素的决定因素的研究。采用 Joanna Briggs 研究所的批判性评价清单来评估研究。从研究中提取特征和发现，并以摘要表的形式进行描述性综合。
共筛选出 3827 篇文章，纳入了 25 项来自世界各地的研究，包括定量、定性和前瞻性设计。报告农村照顾者数量的研究包括 12143 名参与者。数据分析产生了代表影响父母获取和使用抗生素的机制的六个广泛主题：儿童的症状；外部建议和影响；与父母相关的决定因素；医疗保健障碍；抗生素的获取；以及社会人口特征。
确定了一些影响父母在农村地区谨慎使用抗生素的因素。在寻求加强农村和偏远地区父母对抗生素的合理使用时，这些决定因素可以为干预措施提供信息。然而，所确定的研究都依赖于父母的自我报告，并非所有审查的研究都报告了调查验证。需要进一步研究，包括验证措施和干预策略。
我的孩子应该用抗生素吗？农村和偏远地区父母决策的系统评价；CRD42023382169；2023 年 1 月 29 日（登记日期）。可在 PROSPERO 中获得。
