Emotional, cognitive and social factors of antimicrobial prescribing: can antimicrobial stewardship intervention be effective without addressing psycho-social factors?
Emotional, cognitive and social factors of antimicrobial prescribing: can antimicrobial stewardship intervention be effective without addressing psycho-social factors?
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DOI：
10.1093/jac/dkz308
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发表时间：
2019-10-01
影响因子：
5.2
通讯作者：
Tacconelli, E.
中科院分区：
文献类型：
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作者：
Donisi, V.;Sibani, M.;Tacconelli, E.
越来越多的证据表明，心理社会因素可以影响医院和社区的抗菌药物处方实践，并代表抗菌药物管理干预的潜在障碍。临床医生受到基于恐惧，不确定性，一套信念，风险感知和认知偏见的情感和认知因素以及通过社会规范和同行和医患沟通建立的人际因素的制约。然而，研究和实践之间正在出现差距，没有管理建议解决最适当的人力资源分配或模式，以考虑处方的心理社会决定因素。有必要将人类行为研究提供的证据转化为医院和社区一级管理干预措施和政策的设计和实施。将行为专家纳入多学科管理团队似乎对处方者的沟通和决策能力产生积极影响，并减少不适当的抗生素处方至关重要。
There is increasing evidence that psycho-social factors can influence antimicrobial prescribing practice in hospitals and the community, and represent potential barriers to antimicrobial stewardship interventions. Clinicians are conditioned both by emotional and cognitive factors based on fear, uncertainty, a set of beliefs, risk perception and cognitive bias, and by interpersonal factors established through social norms and peer and doctor-patient communication. However, a gap is emerging between research and practice, and no stewardship recommendation addresses the most appropriate human resource allocation or modalities to account for psycho-social determinants of prescribing. There is a need for translation of the evidence available from human behaviour studies to the design and implementation of stewardship interventions and policies at hospital and community levels. The integration of behaviour experts into multidisciplinary stewardship teams seems essential to positively impact on prescribers' communication and decision-making competencies, and reduce inappropriate antibiotic prescribing.