Perceptions among Swedish hospital physicians on prescribing of antibiotics and antibiotic resistance
Perceptions among Swedish hospital physicians on prescribing of antibiotics and antibiotic resistance
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DOI：
10.1136/qshc.2008.029199
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发表时间：
2010-12-01
影响因子：
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通讯作者：
Lundborg, C. S.
中科院分区：
文献类型：
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作者：
Bjorkman, I.;Berg, J.;Lundborg, C. S.
目的了解和描述瑞典医院医生对抗生素处方的认知，特别是对抗生素耐药性(AR)的认知。设计采用现象学方法，采用面对面访谈的方法收集数据。研究对象设在瑞典中部7个不同县的医院。研究对象是20名内科、外科或泌尿科专科医生的战略样本。主要结果是对抗生素处方的认知发生了变化。结果共发现5种不同的认知。AR被考虑在两种看法中。不考虑AR的原因包括对患者护理的主要关注，以及对限制抗生素使用的缺乏关注，或者对如何管理传染病的不确定性，或者来自医疗组织的压力。这五种看法与健康行为改变跨理论模型中的阶段有相似之处。结论在其中三种看法中，在开抗生素时没有考虑AR。主要表达这三种看法的医生似乎不准备改变为限制性处方。我们的发现对设计鼓励AR预防的活动是有用的。组织上的变革也是必要的。
Objective To explore and describe perceptions of antibiotic prescribing among Swedish hospital physicians, with special reference to whether the perceptions included awareness of antibiotic resistance (AR).Design A phenomenographic approach was used and data were collected in face-to-face interviews.Setting Hospitals in seven different counties in central Sweden.Participants A strategic sample of 20 hospital physicians specialising in internal medicine, surgery or urology.Main outcome The variation of perceptions of antibiotic prescribing.Results Five qualitative different perceptions were found. AR was considered in two of the perceptions. Reasons for not considering AR included a dominating focus on the care of the patient combined with lack of focus on restrictive antibiotic use, or uncertainty about how to manage infectious diseases or the pressure from the healthcare organisation. Parallels between the five perceptions and the stages in the transtheoretical model of health behaviour change were seen.Conclusions In three of the perceptions, AR was not considered when antibiotics were prescribed. Physicians who primarily express these three perceptions do not seem to be prepared to change to restrictive prescribing. Our findings can be useful in designing activities that encourage AR prevention. Organisational changes are also needed.