越南初级保健中抗生素处方的决定因素:使用理论领域框架进行定性研究
Duy Vu Minh1, Yen Nguyen Thi Hong2, Shobhana Nagraj3,4,5
1Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam. duyvm@oucru.org.
了解处方者的行为是初级保健中抗菌药物管理 (AMS) 的关键. 诸如对抗菌素耐药性 (AMR) 的认识不足和补偿政策等因素导致不必要的抗生素处方,需要有针对性的干预措施.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 行为科学 行为科学
- 传染病流行病学 传染病流行病学
背景情况:
- 在初级保健中,有效的抗微生物药物管理 (AMS) 需要了解处方者的行为.
- 使用理论领域框架 (TDF) 的定性研究被用来识别这些行为影响.
研究的目的:
- 探索影响初级保健机构抗生素处方行为的因素.
- 确定设计有针对性的AMS干预措施的决定因素.
主要方法:
- 有关越南农村地区初级保健工作者进行深入访谈和焦点小组的定性研究.
- 数据分析采用了结合的归纳和演方法,以TDF为指导.
主要成果:
- 从38名参与者中确定了与7个TDF领域相关的16个主题.
- 不必要的抗生素处方的驱动因素包括低抗菌素耐药性 (AMR) 意识,诊断不确定性和政策因素.
- 对AMS的促进者包括咨询时间,沟通技巧和对抗AMR的意愿.
结论:
- TDF提供了一种结构化的方法来分析AMS干预的行为决定因素.
- 有效的AMS策略需要解决知识,技能,环境因素和社会影响,以减少不必要的抗生素处方.
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