Impact of patients' professional and educational status on perception of an antibiotic policy campaign: a pilot study at a university hospital

Do health service waiting areas contribute to the health literacy of consumers? A scoping review

Health service waiting areas commonly provide health information, resources and supports for consumers; however, the effect on health literacy and related outcomes remains unclear. This scoping review of the literature aimed to explore the use of waiting areas as a place to contribute to the health literacy and related outcomes of consumers attending health appointments. Articles were included if they focussed on health literacy or health literacy responsiveness (concept) in outpatient or primary care health service waiting areas (context) for adult consumers (population) and were published after 2010. Ten bibliographic databases, one full-text archive, dissertation repositories and web sources were searched. The search yielded 5095 records. After duplicate removal, 3942 title/abstract records were screened and 360 full-text records assessed. Data were charted into a standardized data extraction tool. A total of 116 unique articles (published empirical and grey literature) were included. Most articles were set in primary and community care (49%) waiting areas. A diverse range of health topics and resource types were available, but results demonstrated they were not always used by consumers. Outcomes measured in intervention studies were health knowledge, intentions and other psychological factors, self-reported and observed behaviours, clinical outcomes and health service utilization. Intervention studies overall demonstrated positive trends in health literacy-related outcomes, although the benefit declined after 3-6 months. Research on using waiting areas for health literacy purposes is increasing globally. Future research investigating the needs of consumers to inform optimal intervention design is needed.

Knowledge, perspectives and health outcome expectations of antibiotic therapy in hospitalized patients

Background

The World Health Organization (WHO) has recognized antimicrobial resistance (AMR) as a top threat to global health. However, the public has an incomplete understanding of AMR and its consequences.

Aim

The aim of this study was to explore patients’ understanding, perspective and health outcome expectations for antibiotic therapy within an inpatient internal medicine population.

Methods

A mixed methods study, combining a cross-sectional survey with qualitative methods. Fourteen questions (10 paper survey and four open ended interview questions) were used, and were completed by the participant in one sitting. Participants were recruited from General Internal Medicine units at two academic hospitals in Canada (convenience sample).

Findings

Thirty participants were included. Out of a scale of 1–100%, participants indicated moderate concern (mean of 40%) about getting an infection that could not be cured by antibiotics. The majority agreed that they trusted their healthcare team to decide on appropriate antibiotic therapy (mean of 81%). The participants strongly agreed (mean of 90%) that it was important to understand the rationale for their antibiotic therapy. Three themes emerged from the qualitative analysis: 1) varying levels of knowledge; 2) viewing antibiotics as beneficial while emphasizing effectiveness; and 3) trusting the healthcare team with expectations for inclusion in decision making.

Conclusion

The study results showed varying levels of patients’ antibiotic knowledge and large gaps in awareness related to AMR. Exploring the role and workflow of interdisciplinary healthcare professionals may be a potential strategy to minimize patients’ knowledge gap related to antimicrobial therapy and AMR.

A scoping review on the influential cognitive constructs informing public AMR behavior compliance and the attribution of personal responsibility

BACKGROUND

Antibiotic resistance is a growing threat to public health. Despite various attempts at educating the public on antimicrobial resistance (AMR) and judicial antibiotic use, fallacies and misconceptions remain. To successfully promote behavior change, various cognitive constructs pertaining to antibiotic behavior need to be identified and targeted.

METHODS

Using the Arksey and O'Malley (2005) methodological framework, a credible reflexive examination of literature was conducted, permitting identification of a breadth of literature that pertained to the influence of cognitive constructs on public antimicrobial behavior.

RESULTS

From 393 abstracts identified, 67 full articles were screened, and 43 papers were chosen for review. Three themes were identified (1) sociodemographic influences; (2) knowledge, misconceptions, and fallacies; and (3) public attitudes and the social influence of friends and family. Geographical location, education level, cognitive dissonance, and social norms were found to influence AMR cognition, resulting in disproportionate risk assessments that are facilitated by social information brokering.

CONCLUSIONS

Public AMR resilience, responsibility, and behavior compliance are influenced by cognitive constructs, which are liable to the appropriation of misconceptions, fallacies, and social behavior models obtained via information brokering. A cohesive multidisciplinary participatory approach to AMR management and interventional design that applies the influence of cognitive constructs to inform public AMR behavior compliance is recommended.

A scoping review to assess the impact of public education campaigns to affect behavior change pertaining to antimicrobial resistance

BACKGROUND

Years of global antibiotic misuse has led to the progression of antimicrobial resistance (AMR), posing a direct threat to public health. To impact AMR and maintain antimicrobial viability, educational interventions toward fostering positive AMR behavior change have been employed with some success.

METHODS

This scoping review sought to identify research-supporting use of public educational AMR campaigns, and their efficacy toward informing positive AMR behaviors to inform current debate. To enable credible and reflexive examination of a wide variety of literature, Arksey and O'Malley's (2005) methodological framework was used.

RESULTS

Three primary themes were identified: (1) behavior change and theoretical underpinnings, (2) intervention paradigm, and (3) educational engagement. From 94 abstracts identified, 31 articles were chosen for review. More attention is required to identify elements of intervention design that inform and sustain behavior change, and the impact of how an intervention is delivered and targeted is needed to limit assumptions of population homogeneity, which potentially limits intervention efficacy. Moreover, research on the impact of hospital-based inpatient interventions is needed.

CONCLUSIONS

The existing body of research fails to provide robust evidence to support sound evidential interventions supported by theoretical justifications. Furthermore, interventions to ensure long-term sustained behavior change are unclear and not addressed.

Interprofessional perceptions and emotional impact of multidrug-resistant organisms: A qualitative study

BACKGROUND

Hospital-acquired infections caused by multidrug-resistant organisms (MDROs) are a threat to patient safety and hospital economy. Training in hygiene precautions is known to limit MDRO spread and patient morbidity. As infection prevention is a collaborative task, we developed an interprofessional educational intervention, including a reflective unit about MDRO. This article reports on the perceptions of professionals for MDRO management.

METHODS

In 2017, we conducted 8 trainings, including facilitated group discussions focusing on the question how participants think others experience MDRO. Results were analyzed using a socio-constructivist qualitative approach.

RESULTS

A total of 51 health care workers from 13 professions and 5 hospitals participated, generating 366 items for coding. Three main themes could be identified: (1) significant barriers in educating clinicians and informing lay persons, (2) emotional reactions-especially anxiety and anger-from the perspective of lay persons and professionals evoked by MDRO, and (3) perceived economic burden.

CONCLUSIONS

MDROs generate psychosocial side effects with an impact on health care management and on professional-patient relationships and interprofessional relationships. Specifically, emotions evoked by insufficient information and transparency play a major role. Therefore, hygiene trainings must not be limited to basic skills. In addition, they should be comprised of communication and educational techniques and evoke attentiveness for emotional stress.

Analysis of citizens' subjective perception of safe antibiotic use in European Union countries

OBJECTIVES

Antibiotic consumption is high and varies between different European Union countries. One of the reasons could be different subjective perception of safe antibiotic use. The aim of our study was to analyse citizens' subjective perception of safe antibiotic use in the European Union countries in the context of different antibiotic policies. Some countries are prepared comprehensive national strategies and action plans and implement many activities in different areas while other countries implement actions only in particular fields and even do not have prepared strategy or action plan.

METHODS

This article is based on conception of security by Barry Buzan. Variables collected from the Special Eurobarometer public opinion on Antimicrobial Resistance in European Union countries in 2016 were used for creation the factor of subjective perception of safe antibiotic use. Six contextual factors were selected from the scientific literature and their impact on subjective perception of safe antibiotic use was investigated.

RESULTS

High differences in subjective perception of safe antibiotic use were observed in countries despite general European Union recommendations on antibiotic policy. The highest subjective perception of safe antibiotic use was in Netherlands, Finland, Sweden, Luxembourg, and Denmark. Significant negative correlation was observed between factor of subjective perception of safe antibiotic use and antibiotic consumption (r=-0.41, p<0.05). Created factor of information and communication technology (ICT) development, gross domestic product (GDP) and health expenditure had impact on subjective perception of safe antibiotic use (t=4.69, p<0.01). Consumption of antibiotics also had influence on subjective perception of safe antibiotic use (t=-2.43, p<0.05).

CONCLUSIONS

Individuals' subjective perception of safe antibiotic use which is related to antibiotic consumption highly varies between different EU countries despite general EU recommendations on antibiotic policies and depends on ICT development, GDP, health expenditure and consumption of antibiotics.