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Nursing home nurses' and community-dwelling older adults' reported knowledge, attitudes, and behavior toward antibiotic use.
BMC Nursing ( IF 3.2 ) Pub Date : 2017-03-16 , DOI: 10.1186/s12912-017-0203-9
Christine E Kistler 1 , Anna Beeber 2 , Sylvia Becker-Dreps 3 , Kimberly Ward 4 , Megan Meade 5 , Brittany Ross 5 , Philip D Sloane 1
Affiliation  

BACKGROUND Antibiotic overuse causes antibiotic resistance, one of the most important threats to human health. Older adults, particularly those in nursing homes, often receive antibiotics when they are not indicated. METHODS To understand knowledge, attitudes, and behaviors of nursing home (NH) nurses and community-dwelling older adults towards antibiotic use, especially in clinical situations consistent with antibiotic overuse, we conducted a mixed-method survey in two NHs and one Family Medicine clinic in North Carolina, among English-speaking nurses and community-dwelling, cognitively intact adults aged 65 years or older. Based on the Knowledge-Attitude-Practice model, the survey assessed knowledge, attitudes, and behavior towards antibiotic use, including three vignettes designed to elicit possible antibiotic overuse: asymptomatic bacteriuria (ASB), a viral upper respiratory illness (URI), and a wound from a fall. RESULTS Of 31 NH nurses and 66 community-dwelling older adults, 70% reported knowledge of the dangers of taking antibiotics. Nurses more often reported evidence-based attitudes towards antibiotics than older adults, except 39% agreed with the statement "by the time I am sick enough to go to the doctor with a cold, I expect an antibiotic", while only 28% of older adults agreed with it. A majority of nurses did not see the need for antibiotics in any of the three vignettes: 77% for the ASB vignette, 87% for the URI vignette, and 97% for the wound vignette. Among older adults, 50% did not perceive a need for antibiotics in the ASB vignette, 58% in the URI vignette, and 74% in the wound vignette. CONCLUSIONS While a substantial minority had no knowledge of the dangers of antibiotic use, non-evidence-based attitudes towards antibiotics, and behaviors indicating inappropriate management of suspected infections, most NH nurses and community-dwelling older adults know the harms of antibiotic use and demonstrate evidence-based attitudes and behaviors. However, more work is needed to improve the knowledge, attitudes and behaviors that may contribute to antibiotic overuse.

中文翻译:

疗养院护士和社区居住的老年人报告了使用抗生素的知识,态度和行为。

背景技术抗生素过度使用会引起抗生素抗性,这是对人类健康最重要的威胁之一。老年人,特别是在疗养院中的老年人,在没有适应症的情况下经常接受抗生素治疗。方法为了了解疗养院(NH)护士和居住在社区的老年人使用抗生素的知识,态度和行为,特别是在与抗生素过度使用相符的临床情况下,我们在两家NHS和一家家庭医学诊所进行了混合方法调查在北卡罗来纳州,年龄在65岁以上的说英语的护士和居住在社区中的认知完好成人中。该调查基于“知识-态度-实践”模型,评估了对抗生素使用的知识,态度和行为,包括三种旨在引起抗生素过度使用的小插曲:无症状菌尿症(ASB),病毒性上呼吸道疾病(URI)和跌倒造成的伤口。结果在31名NH护士和66名社区居​​民中,有70%的人报告了服用抗生素的危险性。与老年人相比,护士更多地报告了对抗生素的循证态度,但39%的人同意“到我生病足以感冒时去看医生,我希望使用抗生素”这一说法,而只有28%的人同意大人同意。大多数护士都没有在三个小插曲中看到对抗生素的需要:ASB小插曲为77%,URI小插曲为87%,伤口小插曲为97%。在老年人中,ASB小插图中有50%的人认为不需要抗生素,URI小插图中的58%,伤口小插图中的74%。结论虽然少数人不了解抗生素使用的危险性,对抗生素的非循证态度以及行为表明对可疑感染的管理不当,但大多数NH护士和居住在社区的老年人都知道使用抗生素的危害并证明基于证据的态度和行为。但是,需要做更多的工作来改善可能导致抗生素过度使用的知识,态度和行为。
更新日期:2019-11-01
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