학술논문

Understanding Health Worker and Community Antibiotic Prescription-Adherence Practices for Acute Febrile Illness: A Nested Qualitative Study in the Shai-Osudoku District of Ghana and the Development of a Training-and-Communication Intervention.
Document Type
Article
Source
Clinical Infectious Diseases. 2023 Supplement, Vol. 77, pS182-S190. 9p.
Subject
*ANTIBIOTICS
*SHIFT systems
*MEMORY
*FEVER
*ATTITUDES of medical personnel
*COMMUNICATION barriers
*LANGUAGE & languages
*HUMAN services programs
*CONTINUING education
*QUALITATIVE research
*COMPARATIVE studies
*CONCEPTUAL structures
*RELIGION & medicine
*SEVERITY of illness index
*DRUGS
*COMMUNICATION
*INDEPENDENT living
*EMPLOYEES' workload
*RESEARCH funding
*PATIENT compliance
*CONTENT analysis
*DRUG resistance in microorganisms
*EDUCATIONAL attainment
Language
ISSN
1058-4838
Abstract
Background The aim was to explore behavioral factors relating to the prescription and communication of prescription-adherence messages for patients with acute febrile illness, from which to develop a training-and-communication (T&C) intervention to be delivered as part of a clinical trial. Methods The study undertook a content analysis of primary, qualitative data collection using in-depth interviews and focus group discussions, informed by the Capability, Opportunity, Motivation (COM-B) theory of behavior, the Theoretical Domains Framework (TDF), and Behavior Change Wheel (BCW) approach, in health facilities (39 health workers) and communities (66 community members) in the Shai-Osudoku District of Ghana. Results Health workers perceive that prescribers' and dispensers' communication with patients is influenced by the following factors: patient's educational level, existing disease conditions, health worker's workload, patient's religion, language barrier between health worker and patient, outcome of laboratory results, and medicine availability. Community members' adherence to prescription was influenced by the availability of money and affordability of medicine (outside of provision by the national health insurance scheme), the severity of the condition, work schedule, and forgetfulness. Conclusions Our study contributes to knowledge on nesting qualitative methods in a clinical trial and reveals factors that affect the antibiotic prescription communication process. Tailored messages for patient-specific needs can shape antibiotic prescription adherence behavior and ultimately contribute to decreasing the incidence of antibiotic resistance. [ABSTRACT FROM AUTHOR]