"It's safer to …" parent consulting and clinician antibiotic prescribing decisions for children with respiratory tract infections: An analysis across four qualitative studies.
نویسندگان
چکیده
This paper reports a cross-study analysis of four studies, aiming to understand the drivers of parental consulting and clinician prescribing behaviour when children under 12 years consult primary care with acute respiratory tract infections (RTI). Qualitative data were obtained from three primary studies and one systematic review. Purposeful samples were obtained for (i) a focus group study of parents' information needs and help seeking; (ii) an interview study of parents' experiences of primary health care (60 parents in total); and (iii) an interview study of clinicians' experiences of RTI consultations for children (28 clinicians). The systematic review synthesised parent and clinician views of prescribing for children with acute illness. Reoccurring themes and common patterns across the whole data set were noted. Through an iterative approach involving re-examination of the primary data, translation of common themes across all the studies and re-organisation of these themes into conceptual groups, four overarching themes were identified. These were: the perceived vulnerability of children; seeking safety in the face of uncertainty; seeking safety from social disapproval; and experience and perception of safety. The social construction of children as vulnerable and normative beliefs about the roles of parents and clinicians were reflected in parents' and clinicians' beliefs and decision making when a child had an RTI. Consulting and prescribing antibiotics were both perceived as the safer course of action. Therefore perception of a threat or uncertainty about that threat tended to lead to parental consulting and clinician antibiotic prescribing. Clinician and parent experience could influence the perception of safety in either direction, depending on whether previous action had resulted in perceived increases or decreases in safety. Future interventions aimed at reducing unnecessary consulting or antibiotic prescribing need to consider how to make the desired action fit with social norms and feel safer for parents and clinicians.
منابع مشابه
Trust, openness and continuity of care inluence acceptance of antibiotics for children with respiratory tract infections: a four country qualitative study
Background. Clinician–parent interaction and health system inluences on parental acceptance of prescribing decisions for children with respiratory tract infections (RTIs) may be important determinants of antibiotic use. Objective. To achieve a deeper understanding of parents’ acceptance, or otherwise, of clinicians’ antibiotic prescribing decisions for children with RTIs. Methods. Qualitative i...
متن کاملTrust, openness and continuity of care inluence acceptance of antibiotics for children with respiratory tract infections: a four country qualitative study Lucy Brookes-Howell, Fiona Wood, Theo Verheij, Hayley Prout, Lucy Cooper,
Background. Clinician–parent interaction and health system inluences on parental acceptance of prescribing decisions for children with respiratory tract infections (RTIs) may be important determinants of antibiotic use. Objective. To achieve a deeper understanding of parents’ acceptance, or otherwise, of clinicians’ antibiotic prescribing decisions for children with RTIs. Methods. Qualitative i...
متن کاملTrust, openness and continuity of care influence acceptance of antibiotics for children with respiratory tract infections: a four country qualitative study.
BACKGROUND Clinician-parent interaction and health system influences on parental acceptance of prescribing decisions for children with respiratory tract infections (RTIs) may be important determinants of antibiotic use. OBJECTIVE To achieve a deeper understanding of parents' acceptance, or otherwise, of clinicians' antibiotic prescribing decisions for children with RTIs. METHODS Qualitative...
متن کاملReducing antibiotic prescribing for children with respiratory tract infections in primary care: a systematic review.
BACKGROUND Respiratory tract infections (RTIs) in children are common and often result in antibiotic prescription despite their typically self-limiting course. AIM To assess the effectiveness of primary care based interventions to reduce antibiotic prescribing for children with RTIs. DESIGN AND SETTING Systematic review. METHOD MEDLINE(®), Embase, CINAHL(®), PsycINFO, and the Cochrane lib...
متن کاملInterventions to Influence Consulting and Antibiotic Use for Acute Respiratory Tract Infections in Children: A Systematic Review and Meta-Analysis
BACKGROUND Respiratory tract infections (RTIs) are common in children and generally self-limiting, yet often result in consultations to primary care. Frequent consultations divert resources from care for potentially more serious conditions and increase the opportunity for antibiotic overuse. Overuse of antibiotics is associated with adverse effects and antimicrobial resistance, and has been sho...
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ورودعنوان ژورنال:
- Social science & medicine
دوره 136-137 شماره
صفحات -
تاریخ انتشار 2015