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首页> 外文OA文献 >“It’s safer to ...” Parent consulting and clinician antibiotic prescribing decisions for children with respiratory tract infections:an analysis across four qualitative studies.
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“It’s safer to ...” Parent consulting and clinician antibiotic prescribing decisions for children with respiratory tract infections:an analysis across four qualitative studies.

机译：“这样做更安全...”父母咨询和临床医生对患有呼吸道感染的儿童开出抗生素处方的决定：一项四项定性研究的分析。

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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.
机译：本文报告了对四项研究的跨研究分析，旨在了解当12岁以下的儿童向急性呼吸道感染（RTI）咨询初级保健时父母咨询和临床医生开处方行为的驱动因素。定性数据来自三项主要研究和一项系统评价。获得有目的的样本，用于（i）父母信息需求和帮助寻求的焦点小组研究； （ii）一项关于父母的初级保健经历的访谈研究（总共60名父母）； （iii）对临床医生针对儿童（28位临床医生）进行RTI咨询的经历的访谈研究。系统评价总结了父母和临床医生对患有急性疾病的儿童开药的观点。记录了整个数据集中的重复主题和通用模式。通过一种涉及对原始数据进行重新检查，将所有研究中的共同主题转换为主题并将这些主题重新组织为概念性组的迭代方法，确定了四个总体主题。它们是：儿童的脆弱感；面对不确定性寻求安全；从社会的不满中寻求安全；以及对安全的经验和看法。儿童的社会建构是关于父母和临床医生角色的脆弱和规范的信念，这反映在儿童患有RTI时父母和临床医生的信念和决策中。咨询和开处方抗生素都被认为是更安全的方法。因此，对威胁的了解或对该威胁的不确定性倾向于导致父母咨询和临床医生开具抗生素处方。临床医生和家长的经验可能会在两个方向上影响安全感，具体取决于先前的行动是否导致安全感的提高或降低。旨在减少不必要的咨询或抗生素处方的未来干预措施，需要考虑如何使所需的措施符合社会规范，并使父母和临床医生感到更安全。

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