基于计划行为理论的安徽省基层医生抗生素处方行为研究  

A behavior study of antibiotic prescription of doctors in primary care settings based on theory of planned behavior

作　　者：程静[1] 汪贤文 徐宸韵 张雪梅 彭将鑫 梁文文 CHENG Jing;WANG Xianwen;XU Chenyun;ZHANG Xuemei;PENG Jiangxin;LIANG Wenwen(School of Health Management,Anhui Medical University,Hefei,Anhui 230032,China;Department of Public Health and Health Management,Anhui Medical College,Hefei,Anhui 230601,China)

机构地区：[1]安徽医科大学卫生管理学院,安徽合肥230032 [2]安徽医学高等专科学校公共卫生与卫生管理系,安徽合肥230601

出　　处：《中国农村卫生事业管理》2023年第4期292-297,共6页Chinese Rural Health Service Administration

基　　金：国家自然科学基金青年基金项目(71704003)。

摘　　要：目的以计划行为理论为分析框架,理解基层医生在上呼吸道感染处理中的抗生素处方行为。方法采用编制问卷,在275名全科医生转岗培训的学员中进行横断面资料收集。结果50.4%的受访医生表示可能会在上感治疗中使用抗生素,75.8%的受访医生表示,自己的目标是对上感患者不使用抗生素。在自我报告最近首诊接诊的10名上感患者中,44.4%的医生报告对超过半数(≥6人)的上感患者未开抗生素。行为态度、感知行为控制两个维度均与抗生素处方的行为意向相关。行为态度、感知行为控制和行为意向与行为模拟、自我报告抗生素处方行为相关。计划行为理论可解释26.3%的行为意向,9.6%的模拟行为,以及8.0%的自我报告行为。结论该研究为健康相关行为理论在理解和预测抗生素处方行为方面提供了实证。结果提示应关注基层医生的抗生素处方行为;在规范抗生素处方行为的干预与培训中,应帮助基层医生树立合理使用抗生素的积极态度、提升对症治疗的能力和与病患的沟通技巧等,为合理的处方行为提供内驱力。Objective To understand the antibiotic prescribing behavior of general practitioners in primary health institutions in handling upper respiratory infection based on the analysis with theory of planned behavior.Methods A cross-sectional study was conducted among 275 physicians in the general practitioner transfer training using theory-based questionnaires.Results Among the participant physicians 50.4%reported that they were like-ly to use antibiotics in the treatment of upper respiratory tract infections(URTIs),while 75.8%reported that their goal was not to use antibiotics for URTIs patients.Regarding 10 patients with URTI symptoms who visited the clinic for the first time recently,44.4%physicians reported that they did not prescribe antibiotics to more than half(≥6 patients)of the patients.Behavioral attitude and perceived behavioral control were related to behavioral intention of antibiotics prescription.Behavioral attitude,perceived behavioral control and behavioral intention were correlated with behavioral simulation and self-reported behavior of antibiotics prescription.The theory of planned behavior could explain 26.3%of behavioral intentions,9.6%of simulated behaviors,and 8.0%of self-reported behaviors.Conclusions This study provides evidence for applying health-related behavioral theory in understand-ing and predicting antibiotic prescribing behavior.The results suggest that it is necessary to attach importance to the antibiotic prescribing behaviors of primary healthcare providers and that the intervention and training to regulate the prescribing behavior of antibiotics should include helping the physicians to establish a positive attitude towards the rational use of antibiotics,and improving their symptomatic treatment and communication skills with patients,so as to provide a driving force for the rational prescribing behavior.

关 键 词：计划行为理论 抗生素 处方行为 全科医生 行为态度 主观规范 感知行为控制 

分 类 号：R954[医药卫生—药学]