Abstract
BackgroundUnderstanding physicians’ antibiotic-prescribing behaviour is fundamental when it comes to improving antibiotic use and tackling the growing rates of antimicrobial resistance. The aim of the study was to develop and validate -in terms of face validity, content validity and reliability- an instrument designed to assess the attitudes and knowledge underlying physician antibiotic prescribing.MethodsThe questionnaire development and validation process comprised two different steps, namely: (1) content and face validation, which included a literature review and validation both by physicians and by Portuguese language and clinical psychology experts; and (2) reliability analysis, using the test-retest method, to assess the questionnaire’s internal consistency (Cronbach’s alpha) and reproducibility (intraclass correlation coefficient - ICC). The questionnaire includes 17 items assessing attitudes and knowledge about antibiotic prescribing and resistances and 9 items evaluating the importance of different sources of knowledge. The study was conducted in the catchment area covered by Portugal’s Northern Regional Health Administration and used a convenience sample of 61 primary-care and 50 hospital-care physicians.ResultsResponse rate was 64 % (49 % to retest) for primary-care physicians and 66 % (60 % to retest) for hospital-care physicians. Content validity resulted in 9 changes to professional concepts. Face validity assessment resulted in 19 changes to linguistic and interpretative terms. In the case of the reliability analysis, the ICC values indicated a minimum of fair to good reproducibility (ICC > 0.4), and the Cronbach alpha values were satisfactory (α > 0.70).ConclusionsThe questionnaire developed is valid -in terms of face validity, content validity and reliability- for assessing physicians’ attitudes to and knowledge of antibiotic prescribing and resistance, in both hospital and primary-care settings, and could be a very useful tool for characterising physicians’ antibiotic-prescribing behaviour.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-015-1332-y) contains supplementary material, which is available to authorized users.
Highlights
Understanding physicians’ antibiotic-prescribing behaviour is fundamental when it comes to improving antibiotic use and tackling the growing rates of antimicrobial resistance
Considering the pivotal role that physicians play in this process, an in-depth understanding of their attitudes to and knowledge of antibiotic prescribing and antimicrobial resistance is essential when it comes to developing effective interventions and improving antibiotic use [10, 11]
A questionnaire was developed with a dual purpose, namely: to assess physicians’ attitudes and knowledge vis-à-vis antibiotic prescribing, antibiotic use and antibiotic resistance, and the usefulness of different sources of knowledge used in clinical practice; and to collect socio-demographic and professional data on the physicians surveyed, including age, gender, medical specialisation, workplace and workflow
Summary
Understanding physicians’ antibiotic-prescribing behaviour is fundamental when it comes to improving antibiotic use and tackling the growing rates of antimicrobial resistance. Two recent systematic reviews have highlighted physicians’ attitudes and knowledge as factors affecting physician antibiotic prescribing behaviour [12, 13]; those reviews were based on several qualitative and quantitative studies in different settings; any tool have been developed, validated and published which, based on these studies, allow researchers, health professionals and health authorities to measure these specific determinants of antibiotic prescribing. Questionnaires are well-established tools for collecting data in health sciences and could be a very useful instruments for assessing physicians’ clinical-practice characteristics [14] and understanding their antibiotic-prescribing behaviour
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