The views of health care professionals about selective decontamination of the digestive tract: An international, theoretically informed interview study

被引：19

作者：

Duncan, Eilidh M. ^{[1
,2
]}

Cuthbertson, Brian H. ^{[3
,4
]}

Prior, Maria E. ^{[2
]}

Marshall, Andrea P. ^{[5
,6
]}

Wells, Elisabeth C. ^{[7
]}

Todd, Laura E. ^{[8
]}

Bolsover, Denise ^{[2
]}

Newlands, Rumana S. ^{[2
]}

Webster, Fiona ^{[8
]}

Rose, Louise ^{[9
]}

Campbell, Marion K. ^{[2
]}

Bellingan, Geoff ^{[10
]}

Seppelt, Ian M. ^{[11
]}

Francis, Jill J. ^{[12
]}

机构：

[1] Univ Aberdeen, Hlth Serv Res Unit, Aberdeen Hlth Psychol Grp, Aberdeen, Scotland

[2] Univ Aberdeen, Hlth Serv Res Unit, Aberdeen, Scotland

[3] Univ Toronto, Dept Crit Care Med, Sunnybrook Hlth Sci Ctr, Toronto, ON, Canada

[4] Univ Toronto, Dept Anesthesia, Toronto, ON, Canada

[5] Griffith Univ, Griffith Hlth Inst, Ctr Hlth Practice Innovat, Griffith, NSW, Australia

[6] Gold Coast Hosp, Griffith, NSW, Australia

[7] Univ Guelph, Ctr Study Social & Legal Responses Violence, Guelph, ON N1G 2W1, Canada

[8] Univ Toronto, Dept Family & Community Med, Toronto, ON M5S 1A1, Canada

[9] Univ Toronto, Lawrence S Bloomberg Fac Nursing, Toronto, ON, Canada

[10] Univ Coll London Hosp, Intens Care Unit, London, England

[11] Univ Sydney, George Inst Global Hlth, Sydney, NSW 2006, Australia

[12] City Univ London, Sch Hlth Sci, London EC1V 0HB, England

来源：

JOURNAL OF CRITICAL CARE | 2014年 / 29卷 / 04期

基金：

加拿大健康研究院;

关键词：

Antibiotic prophylaxis; Theoretical domains framework; Intensive care unit; Qualitative research; INTENSIVE-CARE; OROPHARYNGEAL DECONTAMINATION; ANTIMICROBIAL RESISTANCE; UNITS; INFECTION; MORTALITY;

D O I：

10.1016/j.jcrc.2014.03.013

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Purpose: Selective decontamination of the digestive tract (SDD) as a prophylactic intervention improves hospital-acquired infection and survival rates. Uptake of SDD is low and remains controversial. This study applied the theoretical domains framework to assess intensive care unit clinicians' views about SDD in regions with limited or no adoption of SDD. Materials and methods: Participants were health professionals with "decisional authority" for the adoption of SDD. Semistructured interviews were conducted as the first round of a Delphi study. Views about SDD adoption, delivery, and further SDD research were explored. Directed content analysis of interview data identified subthemes, which informed item development for subsequent Delphi rounds. Linguistic features of interview data were also explored. Results: One hundred forty-one participants provided interview data. Fifty-six subthemes were identified; 46 were common across regions. Beliefs about consequences were the most widely elaborated theme. Linguistic features of how participants discussed SDD included caution expressed when discussing the risks and benefits and words such as "worry," "anxiety," and "fear" when discussing potential antibiotic resistance associated with SDD. Conclusions: We identified salient beliefs, barriers, and facilitators to SDD adoption and delivery. What participants said about SDD and the way in which they said it demonstrated the degree of clinical caution, uncertainty, and concern that SDD evokes. (C) 2014 Elsevier Inc. All rights reserved.

引用

页码：634 / 640

页数：7

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