Public attitudes towards bacterial resistance: a qualitative study

Objectives: Behaviour of members of the public contributes to bacterial resistance. For behavioural change to occur, individuals need to perceive the issue as important to them and feel able to make a valuable contribution. Public campaigns have, so far, not been informed by detailed understanding of public attitudes to the problem. We therefore set out to explore the attitudes of members of the public to bacterial resistance. Methods: A qualitative grounded theory interview study was undertaken. A purposive maximum variation sample included 32 (70%) women and 14 (30%) men, aged from 18 to 89 years, from areas of high, average and low deprivation. Results: Participants were uncertain about bacterial resistance and their explanations were generally incongruent with prevailing biomedical concepts. Perceived importance and personal threat were low. The media was the main information source and it left the impression that dirty hospitals are the main cause. Some participants dreaded hospitalization because they feared resistant infections. Few recognized resistant infections as a problem in the community. Less than a quarter indicated that they could positively influence the situation by expecting antibiotic prescriptions less often, or taking antibiotics according to instructions, and even fewer through their own hand washing behaviour. Conclusions: Although members of the public can contribute to containing bacterial resistance, most do not feel that they have a personal role in either the problem or its solution. Campaigns should identify bacterial resistance as both a hospital and a community problem that individuals have the power to influence through specific actions.