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Abstract：
Antibiotic resistance rates remain high in China where antibiotics are widely used for common illnesses. This study aimed to investigate the influences on people\'s decisions on treatment and antibiotic use for common illnesses in eastern China.
Semi-structured interviews were conducted with 29 patients recruited through convenience sampling between July 2020 and January 2021 in one hospital in County A in Zhejiang Province, and one hospital and one village clinic in County B in Jiangsu Province, respectively. All interviews were audio-recorded, transcribed verbatim and thematically analysed. This study is nested in a larger interdisciplinary mixed method project and we also compared our qualitative findings with quantitative results from a household survey conducted as part of this wider project.
Participants\' decisions about treatment-seeking and antibiotic use for common illnesses were found to be influenced by four interactive domains. (i) Self-evaluation of illness severity: Participants tend to self-treat minor conditions with ordinary medicines first and do not resort to antibiotics unless the condition worsens or is considered inflammation- related. Visiting healthcare facilities is seen as the final option. (ii) Access to and trust in care: These treatment-seeking practices are also associated with the perception, in contrast with retail pharmacies, hospitals provide professional and trustworthy care but are difficult to access, and hence require visiting only for severe illness. (iii) Prior experience: previous medical treatment and experiences of self-medication also influence participants\' treatment decisions including the use of antibiotics. (iv) Medication characteristics: Participants view antibiotics as powerful medicines with harms and risks, requiring consumers to carefully trade off benefits and harms before use.
People\'s treatment decisions in relation to antibiotic use in eastern China are influenced by an interplay of lay conceptual models of illnesses and antibiotics and broader organisational, social, and contextual factors. Interventions focusing on individual education to incorporate biomedical knowledge into lay understandings, and reducing situational and social incentives for self-medicating with antibiotics by strengthening access to quality professional care, would be helpful in promoting antibiotic stewardship.
Semi-structured interviews were conducted with 29 patients recruited through convenience sampling between July 2020 and January 2021 in one hospital in County A in Zhejiang Province, and one hospital and one village clinic in County B in Jiangsu Province, respectively. All interviews were audio-recorded, transcribed verbatim and thematically analysed. This study is nested in a larger interdisciplinary mixed method project and we also compared our qualitative findings with quantitative results from a household survey conducted as part of this wider project.
Participants\' decisions about treatment-seeking and antibiotic use for common illnesses were found to be influenced by four interactive domains. (i) Self-evaluation of illness severity: Participants tend to self-treat minor conditions with ordinary medicines first and do not resort to antibiotics unless the condition worsens or is considered inflammation- related. Visiting healthcare facilities is seen as the final option. (ii) Access to and trust in care: These treatment-seeking practices are also associated with the perception, in contrast with retail pharmacies, hospitals provide professional and trustworthy care but are difficult to access, and hence require visiting only for severe illness. (iii) Prior experience: previous medical treatment and experiences of self-medication also influence participants\' treatment decisions including the use of antibiotics. (iv) Medication characteristics: Participants view antibiotics as powerful medicines with harms and risks, requiring consumers to carefully trade off benefits and harms before use.
People\'s treatment decisions in relation to antibiotic use in eastern China are influenced by an interplay of lay conceptual models of illnesses and antibiotics and broader organisational, social, and contextual factors. Interventions focusing on individual education to incorporate biomedical knowledge into lay understandings, and reducing situational and social incentives for self-medicating with antibiotics by strengthening access to quality professional care, would be helpful in promoting antibiotic stewardship.
摘要：
背景：在中国，抗生素被广泛用于常见疾病的抗生素耐药率仍然很高。本研究旨在调查中国东部地区常见疾病对人们决定治疗和使用抗生素的影响。
方法：在2020年7月至2021年1月期间，在浙江省A县的一家医院对29名通过便利抽样招募的患者进行了半结构化访谈。江苏省B县的一家医院和一家村诊所，分别。所有采访都是录音，逐字转录和主题分析。这项研究嵌套在一个更大的跨学科混合方法项目中，我们还将定性结果与作为该更广泛项目一部分进行的家庭调查的定量结果进行了比较。
结果：参与者关于寻求治疗和使用抗生素治疗常见疾病的决定被发现受四个互动领域的影响。(i)疾病严重程度的自我评估:参与者倾向于首先用普通药物自我治疗轻微病症,并且不诉诸抗生素,除非病情恶化或被认为与炎症相关。参观医疗机构被视为最终选择。（ii）获得和信任护理：这些寻求治疗的做法也与感知，与零售药店相比，医院提供专业和值得信赖的护理，但很难获得，因此需要访问只有严重的疾病。（iii）先前的经验：以前的药物治疗和自我药物治疗的经验也会影响参与者的治疗决定，包括使用抗生素。(四)用药特点:参与者认为抗生素是有危害和风险的强效药物,要求消费者在使用前仔细权衡利益和危害。
结论：在中国东部地区，人们对抗生素使用的治疗决定受到疾病和抗生素概念模型以及更广泛组织的相互作用的影响。社会,和上下文因素。干预措施侧重于个人教育，将生物医学知识纳入外行理解，通过加强获得优质专业护理，减少使用抗生素自我治疗的情境和社会诱因，将有助于促进抗生素管理。
方法：在2020年7月至2021年1月期间，在浙江省A县的一家医院对29名通过便利抽样招募的患者进行了半结构化访谈。江苏省B县的一家医院和一家村诊所，分别。所有采访都是录音，逐字转录和主题分析。这项研究嵌套在一个更大的跨学科混合方法项目中，我们还将定性结果与作为该更广泛项目一部分进行的家庭调查的定量结果进行了比较。
结果：参与者关于寻求治疗和使用抗生素治疗常见疾病的决定被发现受四个互动领域的影响。(i)疾病严重程度的自我评估:参与者倾向于首先用普通药物自我治疗轻微病症,并且不诉诸抗生素,除非病情恶化或被认为与炎症相关。参观医疗机构被视为最终选择。（ii）获得和信任护理：这些寻求治疗的做法也与感知，与零售药店相比，医院提供专业和值得信赖的护理，但很难获得，因此需要访问只有严重的疾病。（iii）先前的经验：以前的药物治疗和自我药物治疗的经验也会影响参与者的治疗决定，包括使用抗生素。(四)用药特点:参与者认为抗生素是有危害和风险的强效药物,要求消费者在使用前仔细权衡利益和危害。
结论：在中国东部地区，人们对抗生素使用的治疗决定受到疾病和抗生素概念模型以及更广泛组织的相互作用的影响。社会,和上下文因素。干预措施侧重于个人教育，将生物医学知识纳入外行理解，通过加强获得优质专业护理，减少使用抗生素自我治疗的情境和社会诱因，将有助于促进抗生素管理。
