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Abstract：
This article was migrated. The article was marked as recommended. Background and objectives:Overprescribing of antibiotics in primary care is a prominent concern in the context of increasing antimicrobial resistance worldwide. Medical trainees are a key group to deliver thoughtful antimicrobial stewardship training. This study examined the factors influencing antibiotic prescribing for upper respiratory tract infections (URTI) by family medicine residents in order to identify educational interventions. Methods: Using purposive sampling of family medicine residents, semi-structured interviews were conducted until thematic saturation was reached. Interviews were coded into the domains of the Theoretical Domains Framework (TDF). Belief statements were created to characterize each domain and categorized as enablers or barriers to appropriate prescribing. Domains were plotted on the Behaviour Change Wheel (BCW) and intervention functions identified. Results:Twelve participants were interviewed. Nine domains of the TDF were relevant to antibiotic prescribing. Social influence was a prominent theme with the preceptor and patient being key influences on resident prescribing. Learning goals were also a key theme including the desire to strengthen independent clinical decision-making skills and improve antibiotic knowledge. Residents\' beliefs about capabilities were challenged when faced with diagnostic uncertainty. Additional domains included: professional role; environmental context and resources; intentions; beliefs about consequences and capabilities, and knowledge. Using the BCW, nine intervention functions were identified to change antibiotic prescribing behaviour. Conclusion: This study found nine domains of the TDF were relevant to family medicine resident antibiotic prescribing for URTI. Nine intervention functions could be used to guide intervention design.
摘要：
本文已迁移。这篇文章被标记为推荐。背景和目标：在全球范围内抗生素耐药性增加的背景下，初级保健中抗生素的处方过多是一个突出的问题。医疗学员是提供周到的抗菌药物管理培训的关键群体。这项研究调查了影响家庭医学居民上呼吸道感染（URTI）抗生素处方的因素，以确定教育干预措施。方法:采用有目的的家庭医学居民抽样,进行半结构化访谈,直至达到主题饱和.访谈被编码到理论域框架(TDF)的域中。创建信念陈述以表征每个领域，并将其归类为适当处方的促成因素或障碍。在行为变化轮（BCW）上绘制了域，并确定了干预功能。结果：12名参与者接受了采访。TDF的9个领域与抗生素处方有关。社会影响是一个突出的主题，主持人和患者是居民处方的主要影响因素。学习目标也是一个关键主题，包括加强独立临床决策技能和提高抗生素知识的愿望。当面临诊断不确定性时，居民对能力的信念受到了挑战。其他领域包括：专业角色；环境背景和资源；意图；对后果和能力的信念，和知识。使用BCW，9种干预功能被确定为改变抗生素处方行为.结论：这项研究发现TDF的9个领域与家庭医学居民抗生素处方URTI相关。9个干预功能可用于指导干预设计。
