目的:探讨父母和看护者对城市土著和托雷斯海峡岛民儿童急性中耳炎治疗的看法,这些儿童在城市社区生活并发症风险较低。
方法:定性研究;半结构化访谈和简短的电话调查。
方法:访谈:在昆士兰州原住民医疗服务中筛查的城市原住民和托雷斯海峡岛民儿童(18个月至16岁)的父母和照顾者的目的样本,新南威尔士州,和堪培拉的观察研究,一项随机对照试验,比较了土著和托雷斯海峡岛民儿童急性中耳炎的即时抗生素治疗和观察等待。
方法:参加WATCH试验的父母和照顾者已完成第2周的WATCH调查。
结果:我们采访了22位父母和照顾者,包括10名拒绝参与或其子女不符合WATCH试验条件的人.一些受访者更喜欢抗生素治疗急性中耳炎,其他人更喜欢警惕的等待,表达对副作用和过度使用抗生素疗效降低的担忧。影响这种偏好的因素包括严重程度,持续时间,感染复发,以及在试验期间以及从个人和通常多代耳部疾病的经验中获得的有关管理的知识。与会者强调了父母和看护者及其医生共同决策的重要性。262名WATCH参与者中有165名家长和看护者完成了电话调查(63%);81名不确定是否应始终使用抗生素治疗急性中耳炎。开放式反应表明,抗生素的使用应根据临床需要确定,支持全科医生的决定,以及一些全科医生经常开抗生素的观点。
结论:父母和照顾者是处理城市原住民和托雷斯海峡岛民儿童急性中耳炎的关键合作伙伴。我们的发现支持基于父母和照顾者的经验的共同决策,这也可能导致治疗急性中耳炎的抗生素使用减少。
To explore the views of parents and carers regarding the management of acute otitis media in urban Aboriginal and Torres Strait Islander children who are at low risk of complications living in urban communities.
Qualitative
study; semi-structured interviews and short telephone survey.
Interviews: purposive sample of parents and carers of urban Aboriginal and Torres Strait Islander children (18 months - 16 years old) screened in Aboriginal medical services in Queensland, New South Wales, and Canberra for the WATCH
study, a randomised controlled
trial that compared immediate antibiotic therapy with watchful waiting for Aboriginal and Torres Strait Islander children with acute otitis media.
parents and carers recruited for the WATCH
trial who had completed week two WATCH surveys.
We interviewed twenty-two parents and carers, including ten who had declined participation in or whose children were ineligible for the WATCH trial. Some interviewees preferred antibiotics for managing acute otitis media, others preferred watchful waiting, expressing concerns about side effects and reduced efficacy with overuse of antibiotics. Factors that influenced this preference included the severity, duration, and recurrence of infection, and knowledge about management gained during the
trial and from personal and often multigenerational experience of ear disease. Participants highlighted the importance of shared decision making by parents and carers and their doctors. Parents and carers of 165 of 262 WATCH participants completed telephone surveys (63%); 81 were undecided about whether antibiotics should always be used for treating acute otitis media. Open-ended responses indicated that antibiotic use should be determined by clinical need, support for general practitioners\' decisions, and the view that some general practitioners prescribed antibiotics too often.
Parents and carers are key partners in managing acute otitis media in urban Aboriginal and Torres Strait Islander children. Our findings support shared decision making informed by the experience of parents and carers, which could also lead to reduced antibiotic use for managing acute otitis media.