Conectar
The overuse of antibiotics for respiratory tract infections in primary healthcare in rural China is a particular challenge and is highly related to antibiotic resistance. Our research team designed a multi-component intervention focusing predominantly on health practitioners to reduce antibiotic prescriptions in rural communities of China. The effects of the intervention were evaluated through a randomised controlled trial. This study was conducted alongside the trial to develop a contextualised understanding of the implementation of the intervention and related influencing factors.
Qualitative process study nested in a randomised controlled trial, including observation and semi-structured interviews.
Primary healthcare in rural China.
27 health practitioners from township health centres assigned to the intervention arm.
A complex intervention to reduce antibiotic prescriptions in rural communities of China, which includes the following components: training for health practitioners, a public letter of commitment, patient leaflets, a decision support system and a peer support group.
Not applicable.
Data were analysed using thematic analysis.
The overall multi-component intervention was described as useful in reducing antibiotic prescribing, with a particularly high acceptance and use of patient leaflets and the public letter of commitment among health practitioners. There were mixed views on the decision support system and peer support group. Practitioners reported usability-related barriers to using the decision support system during consultations. Practitioners did not understand the role or benefits of the peer support group and found it difficult to initiate group discussions, due to the lack of any existing clinical team at the primary care level.
The multi-component intervention appears to be acceptable and useful in primary healthcare in rural China. Successful implementation requires a comprehensive understanding of the contextual characteristics of the setting. Interventions to reduce antibiotic prescribing in China in the future could consider wider stakeholders including patients, retail pharmacies and health authorities.
ISRCTN30652037 (01/12/2020).
Venous ulcers are the most prevalent among those affecting the lower limbs, with high economic and quality of life impact. Due to the chronicity of venous disease, healing and recurrence cycles are common. Patient adherence to self-care activities to prevent recurrence is very low, so it is crucial to reflect on nurses' experiences with this phenomenon. A qualitative and descriptive study was developed to analyse nurses' perceptions about preventing venous ulcer recurrence. According to the inclusion criteria, focus groups with nurses were implemented. Three focus groups were conducted through the Colibri platform, ensuring all ethical assumptions. Content analysis was performed according to thematic criteria, using the WebQda software. Three main themes emerged: integration of care, context of care, and relationship. The participants emphasised the importance of holistic assessment and the establishment of common goals to promote adherence to fundamental recurrence prevention care. Understanding and respecting individual values, empathy and active listening, considering the established relationship, anticipating the person's needs, and trust are essential to overcoming barriers to implementing recurrence prevention care and to its continuity. Taking these aspects into consideration implies that the professional is part of the process of preventing the recurrence of venous ulcers.
FreshRSS