期刊
JOURNAL OF CRITICAL CARE
卷 29, 期 4, 页码 634-640出版社
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.jcrc.2014.03.013
关键词
Antibiotic prophylaxis; Theoretical domains framework; Intensive care unit; Qualitative research
资金
- United Kingdom by the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) programme
- Canadian Institutes of Health Research
- Australian Intensive Care Foundation
- Australian and New Zealand College of Anaesthetists grant
- Chief Scientist Office of the Scottish Government Health Directorates
- Chief Scientist Office [HSRU2] Funding Source: researchfish
- National Institute for Health Research [09/01/13] Funding Source: researchfish
Purpose: Selective decontamination of the digestive tract (SDD) as a prophylactic intervention improves hospital-acquired infection and survival rates. Uptake of SDD is low and remains controversial. This study applied the theoretical domains framework to assess intensive care unit clinicians' views about SDD in regions with limited or no adoption of SDD. Materials and methods: Participants were health professionals with decisional authority for the adoption of SDD. Semistructured interviews were conducted as the first round of a Delphi study. Views about SDD adoption, delivery, and further SDD research were explored. Directed content analysis of interview data identified subthemes, which informed item development for subsequent Delphi rounds. Linguistic features of interview data were also explored. Results: One hundred forty-one participants provided interview data. Fifty-six subthemes were identified; 46 were common across regions. Beliefs about consequences were the most widely elaborated theme. Linguistic features of how participants discussed SDD included caution expressed when discussing the risks and benefits and words such as worry, anxiety, and fear when discussing potential antibiotic resistance associated with SDD. Conclusions: We identified salient beliefs, barriers, and facilitators to SDD adoption and delivery. What participants said about SDD and the way in which they said it demonstrated the degree of clinical caution, uncertainty, and concern that SDD evokes. (C) 2014 Elsevier Inc. All rights reserved.
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