| ObjectiveTo understand the current situation about residents’ knowledge of antibiotic in China and analyze the potential influencing factors,we conduct this study to make a residents’ antibiotic knowledge evaluation scale and apply this scale to a nationwide large sample survey.MethodsThis study included two stages.The first stage was to make an evaluation scale about residents’ knowledge of antibiotic and the second stage was to apply this scale to our research on the current situation about residents’ knowledge of antibiotic in China.In the first stage,the preliminary scale was completed through literature research and panel discussion,and the draft of scale was completed after the improvement of the preliminary scale through pre-investigation.Firstly,we conducted a questionnaire survey to screen and evaluate the scale items using the discrimination coefficient and exploratory factor analysis among 1,252 residents in Wuhan,Hubei Province from June to July 2018.The reliability of the scale was evaluated by calculating the Cronbach’s alpha coefficient,corrected item-total correlation,split-half reliability and test-retest reliability;the validity of the scale was evaluated by construct validity,content validity and discriminant validity.In addition,logistic regression analysis was used to analyze the relationship between knowledge of antibiotic and medication behaviors,and then established the critical value of the scale according to this results.In the second stage,two cities were selected respectively from the east,central and west of China from January to September 2019.A total of 14,219 residents were surveyed using this scale.Furthermore,residents’ antibiotic knowledge scores among different groups were compared using t-test and variance analysis;logistic regression analysis was used to analyze the correlation between independent variables and antibiotic knowledge scores,and further to identify the potential influencing factors of antibiotic knowledge.All statistical analysis was performed using SAS 9.4 and Amos 23.0 software.Results1.Basic information of the scale:The final residents’ antibiotic knowledge evaluation scale included 2 screening items and 15 knowledge evaluation items.Among them,knowledge evaluation items were divided into 4 dimensions,which were basic knowledge(3 items),adverse reactions(4 items),normative use(4 items)and antibiotic resistance(4 items).The scores of our scale ranged from 0～15.A high score means a high knowledge level of antibiotics.2.The reliability and validity evaluation of the scale:The Cronbach’s alpha coefficient,split-half reliability and test-retest reliability of the whole scale were 0.91,0.89 and 0.88,respectively.Cronbach’s alpha coefficient of the four dimensions of the scale,including basic knowledge,adverse reactions,normative use and antibiotic resistance,were 0.82,0.76,0.79 and 0.95,respectively.Confirmatory factor analysis showed that the goodness-of-fit indicators GFI,AGFI,SRMR,NFI,and CFI are 0.93,0.90,0.07,0.95,0.96,respectively.In addition,participants with higher educational levels and medical education had higher scores in knowledge of antibiotics than those with lower educational levels and no medical education,which was consistent with the expected discriminant validity.3.Critical value of knowledge level evaluation of antibiotics:Logistic regression analysis showed that the level of antibiotic knowledge had the greatest impact on individual medication behavior when the cut-off point was 10 after adjusting the gender,age,cultural level,economic status,and medical education.Therefore,"the score<10 points" was considered as insufficient antibiotic knowledge in this study.4.The current situation of antibiotic knowledge among Chinese residents:After excluding the invalid questionnaires,a total of 12,772 residents were included in this study.The average score of residents’ knowledge of antibiotic was 7.25(standard deviation was 4.76)and 67.00%of these residents were considered to have insufficient knowledge of antibiotics.Among the 15 knowledge evaluation items,the awareness rate of 4 items is lower than 40%,3 items between 40%～50%,7 items between 50%～60%,and only 1 item higher than 60%.5.Analysis of influencing factors of residents’ antibiotic knowledge:Univariate analysis showed that women’s knowledge score was statistically higher than men’s(P<0.05),and knowledge score of the young was statistically higher than that of the old(P<0.01).In addition,the participants who lived in rural areas,had lower education levels,poor economic status and did not receive medical education had lower scores of antibiotic knowledge,and the differences were statistically significant(P<0.01).The multiple logistic regression analysis showed that men,rural residents,middle school education and below,poor economic status,and residents in the western region were at higher risk of lack of knowledge of antibiotics.The OR(odds ratio)values and 95%confidence interval were 1.10(1.04-1.17)、1.19(1.10-1.28)、1.93(1.75-2.13)、1.57(1.38-1.79)and 1.19(1.08-1.31),respectively.In addition,residents who had not received health education on antimicrobial knowledge before participating in this study were more likely to show a lower level of knowledge,and the OR was 9.61(95%CI:8.93-10.34).ConclusionsThis study developed a residents’ antibiotic knowledge evaluation scale.The results showed that the scale has stable reliability and reliable validity,and it can be used as an effective tool to evaluate the residents’knowledge level of antibotic.In this study,we used this scale to conduct a nationwide large-scale sample survey.The results of the study found that the level of antibiotic knowledge among Chinese residents is relatively low.Therefore,so we should carry out nationwide intervention program about antibiotic knowledge.What’s more,residents living in rural areas,with lower educational levels,poor economic situation and living in the western region should be the key population to implement antibiotic knowledge intervention in the future.Highlights and limitationsThe innovation of this study includes two aspects.Firstly,this study developed the first scale for knowledge evaluation of antibiotics for residents,and evaluated its reliability and validity.Secondly,this study carried out a nationwide large-scale sample survey based on the developed scale,and analyzed the current situation and influencing factors of Chinese residents’ knowledge level of antibiotic agents.This study also has some limitations.Firstly,there is no gold standard to evaluate residents’ knowledge level of antibiotic agents.Therefore,this study did not evaluate the criterion-related validity of the scale,and the lack of gold standard also limited the determination of the score boundary value of the scale.Secondly,this study used convenient sampling and mobile phone network questionnaires to carry out the survey in public places.Considering that people with high education and young people can operate mobile phones more skillfully,the response rate of these people participating in the survey will be higher,leading to a certain choice bias in this study. |
PDF Full Text Request