Investigation About The Cognition Of The Rational Antimicrobials Usage Among Intrn

Objective: To investigate the current cognitive situation among interns aboutrational usage of antimicrobials by questionnaire in three teaching hospitals in Dalian,and thereby to provide scientific basis for special further education on rational usage ofantimicrobials among medical students.Methods: A total of580interns from three teaching hospitals in Dalian, of14specialties and including undergraduates and postgraduates, were selected asrespondents. Questionnaire was used and based upon the characteristics of interns. It’sfirst draft was designed after careful studying of relevant documents, and the finalversion was not formed until it was discussed and revised by epidemiologists,statisticians and clinicians discussions jointly. The questionnaire included three partswith24questions altogether: the basic knowledge of antimicrobials including basicconcepts, efficacy, hierarchical management and preventive use of antimicrobials, with10questions; the cognition about the situation of the usage of antibacterials involvingthe current situation about irrational usage of antimicrobials, the resistance of bacteria todrugs and the situation of participation in the propagation of the knowledge aboutrational usage of antimicrobials, with also10questions; the cognitive approaches,including both existing and expecting ones, by which interns got the relevant knowledgeand information, with4questions. The correct rate for total and each question wascalculated. In single-choice part, according to the scoring of1for each correct answerand0for each wrong, the average score based upon gender, age, school, learning stages,specialties, working experience, working duration and family medical background, werecalculated and statistically analyzed. Differences between the average scores based upongender, school, working experience were analyzed using the t test. One-way analysis ofvariance(ANOVA) was used for the comparison between the average scores based uponage, learning stage, specialty, working time, family medical background. Linearregression analysis was performed using the factors with hypothesis testing result of P ≤0.1as independent variables and overall average score as dependent variables. Inmultiple-choice part, the number of people choosing each option, and the constituentratio were calculated. EXCEL2007software was used to establish database whosestructure was consistent with the structure of the questionnaire. SPSS17.0software wasused to analyze the data and two-tailed test was used in all tests. A p-value less than0.05denoted the presence of a statistically significant difference.Results: A total of580interns were investigated, and580questionnaires weredistributed, and559valid questionnaires were recovered with a recovery rate of96.38%.The overall average score was12.60. The score for the cognition about the concept ofantimicrobials was the highest (mean value0.86). Comparatively lower were the scoresfor the cognition about the current situation of the preventive application ofantimicrobials in operation with class II (mean value0.41) and class Ⅰ(mean value0.30) incision, with the score for the cognition about whether the use ofantibiotics must be limited or not being the lowest (mean value0.29).By comparison, the average score on the cognition of the the rational usage ofantimicrobials among interns in internal medicine system was the highest (mean value13.26), followed by interns in surgical system (mean value12.35) and interns in otherspecialties (mean11.52) successively, with a statistically significant difference of P <0.05. There was a significant difference in the cognitive score between the subjectswith working experience and without(12.76vs11.71, P <0.05).Multiple linear regression testing demonstrated a statistically significant result(F=7.534, P<0.01). There was a linear relationship between the cognitive scores ofinterns about the rational usage of antimicrobials and gender, working experience, thenumber of family members with medical background.The interns obtained knowledge about antimicrobials mainly through schoollearning (43%) and clinical practice (42.7%). During clinical practice,77.7%of theteachers gave specific guidance on rational usage of drugs. Most of the respondentsdesired more relevant knowledge, and79.8%of them hoped to be given more guidanceby teachers. The approaches to get the relevant knowledge about antibioticswere by face-to-face instruction (57.7%) and lecturing (28.9%).Conclusion:1. Overall cognition of the interns on rational usage of antimicrobialswas not ideal. Although the interns were able to actively limit the usage ofantimicrobials in clinic, and had high expectation to improve the current situation, their cognition about application principles, the severity of the consequences secondary toirrational use of antimicrobials needed to be improved. Cognitive level was, to someextent, associated with the specialties and working experiences.2. Although interns could be given special guidance on rational use ofantimicrobials by most teachers, their desire for the relevant knowledge needs to be metmore through other pattens, such as face-to-face instructions and trainingeminars.