Study On Antibiotic Self-medication In Children Based On Health Belief Model

Objective: The purpose of this study is to develop a self medication health belief scale based on the health belief model.On the basis of analyzing the current situation of children’s self medication of antibiotics,we can identify the influencing factors of their behavior,and make clear the influencing path of parents’ health belief on children’s self medication of antibiotics,so as to provide reference for reducing parents’ self medication of antibiotics in children.Methods: Firstly,by using the methods of literature research and group discussion,and following the principles and methods of scale development,this study designed a structured questionnaire with the parent antibiotic self-medication Health belief scale as the core.After the completion of the design of the survey tool,the vaccination clinics of six community health service centers in Wuhan,Hubei Province were selected as the survey site by multi-stage sampling method.From July 1 to July 31,2019,1188 valid questionnaires were collected from all parents who came to vaccinate children.Based on the cross-sectional survey data,the items of the scale were screened,and the reliability and validity of the scale were evaluated.On this basis,binary logistic regression analysis was used to identify the influencing factors of children’s self-medication of antibiotics,and structural equation model was used to explore the relationship between the five dimensions of parents’ health belief in self-medication of antibiotics(perceived severity,perceived susceptibility,perceived benefits,perceptual disorders,self-efficacy)and children’s self-medication behavior.The statistical software spss22.0 and amos22.0 were used to analyze all the data.Results: 1.The antibiotic self-medication health belief scale has good reliability and validity.The Cronbach’s α coefficient of the whole scale was 0.89,and the Cronbach’s α of perceived severity,perceived susceptibility,perceived benefit,perceived impairment and self-efficacy were 0.91,0.91,0.95,0.99 and 0.86 respectively.The test-retest reliability of the scale is 0.83.In terms of content validity,there was a significant correlation between the five dimensions of health belief and the total score of the scale,and the correlation coefficients were 0.77,0.71,0.68,0.48 and 0.59 respectively.In terms of construct validity,confirmatory factor analysis showed that all the indexes of RMSEA=0.048,NFI=0.955,CFI=0.967,GFI=0.937,AGFI=0.922,met the requirements of the standard.The average score of parents’ self-use of antibiotics for children’ perceived threat was 15.38 ± 3.36(20 points in total),perceived benefit was 20.94 ± 4.27(25 points in total),perceptual disorders was 13.06 ± 4.36(25 points in total),self-efficacy was 18.60 ± 4.13(25 points in total),and health belief was 65.34 ± 13.68(95 points in total).Univariate analysis found that the parents’ health beliefs were significantly different in gender,residence and antibiotic use habits.2.Analysis of the current situation and influencing factors of antibiotic self-medication in children.In the past six months,14.32% of parents gave antibiotics to their children without a doctor’s prescription.Multivariate analysis showed that parents who would buy antibiotics on their own were more likely to have children’s self-medication behavior(or = 3.31,95% CI: 1.99-5.20);parents who would store antibiotics at home were more likely to have children’s self-medication behavior(or = 3.2,95% CI: 1.71-6.18),3-5-year-old and 1-3-year-old children’s parents have a higher risk of antibiotic self-medication than parents of children less than 1 years old(or = 5.09,95% CI: 2.98-8.72 and or = 3.00,95% CI: 1.76-5.11);the higher the score of parents’ health belief,the lower the risk of antibiotic self-medication in children(or = 0.97,95% CI: 0.96-0.99).3.Path analysis between the dimensions of health belief and children’s self-medication behavior.Parents’ perceived susceptibility and perceptual disorders of antibiotic self-medication have direct effects on children’s self-medication behavior(-0.07 and 0.11,respectively).The indirect effect of perceived benefit on children’s antibiotic self-medication behavior through the mediation of self-efficacy was-0.05.The indirect effect of perceived benefit on children’s self-medication behavior through self-efficacy was-0.05.Self-efficacy not only had a direct effect on antibiotic self-medication behavior,but also had an indirect effect on antibiotic self-medication behavior through perceptual disorders,and the effect values were-0.10 and-0.02,respectively.Conclusions: In this study,the incidence of antibiotic self-medication in children is high,so there is an urgent need to formulate effective intervention measures to improve the current situation of parents’ self-use of antibiotics to their children.In this study,the antibiotic self-medication health belief scale developed has high reliability and validity which could be used as an effective tool to measure parents’ health beliefs about the antibiotic self-medication.There is a complex relationship between parents’ health belief and children’s antibiotic self-medication behavior.Therefore,we need to pay attention to the interaction among the dimensions of parents’ health beliefs,so as to promote the change of their behavior of unreasonable use of antibiotics.Highlights and limitations: The innovation of this study is reflected in the following three aspects.Firstly,in terms of research content,the self-medication behavior of children with antibiotics was studied in depth under the guidance of health belief model.Secondly,in terms of study design,this study developed the self-medication health belief scale of antibiotics,and evaluated its reliability and validity,so as to accurately measure the core concept of health belief.In addition,in terms of research methods,this study uses Structural Equation Model to analyze the action path between each dimension of health belief and children’s self-medication of antibiotics,which has certain methodological innovation.This study also has some limitations.Firstly,the research nature of this study is cross-sectional,so it is difficult to infer the causal conclusion.Secondly,the survey site of this study is limited to Wuhan city,which can not represent the overall situation of China.In addition,this study included only children’s parents as study subjects,which may underestimate the incidence of children self-medication antibiotics.