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J Zhejiang Univ (Med Sci)  2018, Vol. 47 Issue (2): 156-162    DOI: 10.3785/j.issn.1008-9292.2018.04.08
    
Parents' antibiotic use for children in Ningbo: knowledge, behaviors and influencing factors
PENG Dandan(),ZHOU Xudong*()
School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058, China
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Abstract  

Objective: To survey the knowledge and behaviors of antibiotic use for children among parents in Ningbo and to explore the influencing factors. Methods: One kindergarten and one primary school were randomly selected in Yinzhou and Beilun District of Ningbo using stratified random cluster sampling method, respectively. A survey on the knowledge and behaviors of antibiotics use for children was conducted with a self-designed questionnaire among parents of children aged 2 to 14 years in the sampled kindergarten and school. Results: The scores of antibiotic use knowledge were 0-4 in 36.6%(1028/2806) of parents. In the past month, 56.6%(556/983) of parents self-medicated their children, including 20.3%(113/556) medicated with antibiotics. In the past year, 48.5%(1361/2806) of parents stored antibiotics for children at home. Multivariate logistic regression analysis showed that mother, and parents with city residence, higher education level, higher household income, medical background, male children and younger children had higher antibiotic use knowledge scores(P < 0.05 or P < 0.01); parents with city residence, higher education level and medical background were more likely to store antibiotics at home (all P < 0.01); parents with city residence and those store antibiotics at home were more likely to self-medicate their children with antibiotics (P < 0.05 or P < 0.01). Conclusions: Poor knowledge and massive antibiotic missuse for children among parents are of great concern in Ningbo. Tailored health education programs are needed to improve the knowledge and behaviors of rational antibiotic use among parents and reduce storage of antibiotics at home.



Key wordsSampling studies      Anti-bacterial agents/therapeutic use      Cognition      Drug utilization      Family      Child      Questionnaires     
Received: 20 August 2017      Published: 24 July 2018
CLC:  R978.1  
  R179  
Corresponding Authors: ZHOU Xudong     E-mail: pengdandan@zju.edu.cn;zhouxudong@zju.edu.cn
Cite this article:

PENG Dandan,ZHOU Xudong. Parents' antibiotic use for children in Ningbo: knowledge, behaviors and influencing factors. J Zhejiang Univ (Med Sci), 2018, 47(2): 156-162.

URL:

http://www.zjujournals.com/med/10.3785/j.issn.1008-9292.2018.04.08     OR     http://www.zjujournals.com/med/Y2018/V47/I2/156


宁波市儿童家长抗菌药物知识、使用行为及其影响因素分析

目的: 了解浙江省宁波市城乡儿童家长对抗菌药物合理使用知识的掌握情况和抗菌药物使用行为,并探讨其主要的影响因素。方法: 采用多阶段分层整群随机抽样方法,在浙江省宁波市鄞州区和北仑区各随机抽取一所幼儿园和一所小学,采用自制问卷对样本学校2~14岁儿童的家长进行调查,调查内容包括抗菌药物合理使用知识、家中储备抗菌药物行为以及自行对儿童使用抗菌药物治疗的行为。结果: 在调查的2806名家长中,36.6%(1028/2806)的家长抗菌药物合理使用知识得分较低;调查前一个月内,56.6%(556/983)的家长自行对孩子进行过治疗,其中20.3%(113/556)的家长在治疗中给孩子使用了抗菌药物;调查前一年内,48.5%(1361/2806)的家长在家中储备有孩子使用的抗菌药物。多因素logistic回归分析结果显示,母亲、居住在城市、拥有较高的教育程度、较高的家庭收入、有医学背景、孩子是男孩以及孩子年龄较小的家长抗菌药物合理使用知识得分较高(P < 0.05或P < 0.01);居住在城市、教育程度高、有医学背景的家长更倾向于在家中储备抗菌药物(均P < 0.01);居住在城市和家中储备抗菌药物是家长自行给儿童使用抗菌药物治疗的危险因素(P < 0.05或P < 0.01)。结论: 宁波市部分儿童家长儿童抗菌药物合理使用知识欠缺,给儿童治疗时自行使用抗菌药物、家中储备儿童用抗菌药物的比例较高。建议有针对性地对家长开展健康教育,减少家庭抗菌药物储备,促进抗菌药物的合理使用。


关键词: 抽样研究,  抗菌药/治疗应用,  认知,  药物利用,  家庭,  儿童,  问卷调查 
[n(%)]
问题 不知道
对细菌耐药性的认识
  人们使用抗菌药物越频繁,以后细菌感染越难治好 2404(85.7) 126(4.5) 276(9.8)
  若现在不合理使用抗菌药物,以后有效的抗菌药物会越来越少 2280(81.3) 137(4.9) 389(13.9)
抗菌药物使用知识(是否需要使用)
  抗菌药物对治疗病毒感染有效 1580(56.3) 799(28.5) 427(15.2)
  孩子感冒(咳嗽、流鼻涕)需要使用抗菌药物 384(13.7) 2274(81.0) 148(5.3)
  孩子咽痛时应使用抗菌药物 523(18.6) 2111(75.2) 172(6.1)
  抗菌药物可以让孩子感冒好得更快 979(34.9) 1534(54.7) 293(10.4)
抗菌药物使用知识(正确使用)
  若孩子需要用抗菌药物,应优先选用输液方式 568(20.2) 1952(69.6) 286(10.2)
  孩子病情一见好转应立即停用抗菌药物 1873(66.7) 705(25.1) 228(8.1)
Tab 1 Knowledge of rational use of antibiotics in 2806 parents
[n(%)]
因素 n 低(0~4分) 高(5~8分)
χ2检验,**P<0.01.
家长类型** 父亲 588 284(48.3) 304(51.7)
母亲 2218 744(33.5) 1474(66.5)
孩子性别 1429 502(35.1) 927(64.9)
1377 526(38.2) 851(61.8)
孩子年龄(岁)** 2~<7 912 255(28.0) 657(72.0)
7~<11 1212 477(39.4) 735(60.6)
11~14 682 296(43.4) 386(56.6)
子女数量** 1 1946 663(34.1) 1283(65.9)
≥2 860 356(42.4) 495(57.6)
教育程度** 初中及以下 435 298(68.5) 137(31.5)
高中或中专 575 290(50.4) 285(49.6)
大专及以上 1796 440(24.5) 1356(75.5)
医学背景** 276 53(19.2) 223(80.8)
2530 975(38.5) 1555(61.5)
居住地** 农村 1177 580(49.3) 597(50.7)
城市 1629 448(27.5) 1181(72.5)
家庭收入(元/月)** ≤5000 569 321(56.4) 248(43.6)
>5000~10 000 996 377(37.9) 619(62.1)
>10 000 1241 330(26.6) 911(73.4)
Tab 2 Univariate analysis of influencing factors of 2806 parents' knowledge of rational use of antibiotics
[n(%)]
特征 自行使用抗菌药物治疗(n=556) 家中储备抗菌药物(n=1361)
χ2 P χ2 P
—:无相关数据.
家长类型 父亲 21(20.8) 80(79.2) 0.017 0.897 274(46.6) 314(53.4) 1.080 >0.05
母亲 92(20.2) 363(79.8) 1087(49.0) 1131(51.0)
孩子性别 59(21.1) 221(78.9) 0.195 0.659 685(47.9) 744(52.1) 0.376 >0.05
54(19.6) 222(80.4) 676(49.1) 701(50.9)
孩子年龄(岁) 2~<7 53(18.9) 227(81.1) 1.391 0.499 469(51.4) 443(48.6) 14.13 0.01
7~<11 46(23.0) 154(77.0) 603(49.8) 609(50.2)
11~14 14(18.4) 62(81.6) 289(42.4) 393(57.6)
子女数量 1个 86(21.6) 312(78.4) 1.427 0.232 936(48.1) 1010(51.9) 0.416 >0.05
2个或以上 27(17.1) 131(82.9) 425(49.4) 435(50.6)
教育程度 初中及以下 13(28.9) 32(71.1) 2.486 0.288 165(37.9) 270(62.1) 31.90 <0.01
高中或中专 19(21.6) 69(78.4) 259(45.0) 316(55.0)
大专及以上 81(19.1) 342(80.9) 937(52.2) 859(47.8)
医学背景 12(20.0) 48(80.0) 0.004 0.947 172(62.3) 104(37.7) 23.39 <0.01
101(20.4) 395(79.6) 1189(47.0) 1341(53.0)
居住地 农村 36(17.1) 175(82.9) 2.235 0.135 500(42.5) 677(57.5) 29.44 <0.01
城市 77(22.3) 268(77.7) 861(52.9) 768(47.1)
家庭收入(元/月) ≤5000 24(31.2) 53(68.8) 7.954 0.019 256(45.0) 313(55.0) 17.55 <0.01
>5000~10 000 31(15.9) 164(84.1) 448(45.0) 548(55.0)
>10 000 58(20.4) 226(79.6) 657(52.9) 584(47.1)
家中储备抗菌药物 89(28.1) 228(71.9) 27.37 <0.01
24(10.0) 215(90.0)
知识得分抗菌药物 52(31.5) 113(68.5) 18.15 <0.01 469(45.6) 559(54.4) 5.390 <0.05
61(15.6) 330(84.4) 892(50.2) 886(49.8)
Tab 3 Univariate analysis of influencing factors for antibiotic use in 2806 parents in Ningbo
[OR(95%CI)]
特征 抗菌药物知识得分高 家中储备抗菌药物 自行使用抗菌药物治疗
—:无相关数据.*P<0.05, **P<0.01.
家长类型 母亲与父亲 1.92(1.57~2.35)** 1.11(0.92~1.34) 1.15(0.65~2.06)
儿童性别 女与男 0.84(0.71~0.99)* 1.04(0.89~1.21) 0.88(0.56~1.38)
儿童年龄(岁) 7~<11与2~7 0.71(0.58~0.87)** 0.98(0.82~1.62) 1.42(0.88~2.30)
11~14与2~7 0.76(0.60~0.96)* 0.77(0.63~0.95)* 1.01(0.49~2.09)
子女数量 1个与2个或以上 0.99(0.83~1.20) 1.16(0.98~1.37) 0.63(0.37~1.07)
教育程度 高中/中专与初中及以下 1.76(1.34~2.32)** 1.30(0.99~1.70) 0.71(0.28~1.79)
大专及以上与初中及以下 4.16(3.15~5.49)** 1.45(1.11~1.90)** 0.59(0.24~1.45)
医学背景 有与无 1.95(1.41~2.71)** 1.71(1.32~2.22)** 1.16(0.56~2.36)
居住地 城市与农村 1.42(1.17~1.71)** 1.33(1.12~1.58)** 1.82(1.04~3.17)*
家庭收入(元/月) >5000~10 000与≤5000 1.36(1.08~1.72)** 0.83(0.66~1.03) 0.39(0.19~0.79)**
>10 000与≤5000 1.50(1.17~1.93)** 0.98(0.78~1.24) 0.53(0.26~1.06)
家中储备抗菌药物 是与否 3.82(2.29~6.39)**
知识得分 高与低 0.97(0.82~1.15) 0.37(0.23~0.60)**
Tab 4 Logistic regression analysis of the knowledge and behaviors of antibiotic use in 2806 parents in Ningbo
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