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To investigate factors predictive of antibiotic use behaviour in the community.
A cross-sectional study was conducted from May to November 2023.
Standardised instruments were administered to patients who had received services from nurses in sub-district health-promoting hospitals in Thailand for at least one of the three diseases: (1) upper respiratory infection, (2) acute diarrhoea or (3) fresh traumatic wounds. Antibiotic use behaviour was modelled using the generalised estimating equation with an independent error component to account for the clustering of the hospitals.
Five hundred and eighty-five participants (556 patients and 29 nurses) met the inclusion criteria in this study. Of the 556 adult patients who were surveyed, the majority had upper respiratory infections, reported an appropriate level of antibiotic use, a moderate level of awareness of appropriate antibiotic use and antibiotic resistance, and an inadequate literacy level of Rational Drug Use. The generalised estimating equation analysis revealed that factors predictive of antibiotic use behaviour were rational drug use literacy, awareness, process of care, nurses' experience and rate of rational antibiotic prescribing for acute diarrhoea.
The nurses and healthcare providers should focus on enhancing the quality of care by educating and collaborating with the community to ensure appropriate antibiotic use behaviour.
This study indicated that healthcare policymakers should prioritise patient education on antibiotic use behaviour while also ensuring that healthcare workers adhere to strict caregiving protocols.
Providing services by monitoring symptoms and home visits can help patients gain confidence in the treatment approach and lead to a rational change in antibiotic use.
We adhere to the STROBE checklist.
No patient or public involvement.
Dementia resulting from type 2 diabetes mellitus (T2DM) complications significantly impacts older adults' quality of life, increasing suffering for both patients and their families. Numerous studies have identified self-management as a key factor in adopting appropriate health behaviors to prevent diabetes-related complications. However, internationally, there is insufficient empirical evidence for individual and family process factors predicting dementia prevention behaviors in older adults with T2DM. Therefore, we aimed to explore how dementia-preventive self-management behaviors (outcome dimension) are related to contextual and process dimensions based on the Individual and Family Self-Management Theory (IFSMT).
A cross-sectional observational study.
The 444 older adults with T2DM from six community hospitals in Chiang Mai completed valid and reliable self-reported measures, including a Socio-demographic Questionnaire, the Dementia Prevention of Individual and Family Self-Management Process Questionnaire (DP-IFSM-PQ), and the Dementia Preventive Self-Management Behavior Questionnaire (DPSMBQ). Data were analyzed using bivariate correlations, partial correlations, and multivariate linear regression with the stepwise method.
Most participants exhibited high levels of individual and family self-management processes and dementia-preventive self-management behaviors. Bivariate and partial correlation analyses revealed a significant association between DP-IFSM-PQ and DPSMBQ scores. Stepwise multiple linear regression identified self-efficacy, a subdomain of DP-IFSM-PQ, as the strongest predictor of DPSMBQ scores. Other significant predictors included awareness of dementia prevention among family members, neighbors, and the community; family income sufficiency; history of comorbidities; distance to the hospital; and knowledge and beliefs (a subdomain of the DP-IFSM-PQ). The regression model was statistically significant (F [1, 437] = 46.662, p = 0.000, Adjusted R 2 = 0.382).
Self-efficacy and knowledge and beliefs, based on IFSMT, are key predictors of dementia-preventive behaviors among older adults with T2DM. These predictors could be used as potential intervention components in a subsequent co-design study for promoting dementia preventive self-management behaviors in older adults with T2DM. The results also reinforce the importance of family members and healthcare providers in supporting older adults with T2DM to enhance their dementia prevention behaviors.
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