Research On The Parents’ Self-medication Of Antibiotics Use In Children Based On Green Model

ObjectiveThe purpose of the study was to investigate parents’ cognitive and behavior on the use of antibiotics in children. To study the current status of family self-medication for children, explore the factors which influence the self-medication of children, and provide a reference for health administrative department to carry out health education on the safety of using antibiotics for children, so as to use antibiotics appropriately and rationally for children.MethodsThis was a cross-sectional study using a self-administered questionnaire, carried out in children’s hospital of Soochow University by trained investigators from December 2013 to April 2014. We used random sampling method. Respondents in this study were parents and caregivers of hospitalized children of 12 inpatient area apart from the neonatal ward, ICU ward and department of hematology. According to the sample size estimation formula, we estimated 1040 cases of sample size were needed. In fact, 1300 questionnaires were released. And 1158 effective questionnaires were taken back. The valid response rate was 89.1%. The questionnaire collected information on demographic characteristics of parents and their cognitive and behavior on the use of antibiotics. The data was entered into a database using the Epidata 3.10. Statistical Package for Social Sciences(SPSS) version 17.0 was used to analyze data from the questionnaire. P-value of <0.05 was considered to be statistically significant.Results1. Parents’ knowledge score of antibioticsThe survey results showed that the knowledge score ranged 2 to 28, the average score was 14.15, the mode was 12, and the standard deviation was 4.145. Univariateanalysis showed that the respondents in different age, culture degree, occupation categories, types of household registration, medical insurance type had significant differences on knowledge score of antibiotics.2. Parents’ attitudes on antibiotic useAlmost 33.77% of parents admitted to having directly asked a doctor to prescribe antibiotics. The vast majority of parents(97.06%) reported that they would follow advice if physicians rejected their request for antibiotics. 74.35% of parents believed that doctors often or occasionally give antibiotics unnecessary. The vast majority of parents(69.00%) said that if the doctor often give antibiotics unnecessary they will choose to change places for medical treatment. And 41.02% did not hope pediatrician to prescribe antibiotics.3. Parents’ practices on antibiotic use71.90% of parents reported that they had stored antibiotics at home in case of future need, and 39.40% had medicated their children with antibiotics without prescription of a physician. 92.83% of parents can give their children medication on time. Only 26.34% of parents admitted that their children finished the entire course of antibiotics given. Most parents can follow the directions of pediatrician. However,47.15% of parents had the experience of not according to the prescription given by the doctor.4. Effects of demographic characteristics on parents’ practices of self-medicating children with antibioticsThe results of multivariate analysis showed that parents’ gender, age, income and household type were related to the practices of self-medicating. Self-medication behavior of parents was affected by gender, the possibility of that happened in female was 1.401 times of that happened in male. Older parents had higher risk in antibiotic self-medication(OR=1.183, P=0.037). The income was higher, the risk of self-medication was higher(OR=1.123, P=0.037). The possibility of that happened in out-of-town parents was 1.636 times of that happened in local parents.5. The influencing factors of antibiotics self-medication: predisposing factors,enabling factors and the reinforcing factorsLogistic regression analysis showed that the higher knowledge score of parents, themore likely happening of self-medicating behavior(OR=1.089, P=0.000). Those who directly asked a doctor to prescribe antibiotics and hoped pediatrician to prescribe antibiotics were more likely to self-medicated their children. Storing antibiotics(OR=14.517, P=0.000), the pharmacy staff recommendation to buy antibiotics(OR=1.865, P=0.000), the hospital costs high, complex procedures(OR=3.417,P=0.000) and the mass media participation(OR=1.485, P=0.000) were risk factors of self-medication behavior. Had the similar symptom medication experience would expand 4.857 times of the possibility of self-medicating behavior.Conclusions1. The cognitive lever on antibiotics of parents is uneven. Higher school education and higher socio-economic status(income) are significantly associated with higher knowledge score.2. The parents’ self-medication behavior is not scientific and standard. There are many issues existing included self-medication without prescription, using antibiotics with short course, using medicine not on time.3. Parents’ gender, age, income and household type are related to the practices of self-medicating. The risk factors associated with antibiotics self-medication are: female,older parents, higher income and local parents.4. The higher knowledge score of parents, the more likely happening of self-medicating behavior.5. Storing antibiotics in home, the pharmacy staff recommendation to buy antibiotics, the hospital costs high, complex procedures and the mass media participation are risk factors of self-medication behavior.6. Having the similar symptom medication experience will increase the possibility self-medicating behavior.