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Health and Quality of Life Outcomes
Published in: Health and Quality of Life Outcomes 1/2013

Open Access 01-12-2013 | Research

Assessing the overuse of antibiotics in children in Saudi Arabia: validation of the parental perception on antibiotics scale (PAPA scale)

Authors: Arwa Alumran, Xiang-Yu Hou, Cameron Hurst

Published in: Health and Quality of Life Outcomes | Issue 1/2013

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Abstract

Background

Antibiotics overuse is a global public health issue influenced by several factors, of which some are parent-related psychosocial factors that can only be measured using valid and reliable psychosocial measurement instruments. The PAPA scale was developed to measure these factors and the content validity of this instrument was assessed.

Aim

This study further validated the recently developed instrument in terms of (1) face validity and (2) construct validity including: deciding the number and nature of factors, and item selection.

Methods

Questionnaires were self-administered to parents of children between the ages of 0 and 12 years old. Parents were conveniently recruited from schools’ parental meetings in the Eastern Province, Saudi Arabia. Face validity was assessed with regards to questionnaire clarity and unambiguity. Construct validity and item selection processes were conducted using Exploratory factor analysis.

Results

Parallel analysis and Exploratory factor analysis using principal axis factoring produced six factors in the developed instrument: knowledge and beliefs, behaviours, sources of information, adherence, awareness about antibiotics resistance, and parents’ perception regarding doctors’ prescribing behaviours. Reliability was assessed (Cronbach’s alpha = 0.78) which demonstrates the instrument as being reliable.

Conclusion

The ‘factors’ produced in this study coincide with the constructs contextually identified in the development phase of other instruments used to study antibiotic use. However, no other study considering perceptions of antibiotic use had gone beyond content validation of such instruments. This study is the first to constructively validate the factors underlying perceptions regarding antibiotic use in any population and in parents in particular.
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Literature
1.
Jetacar : The use of Antibiotics in Food-producing animals. Australia: Commonwealth Department of Health and Aged Care; 1999.
2.
Wutzke S, Artist M, Kehoe L, Fletcher M, Mackson J, Weekes L: Evaluation of a national programme to reduce inappropriate use of antibiotics for upper respiratory tract infections: effects on consumer awareness, beliefs, attitudes and behaviour in Australia. Health Promot Int 2007, 22: 53–64. 10.1093/heapro/dal034PubMedCrossRef
3.
Cebotarenco N, Bush P: Reducing antibiotics for colds and flu: a student-taught program. Heal Educ Res 2008, 23: 146–157.CrossRef
4.
Huang S, Rifas-Shiman S, Kleinman K, Kotch J, Schiff N, Stille C, Steingard R, Finkelstein J: Parental knowledge about antibiotic Use: results of a cluster-randomized, multicommunity intervention. Pediatrics 2007, 119: 698–706. 10.1542/peds.2006-2600PubMedCrossRef
5.
Grigoryan L, Burgerhof J, Haaijer-Ruskamp F, Degener J, Deschepper R, Monnet D, Di Matteo A, Scicluna E, Bara A, Lundborg C, Birkin J: Is self-medication with antibiotics in Europe driven by prescribed use? J Antimicrob Chemother 2007, 59: 152–156.PubMedCrossRef
6.
Flora K, Scott W, Jason B, Jonathan Z: Improving antibiotic utilization among hospitalists: A pilot academic detailing project with a public health approach. J Hosp Med 2008, 3: 64–70. 10.1002/jhm.278CrossRef
7.
Tenover F: Mechanisms of antimicrobial resistance in bacteria. Am J Med 2006, 119: 3–10.CrossRef
8.
Sorkhou I, Al-Qallaf B, Hajiah A, Al-Sheibani H, Bayoomi A, Mustafa A: Perceptions of patients attending primary care in kuwait regarding upper respiratory tract infections. Kuwait medical Journal 2002, 34: 272–275.
9.
Green R: Symptomatic treatment of upper respiratory tract symptoms in children. South African Family Practice 2006, 48: 14–19.
10.
Mora Y, Avila-Agtiero M, Umafia M, Jimenez A, Paris M, Faingezicht I: Epidemiologic observations of the judicious use of antibiotics in a pediatric teaching hospital. Int J Infect Dis 2002, 6: 74–77. 10.1016/S1201-9712(02)90141-4PubMedCrossRef
11.
Irshaid Y, Al-Homrany M, Hamdi A, Adjepon-Yamoah K, Mahfouz A: A pharmacoepidemiological study of prescription pattern in outpatient clinics in Southwestern Saudi Arabia. Saudi Med J 2004, 25: 1864–1870.PubMed
12.
Simasek M, Blandino D: Treatment of the common cold. Am Fam Physician 2007, 75: 515–520.PubMed
13.
Awad A, Eltayeb I, Matowe L, Thalib L: Self-medication with antibiotics and antimalarials in the community of khartoum state. Sudan J Pharm Pharmaceut Sci 2005, 8: 326–331.
14.
Chan G, Tang S: Parental knowledge, attitudes and antibiotic use for acute upper respiratory tract infection in children attending a primary healthcare clinic in Malaysia. Singapore Med J 2006, 47: 266–270.PubMed
15.
Mitsi G, Jelastopulu E, Basiaris H, Skoutelis A, Gogos C: Patterns of antibiotic use among adults and parents in the community: A questionnaire-based survey in a Greek urban population. Int J Antimicrob Agents 2005, 25: 439–443. 10.1016/j.ijantimicag.2005.02.009PubMedCrossRef
16.
Al-Azzam S, Al-Husein B, Alzoubi F, Masadeh M, Al-Horani M: Self-medication with antibiotics in jordanian population. IJOMEH 2007, 20: 373–380.PubMedCrossRef
17.
Sarahroodi S, Arzi A, Sawalha A, Ashtarinezhad A: Antibiotics self-medication among southern iranian university students. Int J Pharmacol 2010, 6: 48–52.CrossRef
18.
Crossley J, Eiser C, Davies H: Children and their parents assessing the doctor–patient interaction: a rating system for doctors’ communication skills. Medical Education 2005, 39: 820–828. 10.1111/j.1365-2929.2005.02230.xPubMedCrossRef
19.
Alumran A, Hou X-Y, Hurst C: Assessing the overuse of antibiotics in children with URTIs in Saudi Arabia: Development of the parental perception on antibiotics scale (PAPA scale). Global Health: Journal of Epidemiology and; 2013.
20.
Bawazir S: Prescribing pattern at Community Pharmacies in Saudi Arabia. Int Pharm J 1992, 6: 222–224.
21.
Alumran A, Hurst C, Hou X-Y: Antibiotics Overuse in Children with Upper Respiratory Tract Infections in Saudi Arabia: Risk Factors and Potential Interventions. Clinical Medicine and Diagnostics 2011, 1: 8–16.CrossRef
22.
Kimberlin CL, Winterstein AG: Validity and reliability of measurement instruments used in research. Am J Health Syst Pharm 2008, 65: 2276–2284. 10.2146/ajhp070364PubMedCrossRef
23.
Ramaker C, Marinus J, Stiggelbout A, Van Hilten B: Systematic evaluation of rating scales for impairment and disability in Parkinson’s disease. Mov Disord 2002, 17: 867–876. 10.1002/mds.10248PubMedCrossRef
24.
Alumran A, Hou X-Y, Hurst C: Validity and reliability of instruments designed to measure factors influencing the overuse of antibiotics. J Infect Public Health 2012, 5: 221–232. 10.1016/j.jiph.2012.03.003PubMedCrossRef
25.
Colton D, Covert R: Designing and constructing instruments for social research and evaluation. San Francisco, CA: Jossey-Bass; 2007.
26.
Corbett K, Gonzales R, Leeman-Castillo B, Flores E, Maselli J, Kafadar K: Appropriate antibiotic use: variation in knowledge and awareness by Hispanic ethnicity and language. Prev Med 2005, 40: 162–169. 10.1016/j.ypmed.2004.05.016PubMedCrossRef
27.
Britten N, Ukoumunne O: The influence of patients’ hopes of receiving a prescription on doctors’ perceptions and the decision to prescribe: a questionnaire survey. BMJ 1997, 315: 1506–1510. 10.1136/bmj.315.7121.1506PubMedCentralPubMedCrossRef
28.
Akici A, Kalaca S, Ugurlu U, Oktay S: Prescribing habits of general practitioners in the treatment of childhood respiratory-tract infections. Eur J Clin Pharmacol 2004, 60: 211–216. 10.1007/s00228-004-0749-9PubMedCrossRef
29.
Larson E, Dilone J, Garcia M, Smolowitz J: Factors which influence latino community members to self-prescribe antibiotics. Nurs Res 2006, 55: 94–102. 10.1097/00006199-200603000-00004PubMedCrossRef
30.
Hasson F, Keeney S, McKenna H: Research guidelines for the Delphi survey technique. J Adv Nurs 2000, 32: 1008–1015.PubMed
31.
Lawshe C: A Quantitative approach to content validity. Pers Psychol 1975, 28: 563–575. 10.1111/j.1744-6570.1975.tb01393.xCrossRef
32.
Kogan M, Pappas G, Yu S, Kotelchuck M: Over-the-counter medication Use among US preschool-age children. JAMA 1994, 272: 1025–1030. 10.1001/jama.1994.03520130063034PubMedCrossRef
33.
Bi P, Tong S, Partonc K: Family self-medication and antibiotics abuse for children and juveniles in a Chinese city. Soc Sci Med 2000, 50: 1445–1450. 10.1016/S0277-9536(99)00304-4PubMedCrossRef
34.
Borg M, Scicluna E: Over-the-counter acquisition of antibiotics in the Maltese general population. Int J Antimicrob Agents 2002, 20: 253–257. 10.1016/S0924-8579(02)00194-2PubMedCrossRef
35.
Svensson E, Haaijer-ruskamp F, Lundborg C: Self-medication with antibiotics in a swedish general population. Scand J Infect Dis 2004, 36: 450–452. 10.1080/00365540410020721PubMedCrossRef
36.
Linstone HA, Turoff M: The Delphi method: techniques and applications. Addison-Wesley Pub. Co.: Advanced Book Program; 1975.
37.
Ray D, Rohren C: Characteristics of patients with upper respiratory tract infection presenting to a walk-in clinic. Mayo Clin Proc 2001, 76: 169–173.PubMedCrossRef
38.
Van Widenfelt BM, Treffers PDA, de Beurs E, Siebelink BM, Koudijs E: Translation and Cross-Cultural Adaptation of Assessment Instruments Used in Psychological Research With Children and Families. Clinical Child and Family Psychology Review 2005, 8: 135–147. 10.1007/s10567-005-4752-1PubMedCrossRef
39.
UNESCO IBoE: World Data on Education. 7th edition. Saudi Arabia; 2010/11
Metadata
Title
Assessing the overuse of antibiotics in children in Saudi Arabia: validation of the parental perception on antibiotics scale (PAPA scale)
Authors
Arwa Alumran
Xiang-Yu Hou
Cameron Hurst
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2013
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/1477-7525-11-39

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