Understanding physicians’ antibiotic-prescribing behavior is fundamental when it comes to improving antibiotic use and tackling the growing rates of antimicrobial resistance. The aim of the study by Rodrigues, et al. (2016) was to develop and validate -- in terms of face validity, content validity and reliability - an instrument designed to assess the attitudes and knowledge underlying physician antibiotic prescribing.
The questionnaire development and validation process comprised two different steps, namely: (1) content and face validation, which included a literature review and validation both by physicians and by Portuguese language and clinical psychology experts; and (2) reliability analysis, using the test-retest method, to assess the questionnaire’s internal consistency (Cronbach’s alpha) and reproducibility (intraclass correlation coefficient - ICC). The questionnaire includes 17 items assessing attitudes and knowledge about antibiotic prescribing and resistances and 9 items evaluating the importance of different sources of knowledge. The study was conducted in the catchment area covered by Portugal’s Northern Regional Health Administration and used a convenience sample of 61 primary-care and 50 hospital-care physicians.
Response rate was 64% (49% to retest) for primary-care physicians and 66% (60% to retest) for hospital-care physicians. Content validity resulted in nine changes to professional concepts. Face validity assessment resulted in 19 changes to linguistic and interpretative terms. In the case of the reliability analysis, the ICC values indicated a minimum of fair to good reproducibility (ICC > 0.4), and the Cronbach alpha values were satisfactory (α > 0.70).
The researchers concluded that the questionnaire developed is valid for assessing physicians’ attitudes to and knowledge of antibiotic prescribing and resistance, in both hospital and primary-care settings, and could be a very useful tool for characterizing physicians’ antibiotic-prescribing behavior.
Reference: Rodrigues AT and Ferreira M, et al. Physicians’ attitudes and knowledge concerning antibiotic prescription and resistance: questionnaire development and reliability. BMC Infectious Diseases 2016; 16:7.