Knowledge, attitudes, and practices related to antibiotic resistance among physicians and nurses in Italian intensive care: A multicenter cross-sectional survey.

OBJECTIVES: The aim of this study is to investigate the knowledge, attitudes and practices of Italian intensive-care physicians and nurses with respect to antibiotic resistance. METHODS: A multicenter cross-sectional survey was conducted of 20 Italian intensive care units, supported by an online validated questionnaire. RESULTS: A total of 143 participants took part, mainly nurses (79.7%). Most respondents were between 26 and 45 y old (62.9%), with more than 6 y of service (about 71%). Some 90% of those who took part stated that they were aware of the problem of antibiotic resistance and had easy access to guidelines and information materials on the subject. On the other hand, a high level of disagreement, mostly among nurses, emerged in relation to knowledge of the existence of national plans for the fight against AMR (62.9%) or the presence of international information campaigns (80%). A majority (76%) said they had received no specific training in the past 12 months. Most physicians (70%-90%) showed faith in their ability to prescribe, trusted guidelines, and recognized their role in antibiotic resistance by considering it while prescribing antimicrobial therapy. CONCLUSIONS: The study highlights the need for targeted training interventions, especially for nurses, and the importance of involving all healthcare professionals in the fight against antibiotic resistance.

Review of literature on instruments measuring health professionals' knowledges, attitudes, and perceptions of antimicrobial stewardship programs. / Revisione della letteratura sugli strumenti che misurano le conoscenze, atteggiamenti e percezioni dei professionisti sanitari rispetto ai programmi di antimicrobial stewardship.

INTRODUCTION: The establishment of multi-disciplinary antimicrobial stewardship programmes means that there is a need to study how well healthcare personnel are able to deal with the problem on a daily basis. This study therefore aimed to identify and critically examine existing tools to measure knowledge, attitudes and practices with respect to antimicrobial stewardship among physicians and nurses. METHODS: After a literature review of biomedical databases such as PUBMED, EMBASE, SCOPUS, CINAHL, a total of 14 instruments were identified between May and November 2021, the purpose, theoretical framework and statistical validity of which were analysed and described. RESULTS: The theoretical framework and validation process vary widely between instruments and are not described in all of them. The pilot study was not always conducted or well detailed. The questionnaires varied in length and were mostly answered on a 5-7 point Likert scale. The work of Baraka et al 2019 together with that of Ashiru-Oredope et al 2021 appear to be the best from the point of view of statistical validity. Baraka has the high number of questions. CONCLUSION: The literature review and the use of already existing instruments, even by the same author, are the basis of all the identified studies even if the explanation with respect to the reason for this choice is missing. The validation process was not described for all instruments. When selecting and adapting instruments, attention should be paid to the domains within the scale, the number of items and the theoretical-cultural fit.

Validation and Analysis of the European Quality Questionnaire in Italian Language.

The European Quality Questionnaire (euroQ2) is the culturally-adapted version to the European context of the Family Satisfaction in Intensive Care Unit (FS-ICU) and Quality of Dying and Death (QODD) tools in a single instrument divided into three parts (the last is optional). These tools were created for an adult setting. The aim of this study was the Italian validation and analysis of the euroQ2 tool. The Italian version of euroQ2 questionnaire was administered to the relatives, over 18 years of age, of adult intensive care unit patients, with the Hospital Anxiety and Depression Scale (HADS) and the Impact of Event Scale-Revised (IES-r). For the re-test phase the questionnaire was administered a second time. One hundred questionnaires were filled in. The agreement between test and retest was between 17-19 out of 20 participants with an upward trend in the re-test phase. A measure of coherence and cohesion between the euroQ2 variables was given by Cronbach's alpha: in the first part of the questionnaire alpha was 0.82, in the second part it was 0.89. The linear Pearson's correlation coefficients between all questions showed a weak positive correlation. The results obtained agreed with the original study. This study showed a good stability of the answers, an indication of an unambiguous understanding of the Italian translation.