Assessing the overuse of antibiotics in children in Saudi Arabia: validation of the parental perception on antibiotics s
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RESEARCH
Open Access
Assessing the overuse of antibiotics in children in Saudi Arabia: validation of the parental perception on antibiotics scale (PAPA scale) Arwa Alumran1,2,3*, Xiang-Yu Hou1,2 and Cameron Hurst1,2
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. Keywords: Antibiotics overuse, Psychosocial, Measurement instrument, Reliability, Validity, Exploratory factor analysis, Saudi Arabia
Introduction Although antibiotics are targeted to kill or inhibit the growth of bacteria and have no effect on viral agents [1], they are often inappropriately used to treat viral infections such as upper respiratory tract infections (URTIs). URTIs are usually self-limiting and resolve in the same amount of time regardless of antibiotic consumption [2]. * Correspondence: [email protected] 1 School of Public Health & Social Work, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, Brisbane, QLD 4059, Australia 2 Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia Full list of author information is available at the end of the article
Thus, using antibiotics to treat these viral infections is considered misuse or overuse of antibiotics. This misuse/ overuse is common in children [3,4], and is curre
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