Contact investigations for antibiotic-resistant bacteria: a mixed-methods study of patients' comprehension of and compliance with self-sampling requests post-discharge.

Autor: van Veen A; Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands., Lescure DLA; Department of Public Health, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.; Department of Infectious Disease Control, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, The Netherlands., Verhaegh SJC; Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands., de Goeij I; Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands., Erasmus V; Department of Public Health, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands., van Beeck EF; Department of Public Health, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands., Tjon-A-Tsien A; Department of Infectious Disease Control, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, The Netherlands., Splinter J; Department of Medical Microbiology and Infection Prevention, Franciscus Gasthuis and Vlietland, Rotterdam, The Netherlands., Christiaanse JC; General Practitioners Practice 'Nieuwe Maas', Schiedam, The Netherlands., Damen M; Department of Medical Microbiology, Maasstad General Hospital, Rotterdam, The Netherlands., Huijskens EGW; Department of Medical Microbiology, Albert Schweitzer Hospital, Dordrecht, The Netherlands., Paltansing S; Department of Medical Microbiology and Infection Prevention, Franciscus Gasthuis and Vlietland, Rotterdam, The Netherlands., van Rijn M; Department of Medical Microbiology and Infectious Diseases, Ikazia Hospital, Rotterdam, The Netherlands., Veenemans J; Department of Medical Microbiology, Albert Schweitzer Hospital, Dordrecht, The Netherlands.; Department of Infection Prevention, Admiraal de Ruyter Hospital, Goes, The Netherlands., Vos MC; Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands., Severin JA; Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands. j.severin@erasmusmc.nl.
Jazyk: angličtina
Zdroj: Antimicrobial resistance and infection control [Antimicrob Resist Infect Control] 2023 Aug 10; Vol. 12 (1), pp. 77. Date of Electronic Publication: 2023 Aug 10.
DOI: 10.1186/s13756-023-01277-1
Abstrakt: Background: Contact investigation is an important tool to identify unrecognized patients who are colonized with antibiotic-resistant bacteria. Many Dutch hospitals include already discharged contact patients by sending them a self-sampling request at home, incl. an information letter and sampling materials. Each hospital composes these information letters on their own initiative, however, whether discharged patients comprehend and comply with these requests remains unclear. Therefore, the aim was to provide insight into patients' comprehension of and self-reported compliance with self-sampling requests post-discharge.
Methods: This mixed-methods study was performed in eight Dutch hospitals. First, the Common European Framework of Reference (CEFR) language level of self-sampling request letters was established. Second, a questionnaire about patients' comprehension of the letter, self-reported compliance, and reasons for compliance or non-compliance were sent to patients that received such a request in 2018/2019. Finally, a random selection of questionnaire respondents was interviewed between January and March 2020 to gain additional insights.
Results: CEFR levels of 15 letters were established. Four letters were assigned level B1, four letters B1-B2, and seven letters B2. The majority of patients reported good comprehension of the letter they had received. Conversely, some respondents indicated that information about the bacterium (18.4%), the way in which results would be communicated (18.1%), and the self-sampling instructions (9.7%) were (partially) unclear. Furthermore, self-reported compliance was high (88.8%). Reasons to comply were personal health (84.3%), the health of others (71.9%), and general patient safety (96.1%). Compliant patients appeared to have a need for confirmation, wanted to protect family and/or friends, and felt they were providing the hospital the ability to control the transmission of antibiotic-resistant bacteria. Although a limited number of non-compliant patients responded to the questionnaire, it seemed that more patients did not comply with self-sampling requests when they received a letter in a higher CEFR-level (B2) compared to a lower CEFR-level (< B2) (9.8% vs. 2.5%, P = 0.049).
Conclusions: This study showed an overall good comprehension of and high self-reported compliance with self-sampling requests post-discharge. Providing balanced information in self-sampling request letters has the potential to reduce patient's ambiguity and concerns, and can cause increased compliance with self-sampling requests.
(© 2023. BioMed Central Ltd., part of Springer Nature.)
Databáze: MEDLINE
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