ABSTRACT. Objective. To describe parents' opinions and concerns about antibiotics and to contrast these opinions with those of pediatricians.Design. Parents were surveyed using an intervieweradministered questionnaire and pediatricians were mailed a self-administered questionnaire.Results. Parents from two private practices (N ؍ 300) were largely white (84%) and had completed college (81%). The parents from a community health center (N ؍ 100) were mostly black (80%) and had not completed college (91%). Twenty-nine percent of parents were worried that their children were receiving too many antibiotics. Eighty-five percent believed there were problems with receiving too many antibiotics, with 55% mentioning resistance or immunity as concerns. Eighteen percent of parents had given their child an antibiotic at home before consulting a physician. Parents believed that antibiotics were always or sometimes required for ear infections (93%), throat infections (83%), colds (32%), cough (58%), and fever (58%). Fourteen percent of parents believed that their child had required an antibiotic when the doctor did not prescribe one, with clinic parents significantly more likely to report this issue (22%) than private practice parents (12%). Nine percent believed that their doctor had prescribed an antibiotic unnecessarily (private practice ؍ 12%, community health center ؍ 3%). Parents from the private practices were also more likely to report requesting a specific antibiotic (34%) in comparison with 19% of clinic parents.Sixty-one percent of the physician surveys were returned after two mailings and a follow-up phone call. The pediatricians had been in practice for a median of 12 years, seeing a median of 110 patients per week. Fiftyeight percent of pediatricians reported that some, many, or most of the parents in their practices were worried that their children were receiving too many antibiotics. Seventy-one percent indicated that four or more times during the previous month, a parent had requested an antibiotic when the physician believed it was unnecessary, and 35% said that at least occasionally they went along with these requests. Sixty-one percent reported that parents requested a different antibiotic from the one they were going to prescribe at least four times in the previous month, and 30% of pediatricians said that they agreed to parents' requests often or most of the time.Conclusions. Both the parent and the physician surveys suggest that parents are concerned about the overuse of antibiotics, but often request them when their physicians believe they are unnecessary. Parents often administer antibiotics without physician knowledge, and many parents have misconceptions about which illnesses warrant antibiotic therapy. Understanding parents' concerns and beliefs about antibiotics and the range of physician practice styles with respect to antibiotics may direct the development of intervention strategies to reduce the inappropriate use of oral antibiotics. Pediatrics 1997; 99(6). URL: http://www.pediatrics.org/...
There is increasing recognition of the psychosocial impact of cervical cytology screening programs as well as of the treatment of screening-detected human papillomavirus (HPV) - related disease. The HPV Impact Profile (HIP) includes 29 items with standard response categories representing nine psychosocial impact domains: 'worries and concerns, emotional impact, sexual impact, self image, health perception, cognition, partner and social relations, interaction with doctors and sleep'. Higher scores (0-100) are associated with higher disease burden. The HIP and other generic quality of life instruments such as the Sheehan Disability Scale were administered to women who had experienced and were aware of an HPV related diagnosis in the past 3 months (total n�=�333): 103 women with normal Pap test results (N. Pap), 111 with abnormal Pap tests (58 low grade squamous intraepithelial lesions (LSIL) and 53 high grade SIL (HSIL)), 80 women with biopsy confirmed cervical intraepithelial neoplasia (CIN) (36 CIN1 and 44 CIN 2/3) and 39 women with external genital warts (EGW). In univariate analysis, estimated HIP scores (95% CI) were lower for N.Pap than for all other groups (p�<�0.0001), N. Pap: 25.8 (22.6-29.0); LSIL: 38.8 (34.6-43.1); HSIL: 41.7 (37.2-46.2); CIN1: 41.7 (36.3-47.1); CIN 2/3: 46.6 (41.6-51.5) (p�=�0.013 vs LSIL); EGW: 44.6 (39.4-49.8). The effect was maintained after adjusting for age, race and occupation. On the Sheehan scale, CIN 2/3 and EGW demonstrated increased interference with work and social activities. Results demonstrate: a) HPV infection and disease are associated with significantly increased psychosocial burden, beyond that of the Pap test experience; b) The HIP instrument can adequately distinguish between different HPV conditions; c) Despite their non life threatening nature, the psychosocial impact of genital warts is similar to that of potentially life threatening high grade cervical lesions.
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