Background: The irrational use of antibiotics among the public is a major contributor to antimicrobial resistance (AMR), which is a serious global threat. Prior studies have demonstrated that there are different behavioural patterns regarding antibiotic use among the public, and targeted interventions for subgroups with different behavioural patterns may be more effective. Thus, this study aimed to identify the public’s behavioural patterns of antibiotic use for upper respiratory tract infections (URTIs) and their influencing factors.Methods: A cross-sectional survey was conducted among the general population in Chongqing, China. Consumer decision-making (Consumer Behaviour Model, CBM) was used to assess the public’s behaviours regarding antibiotic use, including need recognition, information searching, alternative evaluation, obtaining antibiotics, antibiotic consumption, and postuse evaluation. Furthermore, a latent class analysis was used to identify the underlying behavioural patterns among the public. The identified behavioural patterns of antibiotic use were further linked with individuals’ capacity, opportunity, and motivation factors of antibiotic use based on a multinominal logistic regression to explore possible determinants.Results: A total of 815 respondents were enrolled in the study. The public’s irrational use of antibiotics was prevalent, including antibiotic self-medication (39.63%), nonprescription antibiotic purchasing (59.02%), and early stopping of antibiotic prescriptions (76.56%). Participants had inadequate knowledge of antibiotics (Mean = 2.33, SD = 1.71), reported high availability to antibiotics (Mean = 7.13, SD = 2.41), held strong belief in antibiotic effectiveness (Mean = 10.29, SD = 2.71), and demonstrated a high perceived threat of AMR (Mean = 12.30, SD = 3.20). Four behavioural patterns regarding antibiotic use for URTIs were identified, namely, “antibiotic self-medicators” (n = 165, 20.25%), “formal health care seekers” (n = 216, 26.50%), “various treatment users” (n = 198, 24.20%), and “self-medication without antibiotics” (n = 236, 28.96%). Individuals’ self-efficacy of antibiotic use, belief in antibiotic effectiveness, awareness of antibiotic side effects, perceived antibiotic availability, social influence, and demographics (age, education, medical insurance, and having a medical background) were significantly associated with the public’s different behavioural patterns of antibiotic use for URTIs.Conclusion: This study calls for collaborative efforts among the public, physicians, policy makers, and the implementation of precise and multifaceted interventions to effectively reduce irrational use of antibiotics in the public. Such interventions include identifying subgroups within the public to provide more targeted education about antibiotics and the management of URTIs, reinforcing the regulation of antibiotic dispensing, and improving physicians’ rational antibiotic prescriptions.

To understand the reasons for the public’s irrational use of antibiotics based on the health belief model (HBM). A questionnaire survey was conducted based on cluster random sampling in Chongqing, China. The public’s antibiotic use behaviors, knowledge, perceived threat of diseases [both short-term upper respiratory tract infections (URTIs) and long-term antibiotic resistance (AR)], perceived value of antibiotic use (benefits and harm), self-efficacy, antibiotic availability and social influences were measured. Structural equation modeling (SEM) was applied to test the fitness of the survey data with the theoretical framework based on the HBM. A total of 815 respondents were enrolled. The irrational use of antibiotics was prevalent among the public (mean: 2.95, SD = 2.12). The public had limited knowledge about antibiotic use (average 29.17% correct answers to 8 questions), a high perceived threat of AR (mean = 2.46, SD = 0.64) and a moderate perceived threat of URTIs (mean = 2.13, SD = 1.04). They also perceived high benefits (mean = 2.57, SD = 0.68) and moderate harm (mean = 2.16, SD = 0.83) from antibiotic use. In addition, respondents had easy access to antibiotics (mean = 2.38, SD = 0.80), perceived a high prevalence of use of antibiotics by relatives (mean = 2.40, SD = 0.65) and had a moderate level of self-efficacy in using antibiotics (mean = 1.97, SD = 0.75). The SEM results showed that higher levels of the perceived threat of URTIs, perceived benefits of antibiotic use, self-efficacy, antibiotic availability and social influence were associated with more irrational antibiotic use behavior (p < 0.005). Moreover, higher knowledge indirectly led to irrational use of antibiotics by promoting self-efficacy (p < 0.001) and the perceived threat of URTIs (p < 0.005). To curb the irrational use of antibiotics, improving knowledge alone is insufficient. A ​​systematic approach addressing multiple dimensions of health beliefs​​ is critical. This includes: (1) ​​targeted public education campaigns​​ emphasizing the limited efficacy of antibiotics for viral infections and reframing perceptions of antibiotic “benefits”; (2) ​​regulatory measures to restrict non-prescription antibiotic sales​​ in pharmacies; (3) ​​clinical guidelines and training​​ to reduce unnecessary antibiotic prescriptions by healthcare providers; and (4) ​​community-level interventions​​ leveraging social norms to discourage inappropriate antibiotic use. Policymakers should prioritize interventions that address both individual perceptions (e.g., fear of untreated infections) and systemic drivers (e.g., antibiotic accessibility).

Background: Second victims, defined as healthcare providers enduring emotional and psychological distress after patient safety incidents (PSIs). The potential for positive transformation through these experiences is underexplored but is essential for fostering a culture of error learning and enhancing patient care. Objective: To explore the level and determinants of post-traumatic growth (PTG), applying the stress process model. Methods: The study was conducted at a tertiary general hospital in Chongqing, China. A descriptive, cross-sectional study design was used. A total of 474 s victims were included. An online survey was conducted in November 2021 to assess various factors related to the second victim experience. These factors included PSIs (considered as stressors), coping styles, perceived threats, and social support (acting as mediators), as well as the outcomes of second victim syndrome (SVS) and PTG. Statistical description, correlation analysis, and structural equation modeling were utilized for the data analysis. A p-value ≤ 0.05 was considered to indicate statistical significance. Results: The participants reported moderate distress (SVS = 2.84 ± 0.85) and PTG (2.72 ± 0.85). The total effects on SVS of perceived threat, negative coping, social support, positive coping, and PSIs were 0.387, 0.359, -0.355, -0.220, and 0.115, respectively, accounting for 47% of the variation in SVS. The total effects of social support, positive coping, and PSIs on PTG were 0.355, 0.203, and − 0.053, respectively, accounting for 19% of the variation in PTG. Conclusions: The study provides novel insights into the complex interplay between perceived threats, coping styles, and social support in facilitating PTG among second victims. By bolstering social support and promoting adaptive coping strategies, the adverse effects of PSIs can be mitigated, transforming them into opportunities for resilience and growth, and offering a fresh perspective on managing PSIs in healthcare settings.

This study aims to construct a multivariable relationship network between nurses’ patient safety competency (PSC) and patient safety culture (PSCu) b

Objective: Barriers to healthcare accessibility and individuals’ perceived fairness of medical services are crucial indicators for evaluating the performance of a health system. An in-depth analysis of the statistical associations among these factors and the role played by different types of medical insurance can provide targeted, evidence-based references for policy formulation in China. Methods: Data were analyzed from 9109 respondents of the 2023 Chinese Social Survey (CSS2023). Descriptive statistics, Spearman correlation analysis, multinomial logistic regression, and path analysis based on structural equation modeling were employed to examine the distribution of barriers and perceived fairness, the correlations among them, the differential impacts of various obstacles on perceived fairness, and the statistical pathways between insurance types and perceived fairness. Results: Economic barriers (reported as severe by 48.16% of respondents) and capacity barriers (reported as severe by 22.48%) were the most prevalent types of obstacles. All five types of barriers exhibited significant negative correlations with perceived healthcare fairness (p < 0.01), with economic barriers (ρ = −0.309) and capacity barriers (ρ = −0.267) demonstrating the strongest associations. Multinomial logistic regression revealed a progressively smaller magnitude of association across the outcome contrasts: for each one-unit increase in the economic-barrier score, the odds ratios for reporting “very unfair,” “somewhat unfair,” and “fair” (compared to “very fair”) were 2.30, 1.77, and 1.23, respectively (all p < 0.001), while the impact of geographical barriers was comparatively limited. Lower levels of perceived fairness were reported by adults aged 31–45 years and 46–60 years, divorced individuals, and the unemployed. Path analysis indicated that Urban Employee Basic Medical Insurance (indirect statistical association = 0.022, 95% CI: 0.002–0.042, p = 0.029) and Urban Resident Basic Medical Insurance (indirect statistical association =0.050, 95% CI: 0.001–0.099, p = 0.044) were significantly associated with higher perceived fairness, and a portion of these associations was statistically consistent with the reduction in accessibility barriers, whereas no statistically significant indirect associations were detected for Government-funded Medical Insurance, NRCMS, or Critical Illness Insurance. Given the small sample sizes for Government-funded Medical Insurance (n = 189) and Critical Illness Insurance (n = 83), these non-significant findings should not be interpreted as evidence of the absence of an association. Conclusions: Economic burdens and substandard medical services are the primary drivers of perceived inequity. Urban employee and resident insurance programs were statistically associated with higher perceived fairness, and a portion of these associations was consistent with the reduction in accessibility barriers, whereas rural and critical illness schemes lack such an indirect association. Policy priorities should focus on alleviating financial burdens, improving healthcare quality, strengthening insurance schemes for vulnerable groups, and addressing the specific needs of adults aged 31–45 years and 46–60 years, divorced, and unemployed populations to advance healthcare fairness in China.