Nurses’ Anxiety Mediates the Relationship between Clinical Tolerance to Uncertainty and Antibiotic Initiation Decisions in Residential Aged-Care Facilities

Saniya Singh, Chris Degeling, Peta Drury, Amy Montgomery, Peter Caputi and Frank P. Deane
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Saniya Singh: School of Psychology, University of Wollongong, Wollongong, NSW, Australia
Chris Degeling: Australian Centre for Health Engagement, Evidence and Values, School of Health and Society, University of Wollongong, Wollongong NSW, Australia
Peta Drury: School of Nursing, University of Wollongong, Wollongong NSW, Australia
Amy Montgomery: School of Nursing, University of Wollongong, Wollongong NSW, Australia
Peter Caputi: School of Psychology, University of Wollongong, Wollongong, NSW, Australia
Frank P. Deane: School of Psychology, University of Wollongong, Wollongong, NSW, Australia

Medical Decision Making, 2024, vol. 44, issue 4, 415-425

Abstract: Aim. Diagnostic uncertainty, risk perceptions, time constraints, and pressure from resident/family members and nurses have been identified as potential barriers to reducing antibiotic prescribing in residential aged-care facilities. The current study investigated the relationship between nurses’ anxiety, clinical tolerance of uncertainty, and behaviors that favor antimicrobial initiation. Methods. A cross-sectional online survey was used to present a clinical vignette with measures of situational anxiety, clinical tolerance to uncertainty using the Physicians Reactions to Uncertainty Scale (adapted for nurses), and self-reported behavior on the Immediate Assessment and Antibiotics scale. The vignette described a hypothetical resident with a potential upper respiratory tract infection. Incremental information was provided with varying levels of symptoms, input from aged-care staff, and the availability of test results. Results. A total of 157 registered and enrolled nurses completed the survey from August 2021 to August 2022. Nurses’ anxiety fully mediated on the relationship between clinical tolerance of uncertainty and perceived need for antibiotics and immediate assessment ( P = 0.004), with 6% of variation explained by the model. Significant effects of clinical tolerance of uncertainty on anxiety ( P

Keywords: antimicrobial resistance; prescribing; stewardship; residential aged care; tolerance of uncertainty; uncertainty; anxiety; clinical decision making (search for similar items in EconPapers)
Date: 2024
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:44:y:2024:i:4:p:415-425

DOI: 10.1177/0272989X241239871

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