Poorer people are more likely to use antibiotics; inappropriate antibiotic use causes resistance, and health campaigns attempt to change behaviour through education. However, fuelled by the media, the public think antibiotic resistance is outside their control. Differences in the attribution of blame for antibiotic resistance in two genres of UK newspapers, targeting distinct socioeconomic groups, were examined using a mixed methods approach. Firstly, depiction of blame was categorised as either external to the lay public (outside their control) or internal (lay person accountable) and subjected to a chi-square test. Secondly, using critical discourse analysis, we examined the portrayal of the main agents through newspaper language. Data from 597 articles (307 broadsheets) analysed revealed a significant association between newspaper genre and attribution of blame for antibiotic resistance. While both newspaper types blamed antibiotic resistance predominantly on factors external to the lay public, broadsheets were more likely to acknowledge internal factors than tabloids. Tabloids provided a more skewed representation, exposing readers to inaccurate explanations about antibiotic resistance. They highlighted ineptitude in health professionals, victimising patients and blaming others, while broadsheets used less emotive language. Pharmacists should take special care to communicate the importance of appropriate antibiotic use against this backdrop of distortion.
References
[1]
Hojgard, S. Antibiotic resistance–why is the problem so difficult to solve? Infect. Ecol. Epidemiol. 2012, doi:10.3402/iee.v2i0.18165.
[2]
Alanis, A.J. Resistance to antibiotics: Are we in the post-antibiotic era? Arch. Med. Res. 2005, 36, 697–705, doi:10.1016/j.arcmed.2005.06.009.
[3]
Brooks, L.; Shaw, A.; Sharp, D.; Hay, A.D. Towards a better understanding of patients’ perspectives of antibiotic resistance and MRSA: A qualitative study. Fam. Pract. 2008, 25, 341–348, doi:10.1093/fampra/cmn037.
[4]
French, G.L. The continuing crisis in antibiotic resistance. Int. J. Antimicrob. Agents 2010, 36, S3–S7, doi:10.1016/S0924-8579(10)70003-0.
[5]
Gerlich, M.G.; M?ller, A.; Sch?fer, C.; Strohbach, A.K.; Krafczyk-Korth, J.; Hoffmann, W. Epidemiology of multi-resistant organisms—challenges to a regional data management system. GMS Krankenhhyg Interdiszip. 2011, 6, 1–6. (in German).
[6]
World Health Organization. Communicable Disease Surveillance and Response. In Containing Antimicrobial Resistance: Review of the Literature and Report of a WHO Workshop on the Development of a Global Strategy for the Containment of Antimicrobial Resistance; World Health Organization: Geneva, Switzerland, 1999.
Aiello, A.E.; Larson, E. Antibacterial cleaning and hygiene products as an emerging risk factor for antibiotic resistance in the community. Lancet Infect. Dis. 2003, 3, 501–506, doi:10.1016/S1473-3099(03)00723-0.
[9]
McNulty, C.A.; Johnson, A.P. The European Antibiotic Awareness Day. J. Antimicrob. Chemother. 2008, 62, 853–854, doi:10.1093/jac/dkn410.
[10]
Newton, J.T.; Constable, D.; Senior, V. Patients’ perceptions of methicillin-resistant Staphylococcus aureus and source isolation: A qualitative analysis of source-isolated patients. J. Hosp. Infect. 2001, 48, 275–280, doi:10.1053/jhin.2001.1019.
[11]
McNulty, C.A.; Boyle, P.; Nichols, T.; Clappison, P.; Davey, P. Don’t wear me out—the public’s knowledge of and attitudes to antibiotic use. J. Antimicrob. Chemother. 2007, 59, 727–738, doi:10.1093/jac/dkl558.
[12]
Wilson, R.P.; Hatcher, J.; Barton, S.; Walley, T. The association of some practice characteristics with antibiotic prescribing. Pharmacoepidem. Dr. S. 1999, 8, 15–21, doi:10.1002/(SICI)1099-1557(199901/02)8:1<15::AID-PDS386>3.0.CO;2-1.
[13]
Donyai, P. Social and Cognitive Pharmacy: Theory and Case Studies; Pharmaceutical Press: London, UK, 2012.
[14]
Stockley, J.M. European antibiotic awareness day 2010: Why doesn’t promoting antibiotic awareness always work? J. Infect. 2010, 61, 361–363, doi:10.1016/j.jinf.2010.09.003.
[15]
Hawkings, N.J.; Wood, F.; Butler, C.C. Public attitudes towards bacterial resistance: A qualitative study. J. Antimicrob. Chemother. 2007, 59, 1155–1160, doi:10.1093/jac/dkm103.
[16]
Easton, P.M.; Marwick, C.A.; Williams, F.L.; Stringer, K.; McCowan, C.; Davey, P.; Nathwani, D. A survey on public knowledge and perceptions of methicillin-resistant Staphylococcus aureus. J. Antimicrob. Chemother. 2009, 63, 209–214.
[17]
Bucks, R.S.; Hawkins, K.; Skinner, T.C.; Horn, S.; Seddon, P.; Horne, R. Adherence to treatment in adolescents with cystic fibrosis: The role of illness perceptions and treatment beliefs. J. Pediatr. Psychol. 2009, 34, 893–902, doi:10.1093/jpepsy/jsn135.
[18]
Przybylski, M. Health locus of control theory in diabetes: A worthwhile approach in managing diabetic foot ulcers? J. Wound Care 2010, 19, 228–233.
[19]
Audulv, A.; Asplund, K.; Norbergh, K.G. Who’s in charge? The role of responsibility attribution in self-management among people with chronic illness. Patient Educ. Counsel. 2010, 81, 94–100, doi:10.1016/j.pec.2009.12.007.
[20]
Locher, J.L.; Burgio, K.L.; Goode, P.S.; Roth, D.L.; Rodriguez, E. Effects of age and causal attribution to aging on health-related behaviors associated with urinary incontinence in older women. Gerontologist 2002, 42, 515–521, doi:10.1093/geront/42.4.515.
[21]
Runions, S.; Arnaert, A.; Sourial, R. Causal attributions and health behavior choices among stroke and transient ischemic attack survivors. J. Neurosci. Nurs. 2006, 38, 288–295, doi:10.1097/01376517-200609000-00004.
[22]
Washer, P.; Joffe, H.; Solberg, C. Audience readings of media messages about MRSA. J. Hosp. Infect. 2008, 70, 42–47, doi:10.1016/j.jhin.2008.05.013.
[23]
Calloway, C.; Jorgensen, C.M.; Saraiya, M.; Tsui, J. A content analysis of news coverage of the HPV vaccine by US newspapers, January 2002–June 2005. J. Wom. Health 2006, 15, 803–809.
[24]
Carducci, A.; Alfani, S.; Sassi, M.; Cinini, A.; Calamusa, A. Mass media health information: quantitative and qualitative analysis of daily press coverage and its relation with public perceptions. Patient Educ. Counsel. 2011, 82, 475–478, doi:10.1016/j.pec.2010.12.025.
[25]
Matamoros, D.J.; Axelsson, R.; Strid, J. How do newspapers deal with health in Sweden? A descriptive study. Patient Educ. Counsel. 2007, 67, 78–83, doi:10.1016/j.pec.2007.02.003.
[26]
McDonnell, D.D.; Lee, H.J.; Kim, Y.B.; Kazinets, G.; Moskowitz, J.M. Cancer coverage in a mainstream and Korean American online newspaper: lessons for community intervention. Patient Educ. Counsel. 2008, 71, 388–395, doi:10.1016/j.pec.2008.03.004.
[27]
Mizuno, Y.; Narimatsu, H.; Kishi, Y.; Kodama, Y.; Murashige, N.; Yuji, K.; Matsumura, T.; Kami, M. Structural problems of medical news reports in newspapers: A verification of news reports on an incident of mass nosocomial Serratia infection. J. Infect. Chemother. 2010, 16, 107–112, doi:10.1007/s10156-009-0013-4.
[28]
O’Hara, S.K.; Smith, K.C. Presentation of eating disorders in the news media: What are the implications for patient diagnosis and treatment? Patient Educ. Counsel. 2007, 68, 43–51, doi:10.1016/j.pec.2007.04.006.
[29]
Crawford, P.; Brown, B.; Nerlich, B.; Koteyko, N. The ‘moral careers’ of microbes and the rise of the matrons: An analysis of UK national press coverage of methicillin-resistant Staphylococcus aureus (MRSA) 1995–2006. Health Risk Soc. 2008, 10, 331–347, doi:10.1080/13698570802167397.
[30]
Chan, P.; Dipper, A.; Kelsey, P.; Harrison, J. Newspaper reporting of meticillin-resistant Staphylococcus aureus and ‘the dirty hospital’. J. Hosp. Infect. 2010, 75, 318–322, doi:10.1016/j.jhin.2010.01.027.
[31]
Boyce, T.; Murray, E.; Holmes, A. What are the drivers of the UK media coverage of meticillin-resistant Staphylococcus aureus, the inter-relationships and relative influences? J. Hosp. Infect. 2009, 73, 400–407, doi:10.1016/j.jhin.2009.05.022.
[32]
Readership Estimates–Newspapers and Supplements: July 2011–June 2012. Available online: http://www.nrs.co.uk/choose-trends/ (accessed on 15 October 2013).
[33]
Fritz, E. Audience Orientation in News Stories: A Comparison between The Guardian and The Sun; GRIN Verlag OHG: Munich, Germany, 2009.
[34]
Barnes, R.C.; Earnshaw, S. Mental illness in British newspapers: (Or my girlfriend is a rover metro). Psychiatr. Bull. 1993, 17, 673–674, doi:10.1192/pb.17.11.673.
[35]
Newton, J. Mass media effects: Mobilization or media malaise? Br. J. Polit. Sci. 1999, 29, 577–599, doi:10.1017/S0007123499000289.
[36]
Seale, C. Media and Health; Sage Publications Ltd.: London, UK, 2003.
[37]
Donyai, P.; van den Berg, M. Coronary heart disease risk screening: The community pharmacy Healthy Heart Assessment Service. Pharm. World Sci. 2009, 31, 643–647, doi:10.1007/s11096-009-9338-4.
[38]
Van den Berg, M.; Donyai, P. How was patient empowerment portrayed in information leaflets describing the community pharmacy Medicines Use Review service in the UK? Patient Educ. Counsel. 2010, 80, 274–276, doi:10.1016/j.pec.2009.11.013.
[39]
Circulations ABC. Newspaper Circulation Figures, 2013. Available online: http://www.abc.org.uk/ (accessed on 23 August 2013).
[40]
SPSS v.15 Software. SPSS Inc, Chicago, IL, USA, 2006.
[41]
Potter, J.; Wetherell, M. Social Psychology and Discourse: Beyond Attitudes and Behaviour; Sage Publications Ltd.: London, UK, 1987.
[42]
Washer, P.; Joffe, H. The “hospital superbug”: Social representations of MRSA. Soc. Sci. Med. 2006, 63, 2141–2152, doi:10.1016/j.socscimed.2006.05.018.