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Table 1 Overview of categories of identified cultural determinants

From: Identification of cultural determinants of antibiotic use cited in primary care in Europe: a mixed research synthesis study of integrated design “Culture is all around us”

Cultural determinant Description References
Patient related determinants
Illness perception/behaviour and health-seeking behaviour Attitudes, knowledge and beliefs towards URTI symptoms (serious or self-limiting, belief in the healing power of the body, fear of complications), initial coping strategies, threshold for consulting a GP, in particular for self-limiting diseases. [18, 21, 24, 25, 27]
Individual experience Previous experience of similar episodes. [27]
Antibiotic awareness Attitudes, knowledge, beliefs and perceptions towards antibiotics (their effectiveness in speeding recovery and preventing complications, their adverse effects, antibiotic resistance). [13, 19, 21, 23, 2527]
Drug perception Perception towards antibiotics and symptomatic medication: scepticism towards medications and fear of toxicity, or considered as accelerators of the healing process with fear of complications if no medicines were used. [24, 27]
Labelling of diagnosis Perception of what is considered as a real symptom and use of labels. [27]
Work ethos Behaviour towards work: continue working in spite of illness or stop working to let the body recover and avoid transmitting infection to others. [13, 27, 28]
Practitioner perception Perception of their practitioner’s competence, trust in the practitioner. [12, 19, 20]
Practitioner related determinants
RTI management Attitudes towards RTI, management, including decision-making. [12, 24, 28]
Initial training Orientation of initial medical training (hospital-centred or outpatient-centred). [28]
Antibiotic awareness Attitudes towards and beliefs concerning antibiotics. [12, 24]
Legal complaints Antibiotic prescription to avoid legal complaints. [28]
Practice context Perceived patients’ expectations, patient education strategies, prescription patterns. [12, 28]