Distribution and associated factors of psychological dimensions related to antimicrobial resistance countermeasures among hospital staff in Japan: an exploratory cross-sectional study.

BACKGROUND

Research on antimicrobial resistance countermeasures primarily relies on the knowledge-attitude-practice (KAP) framework. However, knowledge gains do not reliably translate into behavioural change, and psychological dimensions beyond knowledge remain insufficiently characterized when considered concurrently within a single population.

OBJECTIVES

To characterize four antimicrobial resistance-related psychological dimensions-risk perception, self-efficacy, sense of responsibility and attitude-among hospital staff and examine how they vary according to occupational and organizational factors.

METHODS

A cross-sectional survey was administered to the entire workforce at a Japanese university hospital in 2025. Psychological dimensions were assessed using a researcher-developed questionnaire. Risk perception was a three-item composite score (range: 3-15), and self-efficacy, sense of responsibility and attitude were each measured using single-item indicators. Multivariate linear regression with HC3 robust standard errors was used for the primary analysis, with occupational category, years of clinical experience, managerial position and infection control committee participation entered as covariates.

RESULTS

In total, 1077 staff members were analysed (response rate: 81.7%). Risk perception was positively associated with years of clinical experience, although this association was not consistent across models. Self-efficacy was lower among non-healthcare workers compared with nurses. Sense of responsibility was consistently lower among physicians, other healthcare workers and non-healthcare staff than in nurses. Attitudes showed no clear associations.

CONCLUSIONS

This study extends previous KAP-based evidence by showing that associated factors vary across dimensions. Occupational differences in sense of responsibility emerged as the most consistent finding and may represent a dimension less amenable to knowledge-based interventions.