Les auteurs tiennent à remercier Clément Sayrin-doctorant au Laboratoire Kastler Brossel-pour son aide au calcul des probabilités associées aux co-occurences des mots dans les premiers rangs.

BackgroundMuch effort has been made over the last two decades to educate and train healthcare professionals working on antimicrobial resistance in French hospitals. However, little has been done in France to assess perceptions, attitudes and knowledge regarding multidrug resistant organisms (MDROs) and, more globally, these have never been evaluated in a large-scale population of medical and non-medical healthcare workers (HCWs). Our aim was to explore awareness among HCWs by evaluating their knowledge of MDROs and the associated control measures, by comparing perceptions between professional categories and by studying the impact of training and health beliefs.MethodsA multicentre cross-sectional study was conducted in 58 randomly selected French healthcare facilities with questionnaires including professional and demographic characteristics, and knowledge and perception of MDRO transmission and control. A knowledge score was calculated and used in a logistic regression analysis to identify factors associated with higher knowledge of MDROs, and the association between knowledge and perception.ResultsBetween June 2014 and March 2016, 8716/11,753 (participation rate, 74%) questionnaires were completed. The mean knowledge score was 4.7/8 (SD: 1.3) and 3.6/8 (SD: 1.4) in medical and non-medical HCWs, respectively. Five variables were positively associated with higher knowledge: working in a university hospital (adjusted odds ratio, 1.41, 95% CI 1.16–1.70); age classes 26–35 years (1.43, 1.23–1.6) and 36–45 years (1.19, 1.01–1.40); medical professional status (3.7, 3.09–4.44), working in an intensive care unit (1.28, 1.06–1.55), and having been trained on control of antimicrobial resistance (1.31, 1.16–1.48). After adjustment for these variables, greater knowledge was significantly associated with four cognitive factors: perceived susceptibility, attitude toward hand hygiene, self-efficacy, and motivation.ConclusionsWe found a low level of MDRO awareness and knowledge of associated control measures among French HCWs. Training on hand hygiene and measures to control MDRO spread may be helpful in shaping beliefs and perceptions on MDRO control among other possible associated factors. Messages should be tailored to professional status and their perception. Other approaches should be designed, with more effective methods of training and cognitive interventions.Trial registrationClinical Trials.gov NCT02265471. Registered 16 October 2014 - Retrospectively registered.

Résumé Cet article a pour objectif de présenter le courant de recherches des représentations sociales dans le domaine de la santé, afin de rendre compte de l’intérêt de ce concept pour comprendre les logiques qui sous-tendent l’adoption de pratiques spécifiques. Dans cette optique, quelques enquêtes portant sur les représentations de la santé et de la maladie, de la folie, du corps, du cancer, de l’hygiène, du sida, de la drogue, seront présentées en mettant l’accent sur l’apport de ce type de recherches pour les sciences humaines et sociales.

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Through metacognitive evaluations, individuals assess their own cognitive operations with respect to their current goals. We have previously shown that non-verbal social cues spontaneously influence these evaluations, even when the cues are unreliable. Here, we explore whether a belief about the reliability of the source can modulate this form of social impact. Participants performed a two-alternative forced choice task that varied in difficulty. The task was followed by a video of a person who was presented as being either competent or incompetent at performing the task. That person provided random feedback to the participant through facial expressions indicating agreement, disagreement or uncertainty. Participants then provided a metacognitive evaluation by rating their confidence in their answer. Results revealed that participants’ confidence was higher following agreements. Interestingly, this effect was merely reduced but not canceled for the incompetent individual, even though participants were able to perceive the individual’s incompetence. Moreover, perceived agreement induced zygomaticus activity, but only when the feedback was provided for difficult trials by the competent individual. This last result strongly suggests that people implicitly appraise the relevance of social feedback with respect to their current goal. Together, our findings suggest that people always integrate social agreement into their metacognitive evaluations, even when epistemic vigilance mechanisms alert them to the risk of being misinformed.