摘要
采用简单随机抽样法抽取北京市石景山区、门头沟区、海淀区、朝阳区、丰台区、东城区部分社区卫生站的全科医生进行慢性创面疾病知识笔试，以及慢性创面医疗服务的现状、开展动机、影响因素和教学需求的问卷调查。共调查204名医生，其中笔试考试结果55名（27．0％）医生总分成绩良好，98名（48．0％）医生达合格，有51名（25．0％）医生不合格。服务现状调查有179名（87．7％）表示开展了门诊换药，但仅36．8％可提供专科门诊服务，17．6％可进行外科清创，仅10名（4．9％）表示开展了家庭换药，2名（0．9％）开展长期随访。动机调查中所有医生（100．0％）都认为为患者排忧解难、赢得患者信任是开展慢性创面家庭治疗的动机；但医院不支持（91．7％）、为非社区医疗机构常规项目（86．8％）、潜在的医疗风险（87．3％）、工作繁忙无时间（82．8％）、诊治的知识技能不足（80．9％）等是阻碍医生开展慢性创面家庭治疗的主要因素。培训需求调查表明大部分医生需要涵盖基础知识（90．1％）、病例分析（86．8％）、操作视频（92．6％）的讲座培训；与高级职称医师相比（56．7％），中初级医师（97．1％）选择到上级医院创面专科进修的比例更高。提示，社区医疗机构开展慢性创面疾病诊治管理业务存在阻碍因素。社区全科医生对慢性创面相关知识和技能掌握程度较低，但已认识到开展慢性创面疾病管理的必要性。应针对医生的不同需求开展相关专科培训。
General practitioners from community health service institutions in Shijingshan, Mentougou, Haidian, Chaoyang, Fengtai and Dongcheng Districts of Beijing were selected to take the examination of chronic wounds management. Questionnaire survey was also performed on the status of community chronic wounds management, medical service motivation, influencing factors and their demand for training. Among 204 general practitioners, 55 （ 27.0% ） had mastered basic knowledge, 98 （ 48.0% ） passed the examination and 51 （ 25.0% ） failed. The results showed that 179 （ 87.7% ） had changing dressing service, 36.8% offered out-patient consulting service, 17.6% performed surgical debridement, only 10 （4.9%） provided home chronic wounds care service and 2 （0.9%） of them carried out long-term follow-up. According to the motivation survey, all the practitioners expressed the willingness to help the patients and win their trust. Most of the practitioners claimed no supporting from their institutions（91.7% ） and chronic wounds management was excluded from daily routine. Furthermore, heavy work load（ 82.8% ） and lack of professional knowledge（ 80.9% ）were also considered to be main obstructive factors. The survey showed that the majority of physicians required classroom teaching （90. 1% ）, case analysis （86.8%）, operating video （92.6%） and other teaching forms. More low level doctors （97. 1% ）had the desire to pursue further specialist training than higher level physicians （56.7%）. The results of our investigation indicate that general practitioners in community health service institutions have strong learning motivation for chronic wounds management and systematic training of knowledge and practical skills in this field should be provided.
出处
《中华全科医师杂志》
2015年第12期947-950,共4页
Chinese Journal of General Practitioners
关键词
社区卫生服务
问卷调查
慢性创面
Community health services
Questionnaires
Chronic wounds
