摘要
目的调查社区医院、二级医院、三级医院非肾脏病科临床医生对慢性肾脏病的概念、临床表现、诊断方法、治疗原则、可逆因素、用药注意事项的知晓情况,为探索慢性肾脏病管理模式提供帮助。方法对北京市12家社区医院、10家二级医院、8家三级医院的共304名非肾脏病科临床医生进行问卷调查,从慢性肾脏病的概念与分期、诊断、防治、加重因素和可逆因素四个方面进行调查,答对80%以上为知晓,答对40-80%为部分知晓,答对40%以下为不知晓,数据进行统计分析。结果社区医院全科医生完成问卷97份,慢性肾脏病的概念与分期,知晓25%,部分知晓47%,不知晓28%;慢性肾脏病的诊断,知晓22%,部分知晓43%,不知晓35%;慢性肾脏病的防治,知晓20%,部分知晓45%,不知晓35%;慢性肾脏病的加重因素与可逆因素,知晓17%,部分知晓43%,不知晓40%。二级医院非肾脏病科临床医生完成问卷98份,慢性肾脏病的概念与分期,知晓38%,部分知晓51%,不知晓11%;慢性肾脏病的诊断,知晓25%,部分知晓43%,不知晓32%;慢性肾脏病的防治,知晓22%,部分知晓46%,不知晓32%;慢性肾脏病的加重因素与可逆因素,知晓16%,部分知晓47%,不知晓37%。三级医院非肾脏病科临床医生完成问卷109份,慢性肾脏病的概念与分期,知晓39%,部分知晓50%,不知晓11%;慢性肾脏病的诊断,知晓25%,部分知晓46%,不知晓29%;慢性肾脏病的防治,知晓25%,部分知晓48%,不知晓27%;慢性肾脏病的加重因素与可逆因素,知晓16%,部分知晓51%,不知晓33%。对于慢性肾脏病的概念与分期,二级医院非肾脏病科临床医生较社区医院全科医生知晓率高,χ~2=9.669,P=0.008,差异有统计学意义;三级医院非肾脏病科临床医生较社区医院全科医生知晓率高,χ~2=10.818,P=0.004,差异有统计学意义;二级医院非肾脏病科临床医生与三级医院非肾脏病科临床医生比较无显著差异。对于慢性肾脏病的诊断、防治、加重因素和可逆因素,各组间比较无显著差异。结论对于慢性肾脏病的概念与分期,二级医院和三级医院非肾脏病科临床医生的知晓率不高,社区医院全科医生的知晓率更低,对慢性肾脏病的防治、加重因素和可逆因素的知晓率就更低,不利于患者慢性肾脏病的防治和延缓病情进展,因此应加强慢性肾脏病知识的普及。
Objective To investigate the awareness of chronic kidney disease （CKD） including the knowledge of concept, clinical manifestation, diagnosis, therapeutic principle, reversible factors and medication in order to help us explore the management mode for CKD. Methods Questionnaire survey was carried out among 304 doctors of non-nephro[ogists in 12 community hospitals, 10 second-class hospitals and 8 third-class hospitals. The questionnaire survey about CKD included 4 pans： concept and classification, diagnosis, prevention and cure, and aggravation and reversible factors. The awareness of the doctors was classified as ＂awareness＂ （more than 80% of the answers were correct）, ＂partial awareness＂ （40-80% of the answers were correct）, and ＂no awareness＂ （〈40% of the answers were correct）. Data were analyzed using the SPSS software. Results Ninety-seven doctors in community hospitals completed the questionnaire survey; for concept and classification of CKD： 25% awareness, 47% partial awareness, and 28% no awareness; for diagnosis of CKD： 22% awareness, 43% partial awareness, and 35% no awareness; for prevention and cure of CKD： 20% awareness, 45% partial awareness, and 35% no awareness; for aggravation and reversible factors of CKD： 17% awareness, 43% partial awareness, and 40% no awareness. Ninety-eight doctors in the second-class hospitals completed the questionnaire survey; for concept and classification of CKD： 38% awareness, 51% partial awareness, and 11% no awareness; for diagnosis of CKD： 25% awareness, 43% partial awareness, and 32% no awareness; for prevention and cure of CKD： 22% awareness, 46% partial awareness, and 32% no awareness; for aggravation and reversible factors of CKD： 16% awareness, 47% partial awareness, and 37% no awareness. One hundred and nine doctors in the third-class hospitals completed the questionnaire survey; for concept and classification of CKD： 39% awareness, 50% partial awareness, and 11% no awareness; for diagnosis of CKD： 25% awareness, 46% partial awareness, and 29% no awareness; for prevention and cure of CKD： 25% awareness, 48% partial awareness, and 27% no awareness; for aggravation and reversible factors of CKD： 16% awareness, 51% partial awareness, and 33% no awareness. The awareness rate about the concept and classification of CKD was significantly higher in the doctors of non-nephrologists working in the second-class hospitals and the third-class hospitals than those working in community hospitals （X2=9.669, P=0.008, X2=10.818, P=0.004）. Conclusion The awareness rate about CKD concept and classification was lower among doctors of non-nephrologists working in all levels of hospitals. Thos situation is unfavorable to the prevention, treatment, and interruption of disease progression for CKD patients. Therefore, more efforts should be conducted to increase the awareness of CKD in doctors.
出处
《中国血液净化》
2017年第2期100-103,共4页
Chinese Journal of Blood Purification
基金
北京市科委2013年重大课题项目"延缓慢性肾脏病进展的中西医综合策略研究"课题编号D131100004713002的资助
关键词
慢性肾脏病
知晓率
Chronic kidney disease
Awareness rate
