摘要
目的了解上海市嘉定区社区卫生服务中心全科医生对慢性阻塞性肺疾病(COPD)的认知情况,为COPD的防治工作提供依据。方法采用问卷调查形式对上海市嘉定区13家社区卫生服务中心的全科医生进行调查。问卷主要针对COPD诊断标准、稳定期、急性加重期的处理及肺康复治疗等设计,共计18个问题,采用百分制。结果回收有效问卷334份,平均得分45.86分,最高88.89分,最低5.56分,高级职称医生平均分较中、初级更高;60.8%(203/334)的医生能准确掌握COPD的诊断标准,32.3%(108/334)了解COPD的鉴别诊断,38.3%(128/334)知晓COPD急性加重的表现;药物选择及使用相关问题中,21.6%(72/334)的医生选择了“噻托溴铵可以口服”的错误选项,48.2%(161/334)可将噻托溴铵正确归类,ICS使用方法正确率仅为18.3%(61/334);对综合评估为D组的患者药物选用正确率为23.7%(79/334)。52.4%(175/334)的医生知晓长期氧疗的目的、效果评价指标,但仅有33.5%(112/334)掌握长期氧疗应用的血氧饱和度指征、35.3%(118/334)知晓氧疗时长。71.9%(240/334)的医生对COPD肺康复的主要内容了解,常用的腹式呼吸正确方法有61.7%(206/334)掌握,对于具体适合的运动项目、需要锻炼的肌肉,总体正确率分别为30.8%(103/334)、39.8%(133/334)。以上所有问题,三级职称医生间比较无统计学差异。针对综合评估为B组的患者药物选用的问题中高级职称医生正确率较初级有差异(p=0.005),但全体医生的正确率仅为18.6%(62/334)。结论嘉定区全科医生对COPD的诊治认知、管理水平仍需进一步加强,分级诊疗模式亟待有效推广及应用。
Objective To investigate the awareness level of general doctors about chronic obstructive pulmonary disease(COPD)in Jiading District,and to provide a basis for the prevention and treatment of COPD.Methods A questionnaire survey was conducted by the general doctors from 13 community health service centers in Jiading District,Shanghai.The questionnaire included 18 questions mainly designed for the diagnosis and treatment in stable and acute exacerbation periods and pulmonary rehabilitation treatment of COPD.The full score was 100 points.Results Totally 334 valid questionnaires were collected,with an average score of 45.86 points,a maximum score of 88.89 points and a minimum score of 5.56 points.The average grade of doctors with senior titles was higher than that of middle and junior ones.Nearly 60.8%(203/334)of doctors got good knowledge relevant to the diagnostic criteria of COPD.Approximately 32.3%(108/334)understood the differential diagnosis of COPD.About 38.3%(128/334)knew the performance of acute exacerbations of COPD.Among the issues related to medicine selection and use,21.6%(72/334)of the doctors chose the wrong option for"Tiotropium bromide can be taken orally".About 48.2%(161/334)could correctly classify tiotropium bromide.The correct rate of"ICS usage"question was only 18.3%(61/334)while the rate of medicine selection for patients with comprehensive assessment of the group D was 23.7%(79/334).There were 52.4%(175/334)of doctors who knew the purpose and effect evaluation indicators of long-term oxygen therapy.However,only 33.5%(112/334)knew the blood oxygenation indication,and 35.3%(118/334)knew the duration of oxygen therapy.Meanwhile,71.9%(240/334)of doctors understood the main content of COPD pulmonary rehabilitation.For correct methods of the commonly used abdominal breathing,specific sports and muscles that needed to be exercised,the overall correct rates were 61.7%(206/334),30.8%(103/334)and 39.8%(133/334),respectively.For all the above questions,there was no statistical difference among the three titles of doctors.For the patients with comprehensive evaluation of the medicine selection in the group B,the correct rate of the senior title doctors was different from the primary ones(P=0.005),but the correct rate of all doctors was only 18.6%(62/334).Conclusion The general doctors in Jiading District need to strengthen the awareness and management of COPD,and the hierarchical diagnosis and treatment mode needs to be effectively promoted and applied.
作者
王艺蕾
屠春林
万晓峰
许奋耀
陆秋霞
WANG Yi-lei;TU Chun-lin;WAN Xiao-feng;XU Fen-yao;LU Qiu-xia(Department of Respiratory Medicine,Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences,Shanghai201800,China;Jiading Town Street Community Health Service Center of Shanghai Jiading District,Shanghai 201899,China)
出处
《临床肺科杂志》
2019年第10期1775-1780,共6页
Journal of Clinical Pulmonary Medicine
基金
上海市嘉定区重点学科建设项目(No JDYXZDZK-4)
关键词
慢性阻塞性肺疾病
认知水平
全科医生
分级诊疗
chronic obstructive pulmonary disease
awareness level
general doctors
hierarchical diagnosis and treatment
