摘要
目的了解北京地区医生对痛风的认知现状,以便为其提供更有针对性的继续教育,提高痛风管理水平。方法对北京9个城区298名参加《高尿酸血症社区管理规范》推广项目的医生进行现场痛风知识问卷调查,同时收集答卷者的个人资料、近一年接受痛风和高尿酸血症继续教育次数等。采用单因素分析和多因素logistic回归分析影响痛风认知现状的因素。结果共发放调查问卷298份,收回298份,最终符合标准的问卷250份。127名(50.8%)医生来自社区卫生服务中心(以下简称社区医生),123名(49.2%)医生来自三级医院。97.6%(124/127)的社区医生和96.7%(119/123)的三级医院医生选择高尿酸血症是痛风发病的基础原因(P=0.670)。81.7%(103/126)的社区医生和82.1%(101/123)的三级医院医生选择单关节肿痛作为痛风急性期的典型表现。75.4%(95/126)的社区医生和74.6%(91/122)的三级医院医生选择单钠尿酸盐结晶沉积作为痛风性关节炎的病理学机制。而在治疗无合并症的急性痛风性关节炎时,45.5%(56/123)的社区医生和57.4%(66/115)的三级医院医生选择非甾体抗炎药止痛治疗(P=0.067),仍有28.5%(35/123)的社区医生和27.8%(32/115)的三级医院医生选择在急性期加用别嘌醇;在降血尿酸治疗时,46.3%(57/123)的社区医生和32.2%(38/118)的三级医院医生认为秋水仙碱具有降尿酸作用,仅有42.3%(52/123)和53.4%(63/118)的医生选择别嘌醇(P=0.084);关于降尿酸治疗时间,只有40.5%(51/126)的社区医生和57.6%(68/118)的三级医院医生认为应长期治疗(P=0.007)。单因素分析发现,继续教育是影响痛风诊疗规范知晓的因素。结论目前社区医生对痛风的基本概念了解程度较高,但在诊疗规范方面尚有不足,未来应加强痛风治疗方面的继续教育和实践指导。
Objective To provide helpful continued medical education (CME) for physicians and improve gout treatment, we conducted a questionnaire survey to investigate physicians′ knowledge in nine districts of Beijing. Methods A questionnaire survey including ten gout-related questions was conducted among 298 physicians in Beijing. Demographic data and previous gout CME experience were collected. Chi-square test or Student′s t test, univariate analysis and logistic regression analysis were used to evaluate the relevant factors of physicians′ knowledge level. Results A total of 250 valid copies were collected including 127 from community service centers (CSC), 123 from tertiary hospitals. The correct answer rate of gout etiology, pathogenesis and attack symptoms were over 70% in both groups. 45.5%(56/123) CSC doctors and 57.4%(66/115) tertiary doctors answered right drugs to control acute gout attack (P=0.067). Only 42.3%(52/123) in CSC and 53.4%(63/118) in hospitals chose allopurinol as a urate-lowering drug (ULT), while 46.3%(57/123) and 32.2%(38/118) doctors considered colchicine as a ULT drug (P=0.084) respectively. Near half doctors considered that gout patients should take long-term ULT [40.5%(51/126) vs. 57.6%(68/118)respectively, P=0.007]. Univariate analysis showed that CME training could improve gout-related knowledge in CRC doctors. Conclusion Most CSC doctors generally understand basic knowledge of gout, while confusion of treatment is still significant. CME especially including standard gout treatment should be performed by doctors in tertiary hospitals.
作者
熊洋洋
李晨
张昀
沙悦
方卫纲
曾学军
Xiong Yangyang;Li Chen;Zhang Yun;Sha Yue;Fang Weigang;Zeng Xuejun(Department of General Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China)
出处
《中华内科杂志》
CAS
CSCD
北大核心
2019年第4期288-293,共6页
Chinese Journal of Internal Medicine
基金
北京市卫生科技成果和适宜技术推广项目(TG-2015-16).
关键词
痛风
医生
问卷调查
Gout
Physicians
questionnaire
