摘要
目的探索指南临床适用性的影响因素,为更好地制订、实施指南提供建议。方法计算机检索CNKI数据库,搜集2015—2020年由中华医学会、中国医师协会发布的临床指南。随机抽取61部,每部指南均由来自东、中、西部的医务人员采用指南临床适用性评价工具(2.0版)共同评价。对统计资料进行描述,组间比较采用t检验或秩和检验或卡方检验;采用逐步Logistic回归筛选指南临床适用性各领域和总体标准化评分的影响因素。结果回收有效问卷6904份,涵盖26省119家医疗机构。调查对象越熟悉指南、指南推荐意见与患者及家属意愿越相符,指南临床适用性的总体标准化评分越高。此外,调查对象越熟悉指南,各领域标准化评分越高;医疗机构越重视指南的依从性,可行性标准化评分越高。结论为改善指南临床适用性,指南制订者应重视推荐意见是否符合患者及家属的意愿,医疗机构应重视医务人员对指南的依从性,同时医务人员应熟悉指南推荐意见。
Objective To explore impact factors related to the clinical applicability of guidelines,and provide suggestions for better development and implementation of guidelines.Methods The CNKI database was electronically searched to collect clinical guidelines issued by the Chinese Medical Association and the Chinese Medical Doctor Association from 2015 to 2020.Sixty-one guidelines were randomly selected from included guidelines and each guideline was evaluated by medical staff from three regions using the instrument for evaluating clinical applicability of guidelines(version 2.0).Statistical data were described,and t-test or rank sum test or chi-square test were used for comparison between groups.The impact factors were screened by stepwise logistic regression analysis.Results A total of 6904 valid questionnaires were collected from 119 medical institutions in 26 provinces of China.The more familiar with the guidelines and the more consistent with the wishes of patients or their families,the overall standardized score of the clinical applicability of guidelines would be higher.In addition,the more familiar with the guidelines,the standardized scores in each field would be higher.The higher emphasis on guidelines compliance,the higher the feasibility standardized score.Conclusion In order to improve the clinical applicability of guidelines,developers should pay attention to whether the recommendations are consistent with the wishes of patients or their families.Then,medical institutions should pay attention to the compliance of guidelines.Finally,medical personnel should be familiar with the recommendations.
作者
刁莎
刘峥
石雨晴
李思雨
曾力楠
易秋莎
李海龙
许慧中
王锡雄
黄修森
杨稀策
黄超
王强
张伶俐
DIAO Sha;LIU Zheng;SHI Yuqing;LI Siyu;ZENG Linan;YI Qiusha;LI Hailong;XU Huizhong;WANG Xixiong;HUANG Xiusen;YANG Xice;HUANG Chao;WANG Qiang;ZHANG Lingli(Department of Pharmacy,West China Second University Hospital,Sichuan University,Chengdu 610041,P.R.China;Evidence-based Pharmacy Center,West China Second University Hospital,Sichuan University,Chengdu 610041,P.R.China;NMPA Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation,Chengdu 610041,P.R.China;Key Laboratory of Birth Defects and Related Diseases of Women and Children,Ministry of Education,Chengdu 610041,P.R.China;West China School of Medicine,Sichuan University,Chengdu 610041,P.R.China;West China School of Pharmacy,Sichuan University,Chengdu 610041,P.R.China;Dongtai People's Hospital,Yancheng 224200,P.R.China;The First People's Hospital of Qinzhou,Qinzhou 535099,P.R.China;West China Hospital,Sichuan University,Chengdu 610041,P.R.China;Medical Management Service Guidance Center,National Health Commission of the People’s Republic of China,Beijing 100044,P.R.China;Chinese Evidence-based Medicine Center,West China Hospital,Sichuan University,Chengdu 610041,P.R.China)
出处
《中国循证医学杂志》
CSCD
北大核心
2024年第1期29-35,共7页
Chinese Journal of Evidence-based Medicine
基金
国家卫健委医管中心委托项目(编号:医管中心标准管理处[2020]054号)。
关键词
指南
临床适用性
影响因素
横断面研究
Guidelines
Clinical applicability
Impact factors
Cross-sectional study
