辽宁省六市(县)乡村医生高血压治疗评估能力的调查研究

Evaluation Capability of Hypertension Treatment by Rural Doctors from Six Counties of Liaoning Province

目的了解辽宁省乡村医生高血压治疗评估的能力,为防治高血压提供依据。方法 2008年9—11月对6个示范市(县)626个村的乡村医生基本情况进行调查。每位医生对本村接受高血压管理患者的治疗情况进行评估,计算每项问题的评估正确率及总及格率,并采用Logistic回归进行单因素及多因素分析。结果应答率为79.87%,共有乡村医生500人。在血压是否达标、血压未达标者血压分级、目前用药是否正确、是否联合用药或者服用复方降压药、用药剂量是否正确、用药频次是否正确、是否规律服药方面乡村医生的评估正确率分别为:84.80%(424/500)、83.00%(415/500)、40.40%(202/500)、54.80%(274/500)、48.80%(244/500)、38.40%(192/500)、53.60%(268/500),总及格率为65.80%(329/500)。单因素分析显示,男性、行医方式为中西医结合、对"适宜技术推广"不知晓的乡村医生总及格率高。多因素分析结果有四个因素纳入方程:中专或高中学历、中西医结合行医方式、女性和不知晓"适宜技术推广"。结论乡村医生高血压治疗评估能力较差,应针对重点问题、重点人群加强对乡村医生高血压相关知识的培训。

Objective To learn the evaluation capability of hypertension treatment by rural doctors so as to provide basis for prevention and control of hypertension. Methods The basic conditions of rural doctors from 626 villages of six cities/counties in Liaoning Province were investigated by using questionnaire survey between September and November 2008. The treatment conditions of patients by their own rural doctors were assessed, calculating the rate of accuracy per question and total pass rate. And then both univariate and multivariate analysis with Logistic regression were used statistically. Results Totally 500 rural doctors were surveyed, with an answer rate of 79.87%. The accuracy rates of evaluation on whether the blood pressure reached the standard, grade classification of blood pressure for those failed to reach the standard, whether the medication was correct, whether the medication was in combination of drugs or compound antihypertensives, whether the dosage was correct, whether the frequency of medication was correct, and whether the medication was regular were 84. 80% , 83.00% , 40. 40%, 54. 80% , 48. 80% , 38.40% , and 53.60% , respectively. The total pass rate was 65.80%. The univariate analysis showed that the total pass rate of males, doctors in combination of traditional Chinese and Western medicine or who did not know the ＂ appropriate technologies extension＂ was higher, and the multivariate analysis showed that four factors could get into the equation： high mid- dle school education, medical care in combination of traditional Chinese and Western medicine, females, and doctors who did not know the ＂ appropriate technologies extension＂ . Conclusion It is necessary to enhance the training on hypertension - related knowledge for rural doctors, aiming at the urgent issues and focusing on the key population.