云南省某县内科医师对呼吸系统常见病诊治认知调查

Physicians' Cognition with Diagnosis and Treatment of Common Respiratory Diseases in a County of Yunnan Province

目的评估云南省某县临床医师对呼吸道常见病诊断与治疗的认知水平。方法对六家县级及县级以下医院77名基层临床医师进行问卷调查,了解其对呼吸系统常见疾病社区获得性肺炎(CAP)、慢性咳嗽、支气管哮喘、慢性阻塞性肺疾病(COPD)的认知状况。结果对CAP:71.43%的医师能够正确回答出CAP最常见的病原体;正确了解常用的抗感染治疗方案和诊疗指南者分别占27.27%和25.97%;接受过相关继续教育者占22.08%。对慢性咳嗽:正确了解常见病因和病程者分别占9.09%、24.68%;使用抗生素治疗的比例高达84.42%;所有医师均不了解诊疗指南,也未接受过相关继续教育。对支气管哮喘:无一人具备吸入性糖皮质激素的基本知识;所有医师均不了解诊疗指南;仅有10.39%的医师接受过相关继续教育。对COPD:在诊治过程中检查或建议检查肺功能的医师仅占12.99%;仅10.39%的医师知晓肺功能检查的常用判读指标;无一人了解COPD严重程度分级和诊疗指南;仅10.39%的医师接受过相关继续教育。结论基层临床医师对呼吸系统常见疾病的认知度严重不足,继续教育水平低下,直接影响到医疗质量,应尽快加强和落实继续教育培训与考核体系。

Objective To assess physicians＇ cognition with the diagnosis and treatment of common respiratory diseases in a county of Yunnan province.Methods Questionnaires were distributed to 77 physicians in 6 hospitals at or below the county level to investigate their cognition with common respiratory diseases（community-acquired pneumonia,chronic cough,bronchial asthma and chronic obstructive pulmonary disease）.Results Among the 77 physicians,71.43% correctly answered the questions on the most common pathogens of community-acquired pneumonia,27.27% knew the anti-infection treatment regimen,25.97% had read the therapeutic guidelines,and 22.08% had received the continuing education.For chronic cough,9.09% of the physicians understood the pathogenesis,24.68% knew the duration of disease,and 84.42% prescribed the antibiotics.None of the physicians had read the therapeutic guidelines and received continuing education.For bronchial asthma,10.39% of the physicians had received the continuing education,and none had the basic knowledge of ICS and knew the therapeutic guidelines.For chronic obstructive pulmonary disease,12.99% of the physicians recommended lung function examination to patients,10.39% understood the indicators for lung function tests,10.39% had received the continuing education,and none knew the stages and therapeutic guidelines of chronic obstructive pulmonary disease.Conclusion The lack of knowledge of common respiratory diseases and low levels of continuing education of primary physicians directly decrease the medical care quality.Therefore,continuing education and evaluation system should be strengthened and implemented for primary physicians.