陕西省乡镇卫生院全科医生对抗生素使用的知识-态度-行为研究

On General Practitioner's Knowledge, Attitudes and Practice Concerning Antibiotics Use at Township Hospitals in Shaanxi Province

目的:调查乡镇卫生院全科医生对抗生素的用药知识、态度和行为现状,为规范临床抗生素合理使用提供理论依据。方法:采用自行设计的"全科医生对抗生素合理使用的知识—态度—行为"问卷,于2016年3月到6月期间对陕西省乡镇卫生院全科医生进行问卷调查。问卷包括个人信息、知识、态度和行为4个部分。结果:共发放问卷250份,得到有效问卷234份,有效回收率93.6%。受访者对抗生素相关知识得分的中位数为6(6-7),获得相关知识的主要途径是教材和培训,不同性别受访者对抗生素的认知水平存在统计学差异;受访者对抗生素用药的总体态度和行为得分分别为31.71±3.93和26.97±3.17;抗生素相关知识与态度、态度与行为的相关系数分别为0.139和0.146(p<0.05)。结论:全科医生对抗生素相关专业知识掌握不够牢固,存在滥用倾向,有超过1/3的全科医生会经常经验性地使用抗生素。建议政府继续加大对乡镇卫生院的卫生资源投入和配置;加强对社区医生,尤其是全科医生抗生素用药的岗位培训和继续教育。

Objective:To investigate the knowledge,attitudes and behaviors of general practitioners at township hospitals towards antibiotics use,and to provide references for health education about rational use of antibiotics.Methods:Self-designed knowledge-attitude-practice questionnaires were conducted among general practitioners in township hospitals of Shaanxi Province,China,from March to June 2016.Results:A total of 250 questionnaires were distributed,and 234 valid questionnaires were collected,and the effective response rate was 93.6%.The median knowledge score of the participants was 6(IQR:6-7).The main ways to obtain knowledge were via teaching materials and training.The cognitive level was significantly different between different genders of respondents.The overall attitudes and behavior scores of respondents were 31.71±3.93 and 26.97±3.17,respectively.Positive correlation was noted between respondents'antibiotic knowledge score and their attitude score (p<0.05),as well as attitude score and practice score (p<0.05).Conclusion:General practitioners at township hospitals have appropriate knowledgeabout the use of antibiotics,but the professional knowledge is not strong enough and over one third of general practitioners have tendency of prescribing antibiotics..The government should continue to increase the investment in community hospitals and strengthen the training of community physicians,especially general practitioners concerning antibiotics use.