基层医务人员对小儿高热惊厥了解现状调查分析

Situation of Understanding of Febrile Seizures in Primary Healthcare Workers

目的分析基层医务人员对高热惊厥了解情况,并分析其相关原因,为进一步制定培训方案提供参考依据。方法采用横断面调查方法,2012年9—11月在湖南省14个地州市进行儿科急诊适宜技术推广培训,在推广过程中,对参加培训人员进行闭卷考试,包括高热惊厥的概念、症状、诊断、鉴别诊断、并发症、预防及地西泮的使用7个问题,最终收回调查问卷1 095份。结果 1 095名基层医务人员对高热惊厥的鉴别诊断、并发症、预防及地西泮使用的相关知识掌握度较好,分别为69.95%(766/1 095)、66.03%(723/1 095)、42.00%(460/1 095)及48.86%(535/1 095),而对高热惊厥的概念、症状、诊断相关知识掌握度较低,分别为38.81%(425/1 095)、22.65%(248/1 095)、8.58%(94/1 095)。1 095名基层医务人员中,仅387名(35.34%)对高热惊厥相关知识了解。不同年龄、工作年限、文化程度、地区基层医务人员高热惊厥相关知识了解率比较,差异均有统计学意义(P<0.05);不同性别、执业类别、工作类别、技术资格基层医务人员高热惊厥相关知识了解率比较,差异均无统计学意义(P>0.05)。地区与基层医务人员对高热惊厥相关知识了解有回归关系(P<0.05);年龄、工作年限、文化程度未进入回归方程(P>0.05)。结论基层医务人员对高热惊厥相关知识掌握度偏低,而且掌握水平参差不齐,急需高热惊厥相关知识的培训,培训重点应集中在高热惊厥的概念、症状及诊断等方面,培训重点地区为湘南地区。

Objective To investigate the understanding of febrile seizures among primary healthcare workers and the cause of the situation,and to provide reference for the establishment of further training plans. Methods Cross- sectional survey method was used in the study. Training in appropriate technology for pediatric emergency was carried out in 14 cities and autonomous prefectures in Hunan province from September to November in 2012. Closed book examination was held for the participants of the training,and questions like the concept of febrile seizure,its symptoms,diagnosis,differential diagnosis,complications, prevention and use of diazepam were included in the examination. A total of 1 095 questionnaires were returned. Results The 1 095 primary healthcare workers had a fairly good understanding of the differential diagnosis,complications and prevention of febrile seizures as well as the use of diazepam,being 69. 95%（ 766 /1 095）,66. 03%（ 723/1 095）,42. 00%（ 460 /1 095） and 48. 86%（ 535 /1 095）, respectively. However, the primary healthcare workers had a worse understanding of the concept,symptoms and diagnosis of febrile seizures,being 38. 81%（ 425 /1 095）,22. 65%（ 248/1 095） and 8. 58%（ 94 /1 095）,respectively. Of the 1 095 primary healthcare workers,only 387（ 35. 34%） understood well the febrile seizures. Primary healthcare workers with different age, years of working, education and districts had significantly different understanding of febrile seizures（ P〈0. 05）; primary healthcare workers with different sex,practice category, job category and technical qualification showed no significant differences in the understanding of febrile seizures（ P〉0. 05）. There was a regression relationship between districts and the understanding of febrile seizures among the primary healthcare workers（ P〈0. 05）. Age,years of working and education did not enter into the regression equation（ P〉0. 05）. Conclusion The primary healthcare workers know little about febrile seizures,and the understanding levels are varied. Training in febrile seizures is in dire need,and the focus should be on the concept, symptoms and diagnosis of febrile seizures and on southern Hunan province.