期刊文献+

Medical training fails to prepare providers to care for patients with chronic hepatitis B infection 被引量:2

Medical training fails to prepare providers to care for patients with chronic hepatitis B infection
下载PDF
导出
摘要 AIM: To investigate physicians' knowledge including chronic hepatitis B(CHB) diagnosis, screening, and management in various stages of their training.METHODS: A voluntary 20-question survey was administered in Santa Clara County, CA where Asian and Pacific Islanders(API) account for a third of the population. Among the 219 physician participants,there were 63 interns, 60 second-year residents, 26 chief residents and 70 attending physicians. The survey asked questions regarding respondents' demographics,general hepatitis B virus knowledge questions(i.e.,transmission, prevalence, diagnostic testing, prevention,and treatment options), as well as, self-reported practice behavior and confidence in knowledge.RESULTS: Knowledge about screening and managing patients with CHB was poor: only 24% identified the correct tests to screen for CHB, 13% knew the next steps for patients testing positive for CHB, 18% knew the high prevalence rate among API, and 31% knew how to screen for liver cancer. Wald chi-square analysis determined the effect of training level on knowledge; in all cases except for knowledge of liver cancer screening(p = 0.0032), knowledge did not significantly increase with length in residency training or completion of residency.CONCLUSION: Even in a high-risk region, both medical school and residency training have not adequatelyprepared physicians in the screening and management of CHB. AIM: To investigate physicians' knowledge including chronic hepatitis B(CHB) diagnosis, screening, and management in various stages of their training.METHODS: A voluntary 20-question survey was administered in Santa Clara County, CA where Asian and Pacific Islanders(API) account for a third of the population. Among the 219 physician participants,there were 63 interns, 60 second-year residents, 26 chief residents and 70 attending physicians. The survey asked questions regarding respondents' demographics,general hepatitis B virus knowledge questions(i.e.,transmission, prevalence, diagnostic testing, prevention,and treatment options), as well as, self-reported practice behavior and confidence in knowledge.RESULTS: Knowledge about screening and managing patients with CHB was poor: only 24% identified the correct tests to screen for CHB, 13% knew the next steps for patients testing positive for CHB, 18% knew the high prevalence rate among API, and 31% knew how to screen for liver cancer. Wald chi-square analysis determined the effect of training level on knowledge; in all cases except for knowledge of liver cancer screening(p = 0.0032), knowledge did not significantly increase with length in residency training or completion of residency.CONCLUSION: Even in a high-risk region, both medical school and residency training have not adequatelyprepared physicians in the screening and management of CHB.
出处 《World Journal of Gastroenterology》 SCIE CAS 2015年第22期6914-6923,共10页 世界胃肠病学杂志(英文版)
关键词 LIVER cancer HEPATITIS B ASIAN PacificIslander LIVER disease Health DISPARITY Liver cancer Hepatitis B Asian Pacific Islander Liver disease Health disparity
  • 相关文献

参考文献36

  • 1World Health Organization Hepatitis B fact sheet. Updated June 2014. Available from: URL: http://www.who.int/mediacenter/factsheets/fs204/en/.
  • 2Ott JJ, Stevens GA, Groeger J, Wiersma ST. Global epidemiologyof hepatitis B virus infection: new estimates of age-specific HBsAgseroprevalence and endemicity. Vaccine 2012; 30: 2212-2219[PMID: 22273662 DOI: 10.1016/j.vaccine.2011.12.116].
  • 3Lavanchy D. Worldwide epidemiology of HBV infection, diseaseburden, and vaccine prevention. J Clin Virol 2005; 34 Suppl 1:S1-S3 [PMID: 16461208].
  • 4Kowdley KV, Wang CC, Welch S, Roberts H, Brosgart CL.Prevalence of chronic hepatitis B among foreign-born personsliving in the United States by country of origin. Hepatology 2012;56: 422-433 [PMID: 22105832 DOI: 10.1002/hep.24804].
  • 5Chang ET, So SK. Re: "Ten largest racial and ethnic healthdisparities in the United States based on Healthy People 2010objectives". Am J Epidemiol 2007; 166: 1105-1106; author reply1106-1107 [PMID: 17881381].
  • 6Institute of Medicine (US) Committee on the Prevention andControl of Viral Hepatitis Infection; Colvin HM, MitchellAE, editors. Hepatitis and Liver Cancer: A National Strategy forPrevention and Control of Hepatitis B and C. Washington (DC):National Academies Press (US), 2010 [PMID: 25032367].
  • 7Weinbaum CM, Williams I, Mast EE, Wang SA, Finelli L, WasleyA, Neitzel SM, Ward JW. Recommendations for identification andpublic health management of persons with chronic hepatitis B virusinfection. MMWR Recomm Rep 2008; 57: 1-20 [PMID: 18802412].
  • 8LeFevre ML. Screening for hepatitis B virus infection innonpregnant adolescents and adults: U.S. Preventive Services TaskForce recommendation statement. Ann Intern Med 2014; 161:58-66 [PMID: 24863637 DOI: 10.7326/M14-1018].
  • 9Hutton DW, Tan D, So SK, Brandeau ML. Cost-effectivenessof screening and vaccinating Asian and Pacific Islander adultsfor hepatitis B. Ann Intern Med 2007; 147: 460-469 [PMID:17909207].
  • 10Chu D, Yang JD, Lok AS, Tran T, Martins EB, Fagan E, RousseauF, Kim WR. Hepatitis B screening and vaccination practices inasian american primary care. Gut Liver 2013; 7: 450-457 [PMID:23898386 DOI: 10.5009/gnl.2013.7.4.450].

同被引文献59

  • 1Marija Zeremski,Jon E Zibbell,Anthony D Martinez,Steven Kritz,Bryce D Smith,Andrew H Talal.Hepatitis C virus control among persons who inject drugs requires overcoming barriers to care[J].World Journal of Gastroenterology,2013,19(44):7846-7851. 被引量:1
  • 2Hashem B. El-Serag.Epidemiology of Viral Hepatitis and Hepatocellular Carcinoma[J]. Gastroenterology . 2012 (6)
  • 3Hashem B. El-serag,Thomas Tran,James E. Everhart.Diabetes increases the risk of chronic liver disease and hepatocellular carcinoma[J].Gastroenterology.2004(2)
  • 4El-Serag HB.Hepatocellular carcinoma. The New England Journal of Medicine . 2011
  • 5Schütte K,Schulz C,Poranzke J,et al.Characterization and prognosis of patients with hepatocellular carcinoma (HCC)in the non-cirrhotic liver. BMC Gastroenterology . 2014
  • 6Smith Benjamin D,Smith Grace L,Hurria Arti,Hortobagyi Gabriel N,Buchholz Thomas A.Future of cancer incidence in the United States: burdens upon an aging, changing nation. Journal of clinical oncology : official journal of the American Society of Clinical Oncology . 2009
  • 7Jacques Ferlay,Isabelle Soerjomataram,Rajesh Dikshit,Sultan Eser,Colin Mathers,Marise Rebelo,Donald Maxwell Parkin,David Forman,Freddie Bray.SJWD14121600000297[J]. Int. J. Cancer . 2015 (5)
  • 8H.Kuper,H.‐O.Adami,D.Trichopoulos.??Infections as a major preventable cause of human cancer(J)Journal of Internal Medicine . 2001 (3)
  • 9Basile Njei,Yaron Rotman,Ivo Ditah,Joseph K. Lim.??Emerging trends in hepatocellular carcinoma incidence and mortality(J)Hepatology . 2015 (1)
  • 10Hashem B. El–Serag,Howard Hampel,Fariba Javadi.??The Association Between Diabetes and Hepatocellular Carcinoma: A Systematic Review of Epidemiologic Evidence(J)Clinical Gastroenterology and Hepatology . 2006 (3)

引证文献2

二级引证文献6

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部