苏州市社区全科医生心血管病防治能力研究

Study on capability of cardiovascular disease prevention and treatment among community general practitioner in Suzhou City

目的了解苏州社区全科医生心血管病防治相关技能掌握情况及影响因素,为加强社区全科医生队伍建设提供依据。方法随机抽取苏州市1个中心城区和2个下辖县市城区,整群抽取社区卫生服务机构全科医生,进行自填式问卷调查。结果 155名社区全科医生中,16项心血管病防治技能中有14项技能熟练和不太熟练掌握的人数合计比例均达到90%以上,熟练掌握的比例均低于85%,其中常规心电图分析诊断、动态心电图分析诊断、流行病学调查、康复方法、康复器械、心理治疗等技能熟练掌握的比例低于40%;心血管病防治技能评分得到的标化分平均值为(78.5±9.9)分。主要影响因素为教育程度、培训方式、专业职称和工作地区。认为很重要的培训需求比例由高到低为实践技能(81.94%)、理论知识(76.13%)、心理沟通(70.32%)、心理卫生(68.39%)和公共卫生知识(66.45%)。结论社区全科医生心血管病防治能力不容乐观,亟需提高综合防治水平;应进一步提升社区全科医生人才结构,完善培训体系,加强实践技能方面的培训。

[ Objective ] To understand the status of skills related to prevention and treatment against cardiovascular disease among community general practitioner in Suzhou City, analyze its influencing factor, and provide the basis for strengthening the construction of community general practitioner team. [Methods] With cluster sampling method, the general practitioners working from the community health service institution in one central urban district and two urban districts of Suzhou City were surveyed with self-administration questionnaire.[ Results ] Among 155 community general practitioners, the proportions of practitioners can expertly or not very expertly master 14 of 16 skills of prevention and treatment against cardiovascular disease were more than 90%. The proportion of practitioners with expert mastery was lower than 85% for each skill. The proportion of practitioner can expertly master the analysis and diagnosis of routine ECG, analysis and diagnosis of dynamic ECG, epidemiological survey, rehabilitation methods, rehabilitation appliances and psychotherapy was lower than 40% respectively. The average standardized score of skills of prevention and treatment against cardiovascular disease was （78.5＋9.9）, with the main influencing factors of educational level, training way, professional title and work place. The training needs which the community general practitioners considered very important were practical skill （81.94%）, theoretical knowledge （76.13%）, psychological communication （70.32%）, mental health （68.39%） and public health knowledge （66.45%）. [Conclusion] The capability of prevention and treatment against cardiovascular disease of community general practitioners is not optimistic. It is urgent to improve the comprehensive prevention and treatment level, perfect the structure of community general practitioner team, complete the training system, and strengthen the training in practical skill.