北京市社区卫生服务机构非中医全科医生和防保人员的中医素养及培训需求调查

Attainment of TCM and the Demand for TCM Training Among non- TCM General Practitioners and Prevention and Health Care Staff in Community Health Service Settings in Beijing

目的了解北京市社区卫生服务机构非中医全科医生和防保人员的中医素养及培训需求情况,为政府主管部门制定政策提供决策依据。方法采用随机数字表法,在北京市16个区县各随机抽取3~6家社区卫生服务中心,共抽取62家社区卫生服务中心;在抽中的62家社区卫生服务中心各随机抽取1家社区卫生服务站,共抽取62家社区卫生服务站;在抽中的社区卫生服务中心与社区卫生服务站中,采用整群抽样法,抽取机构内部所有的非中医类全科医生与防保人员为调查对象。于2014-07-16至2014-08-16,采用调查问卷进行调查。调查问卷分为全科医生与防保人员两种,主要内容包括全科医生、防保人员的基本情况、中医素养、中医药培训需求。结果非中医全科医生中医素养指数为（67.74±13.55）分,中医药适宜技术认知、中医药政策认知、中医临床知识认知、中医药基础理论认知4个维度的中医素养指数分别为（39.09±22.61）、（46.18±35.31）、（95.92±10.80）、（72.95±27.25）分。不同学历、是否参加＂北京市全科医师中成药合理使用培训工作＂的全科医生的中医素养指数比较,差异有统计学意义（P〈0.05）。非中医防保人员中医素养指数为（50.09±23.07）分,老年人健康管理中医药知识认知、孕产妇健康管理中医药知识认知、儿童健康管理中医药知识认知3个维度的中医素养指数分别为（33.80±33.75）、（44.71±29.98）、（71.22±34.60）分。不同区县性质的防保人员的中医素养指数比较,差异有统计学意义（P〈0.05）。96.8%（1 060/1 198）的全科医生和78.1%（574/735）的防保人员认为有必要开展中医药知识培训。结论北京市社区卫生服务机构非中医全科医生和防保人员的中医素养较低,对培训的需求程度较高。应加强中医素养指数研究,加强中医药适宜技术、中医药政策等宣传,注重中医药临床知识、中成药应用等方面培训,以提升医务人员的中医药服务能力。

Objective To investigate the attainment of TCM and the demand for TCM training among non-TCM general practitioners and prevention and health care staff in community health service settings in Beijing,in order to provide references for the formulation of relevant policies by governmental departments. Methods Using random number table method,we randomly selected 3 to 6 community health service centers from each of 16 districts / counties of Beijing, and at last 62 community health service centers were selected. We randomly selected one community health service station from each of the 62 centers and selected all together 62 community health service stations. From the selected stations, all non-TCM general practitioners and prevention and health care staff were enrolled by cluster sampling method. From July 16 to August 16 in 2014,questionnaire survey was conducted. The questionnaire had two versions for general practitioners and prevention and health care staff,and the content covered basic information,the attainment of TCM and the demand for TCM training. Results The score of TCM attainment of non-TCM general practitioners was（ 67. 74 ± 13. 55）,and the scores of four dimensions of TCM attainment,namely cognition of appropriate technology for TCM,cognition of policy for TCM,cognition of clinical knowledge of TCM and cognition of elementary theory of TCM,were（ 39. 09 ± 22. 61）,（ 46. 18 ± 35. 31）,（ 95. 92 ± 10. 80） and（ 72. 95 ± 27. 25）respectively. There were significant differences in the score of TCM attainment among general practitioners with different educational degrees and between general practitioners that had attended ＂ the training on the rational use of Chinese patent medicine for general practitioners in Beijing＂ and general practitioners who had not attended that（ P 〈0. 05）. The score of TCM attainment of non-TCM prevention and health care staff was（ 50. 09 ± 23. 07）,and the scores of three dimensions of TCM attainment,namely cognition of TCM knowledge for the health management of elders,cognition of TCM knowledge for the health management of pregnant and lying-in women,and cognition of TCM knowledge for the health management of children,were（ 33. 80 ± 33. 75）,（ 44. 71 ± 29. 98） and（ 71. 22 ± 34. 60） respectively. There were significant differences in the score of TCM attainment among prevention and health care staff from different districts / counties（ P 〈0. 05）. Of all the subjects,96. 8%（ 1 060 /1 198） of general practitioners and 78. 1%（ 574 /735） of prevention and health care staff thought it was necessary to carry out TCM training. Conclusion Non-TCM general practitioners and prevention and health care staff in community health service settings in Beijing have poor TCM attainment and therefore have much demand for TCM training. We suggest research on indexes of TCM attainment,appropriate technology for TCM,publicity for TCM policy,mastery of clinical knowledge of TCM and the application of Chinese patent medicine should be intensified,in order to improve the TCM service ability of medical staff.