专科门诊和多学科综合治疗门诊肺结节患者就诊特点的调查研究

Characteristics of Pulmonary Nodules Outpatients Receiving Treatment in Specialized Clinic Versus Multi-disciplinary Team Clinic

目的调查并分析综合医院专科门诊和多学科综合治疗(MDT)门诊肺结节患者的就诊特点。方法选取2016年7月—2017年4月就诊于南京医科大学附属苏州医院符合纳入标准的肺结节患者114例进行调查,将就诊于本院心胸外科、呼吸内科及肿瘤科门诊的患者记为专科组(n=73),就诊于MDT门诊的患者记为MDT组(n=41)。对每位确诊的患者进行访谈(约30 min),主要记录内容包括首诊科室、性别、首发年龄、文化程度、居住地、首诊时间(指患者自发病到就诊的时间)、家庭人均月收入、婚姻状况、既往史(肺部疾病)、就诊首要目的、对肺结节的理解程度(包含对所患疾病的理解、对相关检查的理解、对诊断的接受情况、对治疗方案的理解)、对此次就诊过程满意度。结果 114例患者均完成调查,全部进入结果分析。专科组患者各专科门诊就诊满意度间差异无统计学意义(P>0.05)。两组患者在首发年龄、文化程度、居住地、首诊时间、家庭人均月收入、婚姻状况、既往史、就诊首要目的、对肺结节的理解程度、对此次就诊过程满意度上差异有统计学意义(P<0.05);但在性别上差异无统计学意义(P>0.05)。结论 MDT组肺结节患者较专科组患者年龄偏大、多伴有肺部疾病,对此次就诊过程满意度较好,建议肺结节患者尽可能在MDT门诊就诊,而专科组患者对肺结节认识有限,需要加大宣传力度。

Objective To investigate the characteristics of pulmonary nodules outpatients receiving treatment in specialized clinic versus multi-disciplinary team（ MTD） clinic. Methods The enrolled participants were 114 cases of pulmonary nodules who received treatment in Suzhou Hospital, Nanjing Medical University from July 2016 to April 2017,including 73 cases from Thoracic Surgery Clinic,Respiratory Clinic,and Oncology Clinic（ specialized treatment group）,and 41 cases from MDT Clinic（ MDT treatment group）. Through a 30-min interview,we collected the following data of each of them： first visited clinic,sex,age of first onset of pulmonary nodules,educational attainment,residence,lag time between onset of pulmonary nodules and first visit（ period from the onset of pulmonary nodules to the first visit）,household monthly income per person,marital status,medical history（ lung diseases）,primary purpose of visit,awareness level of pulmonary nodules（ awareness level of one＇s own disease,accessory examinations and treatment regimen,acceptance of diagnosis）,level of satisfaction with the visit. Results All the 114 patients completed the study. The level of satisfaction with the visit did not differ significantly between the patients in the specialized treatment group by type of visited specialized doctors（ P 〈 0. 05）. The specialized treatment group and MDT treatment group had significant differences in terms of the distribution of age of first onset of pulmonary nodules,educational attainment,residence,lag time between onset of pulmonary nodules and first visit,household monthly income per person, marital status, medical history（ lung diseases）, primary purpose of visit, awareness level of pulmonary nodules and level of satisfaction with the visit（ P 〈 0. 05）. However,no significant difference was identified in sex distribution between the specialized treatment group and MDT treatment group（ P 〈 0. 05）. Conclusion Compared with the pulmonary nodules patients receiving specialized treatment,those receiving MDT treatment were older,and they had higher level of satisfaction with the visit. Moreover,they were more likely to have pulmonary diseases. In view of this,pulmonary nodules patients are suggested to receive the treatment delivered by MTD clinic. Furthermore,the education related to pulmonary nodules should be intensified in those receiving specialized treatment because of their poor understanding of pulmonary nodules.