眼科医师对临床指南的认知与应用情况调查

Investigation on ophthalmologists' cognition and application of clinical practice guidelines

目的:了解眼科医师对临床指南的认知态度和应用情况,发现眼科临床指南现阶段推广应用中存在的问题,并探索可能的解决方案。方法:通过发放纸质及电子问卷,调查各级眼科医师对眼科临床指南的认知和应用情况,对数据结果进行统计描述、秩和检验及Spearman相关分析。结果:回收有效问卷505份,其中纸质有效问卷222份(有效应答率93.3%),电子有效问卷283份(有效应答率99.3%)。95.4%的受访者认为指南在临床工作中"非常重要"或"重要",但仅10.9%的眼科医师认为目前国内共识和指南覆盖面"足够"。不同职称、学历、医院级别的眼科医师对临床指南的认知差异有统计学意义(P<0.05);不同学历、医院级别的眼科医师对指南的应用差异有统计学意义(P<0.001)。受访者的医院级别、职称、最高学历与指南认知相关(P<0.05);医院级别、受访者最高学历与指南应用相关(P<0.001)。结论:眼科医师普遍认可临床指南的重要性,但仍有部分医师对临床指南的认知和应用不足,需进一步推进指南的制定和发布。

Objective:To evaluate ophthalmologists’knowledge and attitudes towards clinical practice guidelines(CPGs)and its application,find out the existing problems in the promotion and application of CPGs at present,and to explore possible solutions.Methods:The status of recognition and implementation of CPGs was investigated through both web-based and paper-based questionnaires.The data were analyzed by using statistic description,Kruskal-Wallis test and Spearman correlation analysis.Results:Five hundred and five valid questionnaires were retrieved,including222paper questionnaires(93.3%valid)and283web questionnaires(99.3%valid).In total,95.4%of participants agreed that clinical guidelines are“important”or“very important”for clinical practice,but only10.9%of participants agreed that the coverage of clinical guidelines is“enough”.There were statistical significances in terms of recognition scores among participants with different professional titles,educational levels,and hospital levels(P<0.05).Implementation scores among participants with different educational and hospital levels were statistically significant(P<0.001).Spearman correlation test showed that the recognition scores were correlated with participants’educational levels,professional titles,and hospital levels(P<0.05),while the implementation scores were correlated with participants’professional titles and hospital levels(P<0.001).Conclusions:While the importance of CPGs is well recognized,some participants showed poor performance in recognition and implementation of CPGs.Further effort on CPGs development and promotion is needed.