上海市社区医院对新型冠状病毒肺炎认知调查和防控

Awareness Investigation and Prevention Experience of Novel Coronavirus Pneumonia in Community Hospitals in Shanghai

目的了解上海市社区卫生服务中心对新型冠状病毒肺炎相关知识的掌握程度和处置能力,为社区防控政策制定提供科学依据。方法2020年2月初采用随机抽样的方法,按地理位置将上海市16个行政区分为6个区域,每个区域随机抽取个5~8家社区卫生服务中心的全科医师作为调查对象。采用自制的调查问卷进行调查,采用描述性方法调查上海市社区全科医师对新型冠状病毒肺炎认知水平。结果共发放问卷244份,回收有效问卷233份,问卷有效回收率为94.26%。所调查的45家社区卫生服务中心的233名全科医师对于《新型冠状病毒肺炎防控知识调查问卷》的平均成绩为76.80±11.68分。新型冠状病毒肺炎的基本知识方面,调查发现全科医师对掌握病毒名称的正确率为95.28%(222/233)、诊疗指南了解的正确率为91.85%(214/233)、明确乙类传染病甲类管控的正确率为93.13%(217/233)、明确2h报告制度的正确率为84.98%(198/233)、传播途径的正确率为98.28%(229/233)、发病中位时间的正确率为45.92%(107/233)、治疗原则的正确率为88.84%(207/233)和防控原则的正确率为72.96%(170/233)。新型冠状病毒肺炎的处置能力方面,调查发现全科医师对有效消毒剂的种类和消毒浓度的正确率分别达到91.84%(214/233)和57.51%(134/233),对新型冠状病毒肺炎的感控基本要求、防护级别、发热门诊感控要求、疑似或重点人群居家隔离要求和治疗场所感控要求的正确率分别为96.13%(224/233)、98.28%(229/233)、95.28%(222/233)、97.42%(227/233)和87.55%(204/233)。有72.10%的全科医师能正确掌握对疑似或确诊患者的转运防护要求,而有39.49%的全科医师能明确收治疑似或确诊患者的病房要求。此外,分别有45.06%和24.03%的全科医师能正确认识新型冠状病毒肺炎患者的临床表现以及重症病例的临床症状。结论上海市社区医院的全科医师不仅能够较好地掌握新型冠状病毒肺炎的基础知识,而且也基本具备新型冠状病毒肺炎的处置能力,但仍需加强对新型冠状病毒肺炎临床症状的识别。同时,在社区疫情防控的经验和做法值得借鉴。

Objective To understand the awareness and skills of general practitioners in Shanghai in the prevention and treatment of novel coronavirus pneumonia,so as to provide a scientific basis for the formulation of community prevention and control policies.Methods A random sampling method was adopted to divide the 16 administrative districts of Shanghai into 6 regions by geographic location in early February 2020.General practitioners of 5-8 community health service centers in each region were selected randomly as the survey object.A self-designed questionnaire was used for the survey,and a descriptive method was applied to investigate their awareness level of novel coronavirus pneumonia.Results A total of 244 questionnaires were distributed,and 233 valid questionnaires recovered,with the effective recovery rate at 94.26%.The average score of the 233 general practitioners of 45 community health service centers surveyed on the Knowledge Questionnaire for Prevention and Control of No-vel Coronavirus Pneumonia was 76.80±11.68.The survey found that the correct rates of mastering the virus name,the diagnosis and treatment guidelines,type A management in type B infectious diseases,2h reporting system,route of transmission,the median onset time,the treatment principle,and the prevention and control principle were 95.28%(222/233),91.85%(214/233),93.13%(217/233),84.98%(198/233),98.28%(229/233),45.92%(107/233),88.84%(207/233)and 72.96%(170/233)respectively.With regard to the ability to treat novel coronavirus pneumonia,it was found that the correct rates of effective disinfectant types and disinfection concentrations by general practitioners reached 91.84%(214/233)and 57.51%(134/233)respectively.The correct rates of basic requirements for sensory control,protection level,infection control requirements for fever clinics,home isolation requirements for suspected or key populations,and infection control requirements for treatment sites were 96.13%(224/233),98.28%(229/233),95.28%(222/233),97.42%(227/233),and 87.55%(204/233),respectively.72.10%general practitioners knew the transfer protection requirements for suspected or confirmed patients,while 39.49%general practitioners could clearly determine the ward requirements for treating suspected or confirmed patients.In addition,45.06%and 24.03%general practitioners were able to correctly identify the clinical manifestations or the symptoms of severe cases with novel coronavirus pneumonia.Conclusion General practitioners in community hospitals in Shanghai not only have been good at the basic knowledge of novel coronavirus pneumonia,but also have the ability to treat novel coronavirus pneumonia.However,they still need to strengthen their skills in identifying clinical symptoms of novel coronavirus pneumonia.Meanwhile,the experience in community epidemic prevention and control is worth learning from.