上海市基层全科医生慢性咳嗽知晓度认知现状的调查分析

Investigation and analysis of the cognitive status of chronic cough among general practitioners in Shanghai

目的调查上海市基层全科医生对慢性咳嗽相关知识的知晓情况。方法2019年6月至2019年8月采用网上问卷对上海16个区的基层全科医生(1282名)进行调查,并进行描述性分析与分层分析。结果43.45%的医生学习过2015版咳嗽的诊断与治疗指南,40.48%的医生参加过慢性咳嗽诊治课程。慢性咳嗽诊断标准全部回答正确占26.52%,在全部五个常见病因中,嗜酸粒细胞性支气管炎知晓率最低(46.88%)。23.24%的医生了解经验性疗法治疗慢性咳嗽;治疗药物中促胃动力药物治疗胃食管反流相关咳嗽的知晓率最低(8.19%)。市区硕士及以上学历的全科医生,明显多于郊区(P<0.001)。学习过咳嗽指南,参加过培训和了解慢性咳嗽经验性疗法的全科医生,高级职称和年龄≥50岁的比例最高(P均<0.05)。结论上海市基层全科医生对慢性咳嗽认知比率低,缺乏对慢性咳嗽的相关知识,应重点加强对慢性咳嗽的诊断、常用药物、常见病因、经验性疗法方面的培训,尤其是青年医生及职称低的医生,并注重提高郊区全科医生的学历。

Objective To investigatethe knowledge level of general practitioners about chronic cough in Shanghai.Methods From June 2019 to August 2019,descriptive analysis and stratified analysis were carried out among 1282 general practitioners in 16 districts of Shanghai via online questionnaires.Results 43.45%of doctorshad studied the guidelines for the diagnosis and treatment of cough(2015),and 40.48%of doctors had participated in the chronic cough diagnosis and treatment courses.26.52%of doctors had answered all the questions about the standard for chronic cough diagnosis correctly.The awareness rate of eosinophilic bronchitis was the lowest in all five common causes,46.88%of doctorswere aware of it,and 23.24%of doctorshad understood the empirical treatment of chronic cough.Among the treatment drugs,gastric motility promoting drugs had the lowest awareness rate(8.19%)in treatment of gastroesophageal reflux related cough.Number of general practitioners with master's degree or above in urban areas was significantly larger than that in suburban areas(P<0.001).The highest percentage in general practitioners who had studied the guidelines of cough,participated in training,and learned method of chronic cough diagnosis and treatment was found in doctors with senior titles and aged over 50 years.Conclusion General practitioners in Shanghai Community Health Service Center have low cognition rate of chronic cough and lack relevant knowledge of it.We should focus on the training of diagnosis,common medicines,common causes and empirical therapy for chronic cough,especially for young or doctors with junior titles.