某三甲医院儿科住院患儿家长对教学查房意见的调查与分析

Investigation and analysis of parents'opinions on teaching ward round for hospitalized children in a top-three hospital

目的调查分析儿科住院患儿家长对教学查房的意见,并提出改进措施。方法2019年1月至2020年12月,对某三甲医院儿科107名接受住院医师规范化培训(以下简称住培)教学查房的患儿家长(以下简称A组)和121名同病室其他患儿家长(以下简称B组)进行问卷调查,采用χ^(2)检验和Fisher确切概率法比较两组患儿家长对教学查房的认知差异。结果A组<3岁患儿占比低于B组[28.1%(30/107)比70.2%(85/121)],其差异具有统计学意义(P<0.01)。A组73.8%(79/107)的患儿不能完全配合教学查房,46.7%(50/107)的患儿家长不愿意再次接受教学查房。A组不愿意再次接受教学查房患儿家长认为体格检查对患儿造成恐惧、疼痛、受凉等不适的比例[82.0%(41/50)比5.3%(3/57)]高于愿意再次接受教学查房的患儿家长,其差异具有统计学意义(P<0.01)。B组患儿家长认为教学查房对认知患儿疾病有帮助[76.0%(92/121)比36.5%(39/107)]、希望进行教学查房[90.1%(109/121)比53.3%(57/107)]的比例均高于A组患儿家长,其差异均具有统计学意义(均P<0.01)。结论大多数未接受教学查房的患儿家长期待教学查房,但接受教学查房的患儿家长对其认可度有待提高;较少患儿能够完全配合教学查房,教学查房病例选择以年龄较大患儿为主。儿科住培医师需要加强医学人文素质培养和基本功训练,同时应当积极探索个体化儿科教学查房方式,以满足患儿家长需求,提高住培质量。

Objective To investigate and analyze the children's parents'opinions on pediatric medical teaching ward round,and put forward the improvement measures.Methods A questionnaire survey was conducted among 107 parents of children(group A)in a top-three hospital who received resident physician standardized teaching ward round and 121 parents of other children(group B)in the same ward from January 2019 to December 2020.Chi-square test and Fisher exact probability test were used to compare the differences of the children's parents'cognition of the teaching ward round between the two groups.Results The proportion of children<3 years old in group A was significantly lower than that in group B[28.1%(30/107)vs.70.2%(85/121)](P<0.01),and 73.8%(79/107)of the children in group A failed to fully cooperate with the performance of teaching ward round.There were 46.7%(50/107)of the parents not willing to accept the teaching ward round again.The percentage of parents who thought that the physical examination caused fear,pain,cold and other discomfort to the children in group A who did not want to go to teaching round again was higher than that of parents who wanted to go to teaching round again[82.0%(41/50)vs.5.3%(3/57)],there was statistically significant(P<0.01).The percentage of the parents in group B thought that teaching ward round was more helpful to the cognition of children's diseases than that in group A[76.0%(92/121)vs.36.5%(39/107)],the percentage of children's parents in group B who wanted to go to teaching rounds was higher than that in group A[90.1%(109/121)vs.53.3%(57/107)],there were statistically significant(all P<0.01).Conclusions Most of the parents who didn't accept the teaching ward round just because they didn't see the performance as what they expected.The acceptance of parents of children undergoing teaching rounds needs to be improved.Few children could fully cooperate with the ward round performance,and the majority of cases selected for teaching ward round is elderly children.It is necessary to strengthen the cultivation of medical humanistic quality and clinical skills training in pediatric education.We are trying to explore a personalized mode of pediatric teaching ward round to meet the needs of parents and improve the quality of pediatric resident standardized training.