河南省驻马店市基层医疗机构医生慢性阻塞性肺疾病知识掌握情况及影响因素调查研究

Knowledge levels of chronic obstructive pulmonary disease among physicians in primary care and related factors:a survey in Zhumadian City of Henan Province

目的了解基层医疗机构医生慢性阻塞性肺疾病(慢阻肺)相关知识的掌握情况及其影响因素,为探索基层医疗机构慢阻肺预防诊治能力提升方法提供依据。方法2020年12月1—31日,在河南省驻马店市761家基层医疗机构中每家随机选取1~3名拟参与慢阻肺高危筛查项目的医生,共1232名,对其基本信息和对慢阻肺相关知识掌握情况进行问卷调查。问卷内容包括基本信息、慢阻肺的危险因素及急性加重常见原因、症状及诊断、治疗及管理相关内容。根据调查对象的学历将其分为本科及以上、大专、中专及以下3组,比较3组对象对慢阻肺相关知识认知的差异,用logistic回归模型分析其影响因素。结果共回收问卷1232份,回收率100.0%,有效问卷1221份,有效率99.1%,最终纳入分析1221份。基层医生的学历与慢阻肺相关认知水平间存在线性关系(χ^(2)=9.91,P<0.05),认知水平随着学历的升高而升高(r=0.09,P<0.05)。慢阻肺患者危险因素及急性加重常见原因、治疗管理认知方面,基层医生的学历与其认知水平间存在线性关系(χ^(2)=13.86,20.93,均P<0.001),且认知水平随着学历的升高而升高(r=0.11,0.13,均P<0.001)。症状及诊断认知方面,学历与其认知水平间不存在相关性(χ^(2)=1.90,P=0.168)。Logistic回归分析显示,慢阻肺认知程度方面,31~40岁基层医生较20~30岁者更高(OR=2.24,95%CI:1.16~4.30,P=0.016);本科及以上学历基层医生较中专及以下学历者更高(OR=1.71,95%CI:1.24~2.37,P=0.001);初级、中级职称基层医生较无职称者更高(OR=1.65,95%CI:1.28~2.13,P<0.001;OR=2.15,95%CI:1.46~3.16,P<0.001);参加培训次数≥3次的基层医生较培训次数<3次者更高(OR=1.15,95%CI:1.21~2.61,P=0.021)。结论基层医生对慢阻肺相关知识的认知受年龄、学历、职称、参加培训次数影响,尤其在慢阻肺患者危险因素及急性加重常见原因、治疗管理认知方面。

Objective To survey the knowledge levels of chronic obstructive pulmonary disease(COPD)among physicians in primary care and related factors.Methods A questionnaire survey was conducted during December 2020 to December 2021 among 1232 primary care doctors in Zhumadian City of Henan Province.The questionnaire included basic information,knowledge of COPD and its management,and the training received.The COPD-related knowledge levels and the influencing factors were analyzed using logistic regression model.Results A total of 1232 questionnaires were collected,and 1221(99.1%)were valid,which were included in the analysis.The survey showed that the COPD-related knowledge level was significantly associated with the educational level of primary care physicians(χ^(2)=9.91,P<0.05);and the Pearson correlation analysis showed that the knowledge level was positively correlated with educational level(r=0.09,P<0.05).In terms of risk factors,causes of acute exacerbations,and treatment and management of COPD,there was a linear relationship between the education level and knowledge level(χ^(2)=13.86,P<0.001;χ^(2)=20.93,P<0.001);the Pearson correlation analysis showed that the knowledge level was correlated with higher educational level(r=0.11,P<0.001;r=0.13,P<0.001).In terms of symptoms and diagnosis,there was no correlation between educational level and awareness level(χ^(2)=1.90,P=0.168).Logistic regression model showed that compared to doctors aged 20-30,those aged 31-40 had a higher COPD-related knowledge level(OR=2.24,95%CI:1.16-4.30,P=0.016);compare to the doctors with associate degree,doctors with bachelor degree or above had a higher COPD-related knowledge(OR=1.71,95%CI:1.24-2.37,P=0.001);compared to doctors without professional title,those with primary or middle-rank professional title had a higher knowledge level(OR=1.65,95%CI:1.28-2.13,P<0.001;OR=2.15,95%CI:1.46-3.16,P<0.001);compared to doctors with training time<3,those with training time≥3 had a higher knowledge level(OR=1.15,95%CI:1.21-2.61,P=0.021).Conclusion The COPD-related knowledge levels(especially in knowledge of risk factors and causes of acute exacerbations,and treatment and management of COPD)among doctors in primary care are affected by age,educational background,professional title,and the number of training sessions.