上海市医疗机构工作人员对患者辐射防护意识的现况研究

A study of current situation of radiation protection awareness for patients among medical institution staff in Shanghai

目的:了解临床工作人员对患者辐射防护的认知,为推进医疗照射正当化提供策略与建议。方法:采用多阶段分层随机抽样的方法,2023年6—9月在上海市10家三级医院、9家二级医院、8家一级医院,对1430名医疗机构的医师或技师通过线下和线上结合方式开展辐射相关认知问卷调查。调查内容包括调查对象的人群特征、放射防护培训情况、对患者辐射防护的自我认知情况、对辐射防护相关问题的实际回答情况、对不同类型检查剂量认知情况、以及期望获取电离辐射知识的途径等内容。结果:研究共收集到有效问卷1229份,其中82.10%的调查对象所属科室为临床科室,17.90%的调查对象所属科室为放射诊疗科室。临床科室调查对象中接受过放射相关培训的人员占比58.37%,放射诊疗科室接受过放射相关培训人员占总人数的98.64%。放射诊疗科室调查对象对辐射防护相关知识的整体掌握情况优于临床科室,且差异有统计学意义(χ^(2)=39.58,P<0.05)。大部分调查对象都倾向于低估CT检查所致受检者与患者剂量,对不同部位的CT检查剂量调查对象低估的比例均>45%。logistic回归分析表明职称、是否接受过放射防护培训、所在医疗机构级别以及所学专业为辐射防护相关认知情况的影响因素(OR值的95%CI不包括1,χ^(2)=5.66~28.26,P<0.05)。结论:临床工作人员已基本认识到了放射诊断检查中控制受检者与患者的电离辐射剂量的重要性,但是对于放射学检查所致剂量的了解还较为欠缺,亟待普及。教育培训是提高电离辐射认识的最佳方法,建议将辐射防护培训贯穿于医学通识教育或医师规范化培训中。

Objective To understand the radiation protecton awareness of clinical staff for patients,and to provide strategies and suggestions for promoting the justification of medical exposure.Methods From June to September 2023,1430 physicians or technicians from 10 tertiary hospitals,9 secondary hospitals and 8 primary hospitals in Shanghai were selected by multi-stage stratified random sampling method to conduct a questionnaire survey about radiation-related cognition through a combination of offline and online survey.The contents of the questionnaire included the characteristics of the respondents,the training of radiation protection,the self-awareness of patients on radiation protection,the actual cognition of the basic knowledge of ionizing radiation,the cognition of the dose caused by different types of the radiological examinations,and the ways to access knowledge of ionizing radiation.SPSS software was used for statistical analysis.Results A total of 1229 valid questionnaires were received,of which 82.10%respondents belonged to the clinical department and 17.90%belonged to the radiology department.58.37%of the respondents in clinical department have received radiation-related training,and 98.64%in radiology department have done so.The overall mastery of radiation protection-related knowledge in radiology department was better than in clinical department,and the difference was statistically significant(χ^(2)=39.58,P<0.05).Most of the respondents tended to underestimate the radiation dose to patients from CT scans,and the proportion of the respondents who underestimated the CT doses to different sites was all greater than 45%.Logistic regression analysis showed that the contributing factors affecting radiation protection cognition are a combination of technical titles,radiation protection training to a varing degree,the level of medical institutions and their majors(95%CI of the OR values did not include 1,χ^(2)=5.66-28.26,P<0.05).Conclusions Most clinical staff have realized the importance of controlling the radiation dose in radiological examinations,but there is less understanding of the dose magnitude caused by different radiological examinations.Education and training are the best way to improve the awareness of ionizing radiation.Radiation protection training should be integrated into general medical education or standardized training for physicians.