CAJ | 학술논문

目的分析与儿童阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)诊治关系最为密切的临床专科医师OSAHS知识水平和自我评估.方法采用经原作者授权翻译的美国儿童阻塞性睡眠呼吸暂停低通气综合征知识及态度问卷(Obstructive sleep apnea knowledge and attitudes questionnaire in children,OSA-KIDS)中文版,以邮寄方式对山东省43所公立医院的耳鼻咽喉科和小儿内科医师进行问卷调查.结果 OSA-KIDS中文版经30名医师重测,r=0.92.回收有效问卷391份,占87.7%.18个知识条目平均正确率((x-)±s)为64.1%±19.1%,克朗巴赫α系数=0.76.耳鼻咽喉科与小儿内科医师知识条目总得分差异无统计学意义,但耳鼻咽喉科医师对"大约有2%的儿童患有OSAHS"判断正确率较高,小儿内科医师对"儿童OSAHS可以导致肺动脉高压"判断正确率较高(P值均＜0.05).仅有24.3%的医师知晓儿童打鼾的强弱程度与OSAHS的严重程度无关;正确回答婴幼儿心脏呼吸监测不能作为中枢性与阻塞性呼吸暂停的可靠鉴别手段只有16.1%.自我评估5个条目的克朗巴赫α系数=0.72.90%以上的医师认为儿童OSAHS作为一种临床疾病具有重要意义,但仅有约36%的医师对儿童OSAHS的诊断与治疗感到自信.知识总得分与医师性别、学历等无关(P值均＞0.05),但随着医师年龄及执业年限的增加而增加(P＜0.05).医师对疾病重要性的认识及诊治自信心的自我评估等级呈正相关趋势(r=0.384,P＜0.0001).结论对山东省部分耳鼻咽喉科和小儿内科医师的调查发现,临床专科医师对儿童OSAHS重要性认识不足,相关知识水平的掌握仍有待提高.
목적 분석여인동조새성수면호흡잠정저통기종합정(obstructive sleep apnea hypopnea syndrome,OSAHS)진치관계최위밀절적림상전과의사OSAHS지식수평화자아평고.방법 채용경원작자수권번역적미국인동조새성수면호흡잠정저통기종합정지식급태도문권(Obstructive sleep apnea knowledge and attitudes questionnaire in children,OSA-KIDS)중문판,이유기방식대산동성43소공립의원적이비인후과화소인내과의사진행문권조사.결과 OSA-KIDS중문판경30명의사중측,r=0.92.회수유효문권391빈,점87.7%.18개지식조목평균정학솔((x-)±s)위64.1%±19.1%,극랑파혁α계수=0.76.이비인후과여소인내과의사지식조목총득분차이무통계학의의,단이비인후과의사대"대약유2%적인동환유OSAHS"판단정학솔교고,소인내과의사대"인동OSAHS가이도치폐동맥고압"판단정학솔교고(P치균＜0.05).부유24.3%적의사지효인동타한적강약정도여OSAHS적엄중정도무관;정학회답영유인심장호흡감측불능작위중추성여조새성호흡잠정적가고감별수단지유16.1%.자아평고5개조목적 극랑파혁α계수=0.72.90%이상적의사인위인동OSAHS작위일충림상질병구유중요의의,단부유약36%적의사대인동OSAHS적진단여치료감도자신.지식총득분여의사성별、학력등무관(P치균＞0.05),단수착의사년령급집업년한적증가이증가(P＜0.05).의사대질병중요성적인식급진치자신심적자아평고등급정정상관추세(r=0.384,P＜0.0001).결론 대산동성부분이비인후과화소인내과의사적조사발현,림상전과의사대인동OSAHS중요성인식불족,상관지식수평적장악잉유대제고.
Objective To investigate the knowledge and attitude of clinicians in the departments of pediatrics and otolaryngology to pediatric obstructive sleep apnea hypopnea syndrome (OSAHS), since in China, the clinicians in these two departments had closest relationship with the diagnosis and treatment of OSAHS in children. Methods A validated questionnaire from USA which was the obstructive sleep apnea knowledge and attitudes questionnaire in children (OSAKA-KIDS) was used and permissioned by original author. The questionnaire was mailed to ENT doctors and pediatricians in 43 public hospitals in Shandong province. Results OSA-KIDS in Chinese version was re-tested by 30 physicians, r = 0. 92. Totally, 391valid questionnaires (87. 7% ) were returned. Average of correct rate ((x-)± s) in 18 knowledge items was 64. 1% ± 19. 1%. Cronbach's α coefficient was 0. 76. There was no difference between ENT doctors and pediatrics in total knowledge score. However, there was significant difference in below 2 questions: ENT doctors had more correction in answer "nearly 2% of children have OSAHS" and pediatrics had more correction in answer "pediatric OSAHS may be associated with pulmonary hypertension". Only 24. 3% clinicians correctly know the degree of snoring (mild to severe) was not correlated with the severity of obstructive apnea in children. Only 16. 1% could correctly answer the question about cardio-respiratory monitor could not reliably detect both central and obstructive apnea in infant. Cronbach's α coefficient was 0. 72 in 5 items which was about importance of disease and serf-evaluation in confidence. While more than 90% clinicians stated that "As a clinical disorder OSAHS is important or very, extremely important".However, among them, only about 36% felt confident in identifying or managing children with OSAHS.Total knowledge score about OSAHS was not different by gender or specialty ( P ＞ 0. 05 ), but more knowledge was associated with more positive attitudes overall ( P ＜ 0. 05 ) and more elder in age or longer years in practice (r = 0. 384, P ＜ 0. 0001 ). Conclusions It should be paid more effort to elevate the knowledge and attitude about pediatric OSAHS in pediatricians and otolaryngologists.