CAJ | 학술논문

目的探讨短期培训对提高基层内科医师对慢性阻塞性肺疾病(COPD)认识水平的作用,及其结合配备肺功能仪后对基层医院COPD诊断水平的影响.方法随机抽取湖南某市的6家未配备有肺功能仪的二级医院,并随机分为干预及对照组(n=3).干预组内科医师进行短期COPD知识培训并免费配备肺功能仪,对照组则不进行任何干预.培训前后对干预组内科医师进行COPD问卷调查,每题1分,总分10分.比较培训前后医师个人得分及各题答题正确率,比较干预前及干预后两组医院40岁以上内科住院患者中COPD可能病例比例及COPD诊断病例比例.结果 (1)干预组培训前、后医师个人得分中位数为5分与9分(U=734.500,P=0.000),及格率分别为43.0％与95.2％(x2=52.764,P=0.000),培训前后比较差异均有统计学意义.(2)干预前,对照组与干预组COPD可能病例比例分别为0.69％及0.84％(x2=0.428,P=0.513),COPD诊断病例比例均为0,组间比较差异均无统计学意义(P＞0.05);干预期间,对照组与干预组COPD可能病例比例分别为0.67％及14.40％(x2=404.017,P=0.000),对照组与干预组COPD诊断病例比例分别为0及2.87％(x2=86.954,P=0.000),组间比较差异均有统计学意义.结论 (1)医师短期培训并结合配备肺功能仪可以有效提高基层医院的COPD诊断水平;(2)短期培训可以有效提高基层内科医师对COPD的认识水平.
목적 탐토단기배훈대제고기층내과의사대만성조새성폐질병(COPD)인식수평적작용,급기결합배비폐공능의후대기층의원COPD진단수평적영향.방법 수궤추취호남모시적6가미배비유폐공능의적이급의원,병수궤분위간예급대조조(n=3).간예조내과의사진행단기COPD지식배훈병면비배비폐공능의,대조조칙불진행임하간예.배훈전후대간예조내과의사진행COPD문권조사,매제1분,총분10분.비교배훈전후의사개인득분급각제답제정학솔,비교간예전급간예후량조의원40세이상내과주원환자중COPD가능병례비례급COPD진단병례비례.결과 (1)간예조배훈전、후의사개인득분중위수위5분여9분(U=734.500,P=0.000),급격솔분별위43.0％여95.2％(x2=52.764,P=0.000),배훈전후비교차이균유통계학의의.(2)간예전,대조조여간예조COPD가능병례비례분별위0.69％급0.84％(x2=0.428,P=0.513),COPD진단병례비례균위0,조간비교차이균무통계학의의(P＞0.05);간예기간,대조조여간예조COPD가능병례비례분별위0.67％급14.40％(x2=404.017,P=0.000),대조조여간예조COPD진단병례비례분별위0급2.87％(x2=86.954,P=0.000),조간비교차이균유통계학의의.결론 (1)의사단기배훈병결합배비폐공능의가이유효제고기층의원적COPD진단수평;(2)단기배훈가이유효제고기층내과의사대COPD적인식수평.
Objective To investigate the effect of short-term training on improving physician's knowledge about chronic obstructive pulmonary disease (COPD),and the effect of short-term training combined with spirometer on diagnostic ratio of COPD in the primary hospitals.Methods Sixe primary hospitals without spirometer were sampled and randomly divided into two groups:intervention (n =3) and control (n =3) groups.Physicians were provided with short-term training about COPD and hospitals were provided with spirometer freely in intervention group,but neither in control group.Physicians in intervention group were required to answer questionnaires about COPD before and after training,respectively;one point per each question and full score was 10 points.Individual scoring and pass rate were compared.In a same period of 3 months before and after intervention,clinical doubtful diagnostic ratio and confirmative ratio of COPD in two groups were compared.Results (1) Before training,there were only 43.0％ physicians who got more than 6 points,and the median was 5 points.After training,there were 95.2％ physicians who got more than 6 points,and the median was 9 points.The difference of individual scoring,and pass rate between before and after training was statistically significant (U =734.500,P =0.000;x2 =52.764,P =0.000).(2) Before intervention,clinical doubtful diagnostic ratio of COPD was 0.69％ in control group and 0.84％ in intervention group(x2 =0.428,P =0.513),both confirmative ratio were 0％;There was no significant difference between them.After intervention,doubtful diagnostic ratio of COPD was 0.67％,confirmative ratio of COPD was 0％ in control group,and doubtful diagnostic ratio of COPD was 14.40％ and confirmative ratio of COPD was 2.87％ in intervention group;there were significant differences between them(x2 =404.017,P =0.000;x2 =86.954,P =0.000).Conclusions (1) Short-term training combined with spirometer could effectively improve the diagnostic level of COPD in the primary hospitals.(2)Short-term training could effectively improve the physician's understanding of COPD.