湖南省部分医学院校毕业生结核病知识、实践能力及相关因素调查

目的评价医学院校毕业生对结核病知识的掌握情况及其实践能力。方法运用自制调查问卷，在湖南省3所医学院校采取随机整群抽样方法抽查临床、预防专业应届毕业生，进行结核病知识、实践能力及相关因素的调查。结果450名调查对象中，439人(97．6％)对所有调查内容作了有效回答。其中男性257人(58．5％)，女性182人(41．5％)；平均年龄23岁(20～26岁)。在结核病知识方面，大多数学生对结核病的临床症状较为熟悉，但仅25．5％的受试知道卡介苗接种的作用；只有6．2％的学生知道我国传染性肺结核的现患率；33．5％了解结核病需归口管理，58．8％知道直接面视下短程治疗(DOTS)的定义。经分析，12个结核病知识条目中有6条在不同学校或专业或性别中差异有显性。在临床实践方面，334名曾管治过结核患的受试写出了80余种化疗方案，其中正确仅占16．8％；33．4％在治疗结核患时作了痰检复查；4．5％执行了结核病归口管理。结论应届医学院校毕业生对结核病知识掌握不够，临床实际能力欠缺。需加强结核病流行病学、预防和国家结核病控制规划等知识的培训。医学教育应将结核病规划纳入教育课程。

Knowledge and practice regarding tuberculosis among final-year medical students in Hunan, China

Objective To ascertain the level of knowledge, skills and ability about tuberculosis among final-year medical students in Hunan province of China. Methods The final-year medical students from 3 medical schools were asked to complete a pre-tested questionnaire by random sampling. The questionnaire consisted of 12 and 6 multiple-choice questions assessing knowledge and practices about tuberculosis, respectively. Results Four hundred and thirty-nine questionnaires were returned with a response rate of 97.6%. The majority of the students knew well on signs/symptoms associated with tuberculosis, but only a few students knew the prevalence of smear-positive pulmonary tuberculosis in China in 2000, while 25.5% of them knew of the BCG vaccination. 33.5% of the participants understood the policy of convergence case-management of tuberculosis. Analysis showed that six of twelve items were slightly statistically different among the respondents. The study also demonstrated that 334 respondents had prescribed 80 different treatment regimens but only 16.8% were correct. 33.4% of the participants ordered sputum examination during tuberculosis treatment course. Only 4.5% had transferred the patients with tuberculosis to local tuberculosis dispensary after their discharge from hospital.Conclusions Knowledge and practice competency regarding tuberculosis among the final-year medical students were generally inadequate. Many misunderstandings were found in the field of BCG vaccination, the status of tuberculosis and the performance of National Tuberculosis Project (NTP). These findings suggest that there is a lack of emphasis on proper health education about tuberculosis. Students in medical schools need more training and more practice.