上海市浦东新区城乡结合部医生心血管疾病急救能力及培训现况分析

目的 了解城乡结合部医生心血管疾病急救的水平、培训状况及需求,探讨提高医生急救技能的方法。方法 以“急救水平”“心血管疾病”“培训”“城乡结合部”“社区医生”“first aid level/condition”“cardiovascular disease”“training”“Rural-urban fringe zone”为检索词,检索中国生物医学文献数据库、中国学术期刊全文数据库、万方知识服务平台、中国科技期刊全文数据库、PubMed和Web of Science数据库,设计调查问卷。经分层随机抽样,对浦东城乡结合部某综合性医院及其辐射的6家社区医院的160名医生问卷调查。结果 调查对象平均得分(14.42±2.39)分,总体正确率为72.1%。心血管疾病急救知识中掌握最差的是体外除颤仪的使用(52.5%),其次是心电图解读(54.0%)、急性心肌梗死的临床症状(61.0%)和心肺复苏的步骤(65.0%)。综合医院的得分高于社区医院(P<0.05),参加过培训且培训次数越多、培训方式有情景模拟的得分更高(P<0.05)。52.6%的调查对象选择未专门开展此项培训是影响参加心血管疾病急救培训的主要因素,98.1%的调查对象认为心血管疾病急救培训非常必要。结论 浦东城乡结合部医生尤其是社区医生对心血管急救的掌握水平不容乐观,培训缺乏,需求很高。体外除颤仪普及程度很低,建议针对薄弱点建立有效培训体系。

Survey on management competence for first-aid of cardiovascular diseases among doctors working in rural-urban fringe zone

Objective To survey the management competence for first aid of cardiovascular disease among doctors working in rural-urban fringe zone. Methods A questionnaire was designed based on the databases. One hundred and sixty doctors from a general hospital and 6 community health service centers in Shanghai Pudong rural-urban fringe zone were selected as study subjects by stratified random sampling method. A questionnaire survey was conducted and the data were analyzed. Results The average score of the survey was (14.42±2.39) with a correct rate of 72.1%. The weakest area was the use of automatic external defibrillator (AED)(52.5%), followed by interpretation of electrocardiogram(54.0%), clinical symptoms of acute myocardial infarction (61.0%) and cardiopulmonary resuscitation (65.0%). The score of been participating in training and having scenario simulation training in doctors from general hospital was higher than that from community health centers (P<0.05). No official training program for cardiovascular disease was the main factor affecting the training (52.6%). Majority of the responders (99.3%) considered that training was necessary. Conclusion The management competence of cardiovascular disease first aid in doctors from Pudong rural-urban fringe zone is less satisfactory, especially for community doctors. The effective training system should be established.