慈溪市乡镇医师支气管哮喘认知状况的调查分析

目的 了解乡镇医师对支气管哮喘(简称哮喘)基本概念、治疗及管理的认知状况,为基层医师的培训提供依据.方法 对慈溪市25家不同级别医院共198名内科医师进行有关哮喘相关知识问卷调查,其中.三级医院1家,内科医师24名;二级医院5家,内科医师70名;一级医院19家,内科医师104名.问题涉及:哮喘定义、一线控制药物、预后、治疗中抗菌药物应用情况、GINA知晓率及医院是否备有吸入激素药物等.结果 对哮喘属气道慢性炎症及可控制性疾病,回答正确率分别为85.4%与96%,上述两问题在三级与一、二级医院间差异无统计学意义.对吸入糖皮质激素者为哮喘一线控制性用药、发作时是否应用抗菌药物、GINA知晓率方面.正确率分别为68.7%、29.3%和58.6%.三级医院与一、二级医院间存在显著差异(P<0.05).关于医院备有吸入糖皮质激素方面.全市共4家医院备有(1家三级医院、3家二级医院).一级医院均无吸入激素的备药.结论 基层医院,尤其是一、二级乡镇医院对哮喘的防治管理认知方面尚存在较多问题,知识较陈旧,对GINA知晓率较低,不利于基层大量哮喘患者的治疗及管理,规范培训基层医务人员,使其掌握哮喘防治指南,从而有效指导哮喘患者是基层哮喘管理亟待解决的问题.

Investigation on understanding levels of bronchial asthma among physicians of small town hospitals around Cixi city

Objective To investigate the understanding levels of basic concept, treatment and management of bronchial asthma(asthma) among physicians in small towns around Cixi city so as to provide a better training for them. Methods Analysis was made on the questionnaires about the knowledge of asthma filled in by 198 physicians from 25 small town hospitals around Cixi. Of all physicians investigated,there were 24 physicians from one hospital of grade 3,70 physicians from 5 hospitals of grade 2, and 104 physicians from 19 hospitals of grade 1. The answered questions in the questionnaire included concept, first-line used drugs and prognosis of asthma;the application condition of antibiotics during treatment of asthma;awareness of GINA;whether inhaling steroid was prepared in hospitai; etc. Results The percentage for the correct answer that asthma is a chronic airway inflammation was 85.4% in physicians from hospital of grade 3 and was 96% in physicians from hospitals of grade 1 and 2 (P >0.05). The percentages for the correct answers that inhaling steroid is the first-line drug for controlling asthma,antibiotics should not be used during episode of asthma, GINA's meaning were 68. 7%, 29.3%, 58.6% respectively among all physicians investigated. The percentages were significantly higher among the physicians from hospital of grade 3 than ones among those from hospital of grade 1 and 2 (P<0.05). As for the question whether there is inhaling steroid prepared at hospital or not,the answer "yes" was in 4 hospital (one hospital of grade 3 and three hospitals of grade 2), but the answer "no" was in other hospitals including all hospitals of grade 1.Conclusions Among small town hospitals,especially hospitals of grade 1 and 2,there are still quite a lot of problems in understanding prevention, treatment and management of asthma, behaving as old or backward knowledge, lower awareness of GINA. This is unavailable for treatment and management of asthma.Therefore,standard training is badly needed for medical doctors from small town hospitals so that guideline for prevention and treatment of asthma can be mastered and effective guidance for asthma management can be achieved.