社区全科医生COPD防治能力的脆弱性调查

目的了解社区全科医生对慢性阻塞性肺疾病防治知识的脆弱性,为社区医生COPD防治知识培训提供参考依据。方法 2009年,在徐州市城乡抽取59家社区卫生服务中心（站）的204名全科医生进行问卷调查。结果调查204人,结果47人不及格,总体脆弱性为23.04%,COPD知识脆弱性评价为（31.67±7.69）分。全科医生COPD知识脆弱性,城区为14.29%,农村为29.17%（P〈0.05）;社区卫生服务中心的为19.14%,社区卫生服务站的为38.10%（P〈0.01）;大专以上文化的为11.71%,高中及以下文化程度的为36.56%（P〈0.01）;工龄1～9年、10～19年、20年以上的分别为12.50%、19.15%、34.29%（P〈0.05）。204名全科医生应对COPD防治知识的脆弱性十分严重,其中以应对全部支气管扩张剂种类的脆弱性最突出,为93.15%,应对全部治疗药物的脆弱性为92.16%,应对危险因素、临床症状、鉴别诊断、体征、辅助检查方法和非药物疗法种类的脆弱性分别为81.37%、75.98%、64.71%、52.94%、52.94%和51.47%。结论徐州市全科医生在慢性阻塞性肺疾病防治知识严重缺乏,提高社区的全科医生对COPD知识的水平十分重要。

Investigation on Ability of General Practitioner about Control and Prevention of Chronic Obstructive Pulmonary Diseases in Community Health Service Centers

Objective To understand the vulnerability of basic knowledge about control and prevention of chronic obstructive pulmonary disease（COPD） among general practitioner（GP） in community health service centers,and to provide more references for community physicians training about COPD prevention and treatment.Methods Questionnaire survey was conducted among 204 GPs at 59 community health service centers in city of Xuzhou in 2009.Results Forty seven GPs failed in the test,the total rate of vulnerability was 23.04%（47/204）,the average knowledge score for COPD was 31.67±7.69;The vulnerability of urban communities,rural communities,community health center,community health service stations,GP with post-secondary education or above,GP with high school education or below were 14.27%,29.17%,19.14%,38.91%,11.71% and 36.56%,respectively.There were statistical significances in the difference between urban and rural communities（P0.05）,community health center and health service stations（P0.01）,GP with post-secondary education or above and with High school education or below（P0.05）,respectively.There was also statistical significance in the difference among 1-9 years seniority,10-19 years seniority,more than 20 years seniority groups（P0.05）,the vulnerability rate of them were 12.50%,19.15%,34.29%,respectively.Among 204 practitioners,the vulnerability with highest rate（93.14%） was the absence of the knowledge about the treatment of bronchodilators;the second（92.16%） was absence of the knowledge about the therapeutic drug of COPD.The vulnerability about all risk factors of COPD,clinical symptoms,the differential diagnosis of disease,physical signs,methods of medical examination and types of non-drug therapy were 81.37%,75.98%,64.71%,52.94%,52.94% and 51.47%,respectively.Conclusion The vulnerability rate of basic knowledge of prevention and treatment for COPD is very high in general practitioners,it is necessary to strengthen training for them.