【摘要】：目的調(diào)查西安市社區(qū)兒童普通感冒的診療預(yù)防服務(wù)情況,同時對社區(qū)全科醫(yī)生關(guān)于該疾病診療的知識態(tài)度進行了解,并分析診療現(xiàn)狀、全科醫(yī)生的認知和態(tài)度水平及其相關(guān)影響因素,從而進一步研究社區(qū)兒童普通感冒診療不規(guī)范的原因,探討相應(yīng)的解決方案。方法采用的是橫斷面調(diào)查研究方法。對西安市城6區(qū)61家社區(qū)衛(wèi)生服務(wù)中心的118名全科醫(yī)生進行關(guān)于兒童普通感冒的診療預(yù)防情況調(diào)查。社區(qū)全科醫(yī)生關(guān)于兒童普通感冒的診療預(yù)防情況調(diào)查表主要包含三部分內(nèi)容:一般情況、目前提供的診療預(yù)防服務(wù)的情況、關(guān)于兒童普通感冒的知識與態(tài)度。使用spss進行相關(guān)統(tǒng)計分析,計數(shù)資料使用x2檢驗,多因素分析采用Logistic回歸分析。結(jié)果1.全科醫(yī)生提供的診療預(yù)防服務(wù)情況:(1)62.7%的全科醫(yī)生治療理念正確;(2)46.6%的全科醫(yī)生會常規(guī)使用抗病毒藥物,21.2%的會使用地塞米松作為退熱劑;(3)僅有14.4%的全科醫(yī)生會滿足患兒家屬抗菌藥物處方的要求,90.7%的醫(yī)生選擇有時或經(jīng)常進行無需抗菌藥物的宣教,但只有57.6%的醫(yī)生肯定了其宣教的有效性;(4)68.6%的全科醫(yī)生經(jīng)常向患兒家屬宣教有關(guān)的預(yù)防知識。2.全科醫(yī)生關(guān)于兒童普通感冒的知曉情況評價:47.5%(56人)知識掌握較差,52.5%(62人)知識掌握較好,總體知識掌握水平較低;比較不同特征的全科醫(yī)生的知識掌握情況,差異無明顯統(tǒng)計學(xué)意義;3.不同特征的全科醫(yī)生兒童普通感冒知識比較:不同臨床工作年限的全科醫(yī)生對普通感冒的認知差異有統(tǒng)計學(xué)意義(P0.05);不同臨床工作年限、不同職稱以及不同收入水平的全科醫(yī)生在首選治療方案的選擇上有明顯差異(P0.05)。4.全科醫(yī)生關(guān)于兒童普通感冒的態(tài)度信念評價:23.7%(28人)態(tài)度消極,76.3%(90人)態(tài)度積極;不同學(xué)歷、不同收入水平的全科醫(yī)生對普通感冒診療的態(tài)度信念差異有統(tǒng)計學(xué)意義(P0.05),更高學(xué)歷、更高收入的全科醫(yī)生態(tài)度更積極。5.全科醫(yī)生關(guān)于兒童普通感冒知識與態(tài)度的影響因素:多因素Logistic回歸分析顯示,學(xué)歷為診療態(tài)度的影響因素,學(xué)歷偏低者態(tài)度相對消極。結(jié)論全科醫(yī)生關(guān)于兒童普通感冒的診療服務(wù)仍需規(guī)范,關(guān)于兒童普通感冒的認知水平仍需提高,態(tài)度信念較積極;應(yīng)當(dāng)開展更多形式的診療知識的宣教和培訓(xùn),重視全科醫(yī)生的繼續(xù)教育,發(fā)揮和利用其積極性,提高社區(qū)兒童普通感冒的診療預(yù)防服務(wù)質(zhì)量。
[Abstract]:Objective to investigate the diagnosis and treatment of common cold in community children in Xi'an, and to understand the knowledge and attitude of community general practitioners on the diagnosis and treatment of the disease, and to analyze the current situation of diagnosis and treatment. The cognition and attitude level of general practitioners and their related influencing factors were studied to further study the causes of non-standard diagnosis and treatment of common cold in community children and to explore the corresponding solutions. Methods A cross-sectional investigation method was used. 118 general practitioners in 61 community health service centers in 6 districts of Xi'an were investigated on the diagnosis and treatment of common cold in children. The questionnaire of community general practitioners on the diagnosis and treatment of common cold in children mainly includes three parts: general situation, current situation of diagnosis and treatment prevention service, knowledge and attitude about common cold in children. Spss was used for statistical analysis, x 2 test was used for counting data, and Logistic regression analysis was used for multivariate analysis. Result 1. (1) 62.7% of the general practitioners had the correct treatment idea, (2) 46.6% of the general practitioners would routinely use antiviral drugs, 21.2% would use dexamethasone as antipyretic, and (2) 46.6% of the general practitioners would use dexamethasone as antipyretic. (3) only 14.4% of the general practitioners will meet the requirement of prescribing antimicrobial drugs in the family of children, and 90.7% of the doctors choose to give education without antimicrobial drugs sometimes or often. But only 57.6% of doctors confirmed the effectiveness of their propaganda. (4) 68.6% of the general practitioners often spread the preventive knowledge to the families of the children. 2. The general practitioners' knowledge of common cold in children: 47.5% (56) were poor, 52.5% (62) had better knowledge, and the overall level of knowledge was low. Compared with the different characteristics of the general practitioners' knowledge, the difference was not statistically significant; 3. Comparison of common cold knowledge among general practitioners with different characteristics: there was significant difference in cognition of common cold among general practitioners with different clinical working years (P0.05); Different clinical working years, different titles and different income levels of general practitioners in the first choice of treatment options were significantly different (P0.05). The attitudes and beliefs of general practitioners on common cold in children were evaluated as follows: 23.7% (28) had negative attitude, and 76.3% (90) had positive attitude. Different educational background, different income level of general practitioners' attitude to common cold diagnosis and treatment belief difference was statistically significant (P0.05), higher education, higher income general practitioners attitude more active. 5. Multivariate Logistic regression analysis showed that education was the influencing factor of diagnosis and treatment attitude, and the attitude of those with low education was relatively negative. Conclusion the general practitioner's diagnosis and treatment of common cold in children still need to be standardized, the cognitive level of common cold in children should be improved, and the attitude and belief should be positive. We should carry out more forms of education and training of diagnosis and treatment, attach importance to the continuing education of general practitioners, give full play to their enthusiasm, and improve the quality of diagnosis and treatment of common cold in community children.
【學(xué)位授予單位】：西安醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R725.1

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