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Students’ knowledge of COPD: projects ASCO-1 and ASCO-­2 results comparison 学生COPD知识:ASCO-1与ASCO- 2项目结果比较
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa1485
R. Bontsevich, T. Filinichenko, A. Gavrilova, K. Shchurovskaya, G. Batisheva, N. Goncharova, G. Ketova, V. Barysheva, O. Myronenko, O. Kompaniets, E. Miliutina, A. Mikhno, Zhanna Zhdanova
The Aim: of study is to assess the dynamics of medical undergraduates’ knowledge of COPD basics. Materials and Methods: Following up our multicenter research ASCO-­1 (‘14­-‘16), conducted in 5 Russian cities, which 213 medical students of higher grades were tested in, we started ASCO-­2 project in 2017. Currently, we obtained the results from 221 undergraduates tested in 5 Russian and Ukrainian centers. The knowledge of COPD basics such as definition, pathogenesis, diagnostics and treatment was evaluated by using 19-single-choice-questions survey. Results: The average level of correct answers in both groups (ASCO-­1 and ASCO-­2) was not significantly decreased (54.5%-47.6% respectively, p>0.05), and varied from 20.2%-­23.3% to 74.6%­-81.1% in different questions. The most difficult question was still related to the statement about influenza vaccination role in the control of COPD exacerbations (20.2%-23.3%, p>0.05). There was a significant improvement in knowledge on such aspects as COPD risk factors (52.6%-81.1%, p 0.05), spirometry as a diagnosis confirmation method (62.0%-76.7%, p 0,05). Conclusion: It was revealed that despite the availability of plenty training and scientific literature in the area of COPD, the level of knowledge remains unsatisfactory. Thus, COPD subject should be studied more thoroughly in higher schools.
本研究的目的是评估医学本科生COPD基础知识的动态。材料与方法:继我们在俄罗斯5个城市开展的多中心研究ASCO- 1(2014 - 2016),对213名高年级医学生进行了测试后,我们于2017年启动了ASCO- 2项目。目前,我们获得了5个俄罗斯和乌克兰中心221名大学生的测试结果。采用19道单选题调查,对COPD的定义、发病机制、诊断和治疗等基础知识进行评估。结果:两组(ASCO—1和ASCO—2)的平均正确率均未显著降低(分别为54.5% ~ 47.6%,p>0.05),不同题目的平均正确率在20.2% ~ 23.3% ~ 74.6% ~ 81.1%之间。最难回答的问题仍与流感疫苗在控制COPD加重中的作用有关(20.2% ~ 23.3%,p < 0.05)。COPD危险因素知识(52.6% ~ 81.1%,p 0.05)、肺活量测定作为诊断确证方法的知识(62.0% ~ 76.7%,p 0.05)均有显著提高。结论:尽管在COPD领域有大量的培训和科学文献,但知识水平仍然令人不满意。因此,高等学校应该对COPD学科进行更深入的研究。
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引用次数: 0
Improving our patients’ understanding of their asthma 提高患者对哮喘的认识
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa1486
E. Heiden, M. Rason, J. Marshall, J. Gates, D. Lodge, R. Harvey, Matthew T Jones, T. Brown, A. Chauhan, S. Babu, H. Rupani
Introduction: The Portsmouth Asthma Service serves a population of over 675,000 people. We regularly identify patients who do not understand their asthma; as a result they lack confidence to seek advice or ask questions about their condition, resulting in a reliance on healthcare providers to manage symptoms and subsequent poor asthma control. Poorly controlled disease can lead to frequent exacerbations, impairing the patient’s quality of life and increasing their risk of premature death. Method: We undertook an appreciative exercise to identify the main gaps in our patient’s understanding of their asthma. We held focus groups with clinic patients to explore their understanding of asthma and to identify potential educational interventions to improve their confidence to manage their symptoms. Results: The majority of patients were unable to define asthma as a condition and responses included “terrifying and life-threatening” and “frustrating and depressing”. Patients felt that there was a lack of educational resources available in the clinic, they did not know where to seek advice and suggested that written information to share with family would be beneficial. They identified that a poor understanding of their condition prevented them from being able to make decisions about their asthma management. In collaboration with patients, we designed asthma information leaflets and a poster to display in the waiting room. Conclusion: Feedback was overwhelmingly positive. As a result of their improved understanding, patients felt empowered to ask questions about their diagnosis and management and felt confident to self-manage symptoms. We will ensure that asthma education remains a prominent and sustainable aspect of the care we provide our patients.
朴茨茅斯哮喘服务中心为超过67.5万人提供服务。我们定期识别不了解自己哮喘的患者;因此,他们缺乏寻求建议或询问有关其病情的问题的信心,导致依赖医疗保健提供者来管理症状和随后的哮喘控制不良。疾病控制不佳可导致病情频繁恶化,损害患者的生活质量并增加其过早死亡的风险。方法:我们进行了一项欣赏练习,以确定患者对其哮喘理解的主要差距。我们与临床病人举行焦点小组,探讨他们对哮喘的理解,并确定潜在的教育干预措施,以提高他们管理症状的信心。结果:大多数患者无法将哮喘定义为一种疾病,反应包括“可怕和危及生命”和“令人沮丧和沮丧”。患者认为诊所缺乏可用的教育资源,他们不知道在哪里寻求建议,并建议与家人分享书面信息将是有益的。他们发现,对自己病情的不了解阻碍了他们对哮喘管理做出决定。与患者合作,我们设计了哮喘信息传单和海报,在候诊室展示。结论:反馈非常积极。由于他们的理解有所提高,患者感到有权询问有关他们的诊断和管理的问题,并感到有信心自我管理症状。我们将确保哮喘教育仍然是我们为患者提供护理的一个突出和可持续的方面。
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引用次数: 0
Level of expertise in TB diagnosis among general practitioners 全科医生在结核病诊断方面的专业水平
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa1480
M. Jakimova, V. Punga, O. Komissarova
Background: Errors in TB diagnosis made by the general practitioners (GPs) lead to the development of severe, chronic, dangerous epidemiological forms of the disease among the population of the Russian Federation. Material and Methods: The training center performed a single-step online testing of 312 GPs to assess their knowledge of diagnostic criteria for TB detection. The test contained 27 questions regarding patient complaints, history, clinical manifestations and tests required for a referral to a specialized TB facility Results: A high level of knowledge (85% or more correct answers) was reported only in 31.6% of physicians who correctly evaluated patient conditions resulting in a low probability of developing severe forms of tuberculosis. Poor level of knowledge - less than 30% of correct answers - was observed in 42.3% of GPs who had some gaps in knowledge about tuberculosis and its diagnostics and did not use the evaluation algorithms for patients with presumed pulmonary TB in their practice. Poor training of GPs in TB diagnosis has an impact on the epidemiological situation in the country. This group of physicians was invited to take a thematic course in the framework of a special 20-hour training program (webinar). The training outcomes will be evaluated and reported in 6 months. Conclusions: There is a need for systematic training in modern approaches to TB diagnosis as part of the curriculum of the Medical universities and advanced training courses in phthisiology.
背景:全科医生(gp)在结核病诊断中的错误导致俄罗斯联邦人口中出现严重、慢性、危险的流行病学形式的结核病。材料和方法:培训中心对312名全科医生进行了单步在线测试,以评估他们对结核病检测诊断标准的了解程度。该测试包含27个问题,涉及患者的主诉、病史、临床表现和转诊到专门的结核病机构所需的检查。结果:只有31.6%的正确评估患者病情的医生报告了高水平的知识(85%或更多的正确答案),从而导致发展为严重形式结核病的可能性较低。42.3%的全科医生在结核病及其诊断知识方面存在一定差距,并且在实践中没有使用对疑似肺结核患者的评估算法,这些全科医生的知识水平很差——不到正确答案的30%。全科医生在结核病诊断方面的培训不足对该国的流行病学情况产生了影响。这组医生被邀请参加一个特殊的20小时培训项目(网络研讨会)框架下的主题课程。培训结果将在6个月内进行评估和报告。结论:有必要将现代结核病诊断方法的系统培训作为医科大学课程和生理学高级培训课程的一部分。
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引用次数: 0
Assessing an Educational Intervention to Improve Recognition of Frailty in Hospitalized Patients with COPD 评估教育干预以提高COPD住院患者对虚弱的认识
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa1476
N. Diab, Aaron Leblanc, C. Backman, J. Leahy, S. Joanisse, S. Huang, Tammy Pulfer, A. Forster, S. Mulpuru
Title: Assessing an Educational Intervention to Improve Recognition of Frailty in Hospitalized Patients with COPD Background: Frailty is common among COPD patients and is associated with poor health outcomes. There is a lack of data regarding the reliability of frailty assessments by frontline hospital staff. Objectives: 1. Design an educational intervention to improve the recognition of frailty among acute-care nurses. 2. Evaluate the inter-rater reliability of frailty assessments among nurses compared to a gold standard (GS). Methods: We conducted a mixed-methods study with 27 Registered Nurses (RNs) on a respiratory hospital ward. RNs evaluated 10 clinical vignettes and assigned a frailty score to each using the validated Clinical Frailty Scale (1=well to 8=terminally ill). A 1-hour frailty educational intervention was delivered to RNs. 1-week later the RNs assigned ratings to the same 10 vignettes. Fleiss Kappa were used to determine agreement between RN and GS ratings for each case. Results: For all scored cases, kappa measurements increased post-education compared to pre-education or remained stable in the case of frailty rating 3. No RN was able to identify vignettes with a GS frailty rating of 8 (Table 1). Conclusion: A 1-hour frailty educational intervention improved RNs ability to provide reliable frailty ratings among patients with COPD. Frailty rating of 8 was difficult to recognize among RNs.
背景:虚弱在COPD患者中很常见,并且与不良的健康结局相关。缺乏关于一线医院工作人员虚弱评估可靠性的数据。目的:1。设计教育干预以提高急症护理护士对虚弱的认知。2. 与金标准(GS)相比,评估护士虚弱评估的内部可靠性。方法:我们对27名注册护士(RNs)进行了一项混合方法的研究。RNs评估了10个临床小样本,并使用经过验证的临床虚弱量表(1=健康至8=绝症)为每个临床小样本分配虚弱评分。对注册护士进行1小时的虚弱教育干预。一周后,注册护士对同样的10个小插曲进行评分。使用Fleiss Kappa来确定每个病例的RN和GS评分之间的一致性。结果:对于所有评分的病例,kappa测量值在教育后比教育前增加,或者在虚弱等级为3的情况下保持稳定。没有注册护士能够识别出GS衰弱评分为8分的受试者(表1)。结论:1小时的衰弱教育干预提高了注册护士在COPD患者中提供可靠的衰弱评分的能力。8分的虚弱评分在注册护士中难以识别。
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引用次数: 1
Audience response systems may help build confidence and competence in diagnosing and managing asthma 受众反应系统可能有助于建立诊断和管理哮喘的信心和能力
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.oa5346
W. Ricketts, P. Pfeffer, R. Ashworth, A. Hakim
Background: Correct interpretation of lung function tests is essential for diagnosis and management of common respiratory diseases. Medical students enrolled at Barts and the London, QMUL, receive a series of teaching sessions describing management of respiratory diseases prior to attendance on respiratory wards. However, a proportion of students struggle to apply managment algorithms to aid clinical decision making in real-life patients. Previous studies suggest that audience response systems (ARS) may aid decision making. We hypothesized that the use of an ARS may improve confidence and competency amongst medical students when undertaking clinical decisions or interpreting lung function tests. Methods: Chest physicians and medical science lecturers collectively designed a new teaching session using an ARS, Mentimeter, which required students to manage a patient that was referred to the respiratory clinic. In a step-wise manner, students were presented with the patient’s medical and physical history, followed by lung function results. At each stage of the presentation, students were questioned to assess their clinical decision making/interpretation of lung function results. Students’ view of the interactive teaching session using ARS were surveyed using a 5-point Likert scale. Results: Following the ARS teaching session, 70 and 97% of students strongly agreed/agreed that they felt more confident in analysing spirometry data and developed a better understanding of clinical-decision making in asthma management, respectively. Discussion: Utilising an ARS can help build medical students’ confidence and clinical decision making, and insights for future clinical study.
背景:正确解读肺功能检查对常见呼吸系统疾病的诊断和治疗至关重要。在巴茨和伦敦QMUL注册的医科学生在进入呼吸病房之前,要接受一系列关于呼吸系统疾病管理的教学课程。然而,有一部分学生很难应用管理算法来帮助现实生活中的患者做出临床决策。先前的研究表明,观众反应系统(ARS)可能有助于决策。我们假设使用ARS可以提高医学生在进行临床决策或解释肺功能检查时的信心和能力。方法:胸科医生和医学讲师共同设计了一个新的教学课程,使用ARS, Mentimeter,要求学生管理一个转介到呼吸诊所的病人。以循序渐进的方式,向学生介绍了患者的医疗和身体病史,然后是肺功能结果。在报告的每个阶段,学生都被询问以评估他们对肺功能结果的临床决策/解释。使用5分李克特量表调查学生对使用ARS的互动教学会话的看法。结果:在ARS教学课程之后,70%和97%的学生强烈同意/同意他们对分析肺活量测定数据更有信心,并对哮喘管理的临床决策有了更好的理解。讨论:利用ARS可以帮助医学生建立信心和临床决策,并为未来的临床研究提供见解。
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引用次数: 0
Evaluating e-consultation implementation in Sleep Apnoea-Hypopnoea Syndrome (SAHS) 评估睡眠呼吸暂停-低通气综合征(SAHS)的电子咨询实施情况
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.oa5344
Marcos Zuil Martin, L. Pérez, N. Sánchez, P. Clavería, A. Castanera, M. A. Santolaria, J. Lázaro, M. Rosell, A. Boldova, J. Carretero
Background: Access to specialist advice remains a barrier for many Primary Care Providers (PCP). We’ve developed an electronic consultation system based on a secure web-based tool as an alternative to traditional consultation. We decided to focus this e-consulting on SAHS as it was deemed to be representative of a high prevalence syndrome. Aims: to study the implementation of an e-consultation service between PCP and a Respiratory Unit as a first consultation about SAHS. Methods: Prospective and pilot study of a secure, web-based e-consultation, from the Regional Health Care Service in Aragon (Spain), developed between our Respiratory Unit and PCP, included in the Hospital health area (250,000 patients per area). Web-messaging via the Internet were sent from PCP and replied by a pneumologist designated for that purpose. The e-consult cycle time was completed within 72 hours. This study took place from March 1, 2018 to December 28, 2018. Results: Total pulmonary consultations: 1357 SAHS related consultations: 433 (31,9%). Answers provided by the specialists (about SAHS): –235 cases (54,2%) underwent directly to home poligraphy (as STOP BANG questionnaire filled out by PCP >4) –17 cases were submitted for treatment, since they reported poligraphic studies carried out previously –7 cases were refused as SAHS –In 60 cases more information was required –114 cases were included as questions about other items Conclusions: The implementation of e-consultation service, increase access to specialty clinics, improve the quality of consultation, reduce the wait times for patients and can lead to overall cost savings for the health care system in a high prevalence syndrome such as SAHS
背景:获得专家意见仍然是许多初级保健提供者(PCP)的障碍。我们开发了一个基于安全网络工具的电子咨询系统,作为传统咨询的替代方案。我们决定将电子咨询的重点放在SAHS上,因为它被认为是一种高患病率综合征的代表。目的:研究PCP与呼吸科之间的电子会诊服务的实施,作为SAHS的首次会诊。方法:前瞻性和试点研究安全的、基于网络的电子咨询,来自阿拉贡(西班牙)地区卫生保健服务,由我们的呼吸科和PCP开发,包括在医院卫生区域(每个区域250,000名患者)。PCP通过互联网发送网络信息,并由指定的肺病专家进行回复。电子咨询周期时间在72小时内完成。该研究于2018年3月1日至2018年12月28日进行。结果:肺部总会诊:1357例SAHS相关会诊:433例(31.9%)。专家提供的答案(关于SAHS): -235例(54.2%)接受了直接到家的采集(如PCP >4填写的STOP BANG问卷)-17例因报告了之前进行的采集研究而提交治疗-7例被拒绝为SAHS - 60例需要更多信息-114例被纳入其他项目的问题。实施电子咨询服务,增加专科诊所的可及性,提高咨询质量,减少患者的等待时间,并可为SAHS等高发综合征的卫生保健系统节省总体成本
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引用次数: 0
Role of Social Media in exploring parental expectations regarding usage and providing education on nebulized medication in children 社交媒体在探索家长对儿童雾化药物使用的期望和提供教育方面的作用
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.oa5342
M. Craiu, I. Stan, V. Comanici
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引用次数: 1
Late Breaking Abstract - An ethnographic study on respiratory physicians’ communicative repertoire 摘要:呼吸内科医生沟通技巧的人种学研究
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.oa5340
Carolin Sehlbach, P. Teunissen, F. Smeenk, E. Driessen, M. Govaerts, Gernot G. U. Rohde
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引用次数: 0
We are not an island - initiating a respiratory trainee research network 我们不是一个孤岛——启动一个呼吸实习生研究网络
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa1471
A. Dipper, H. Morrison, Rachel Jones, P. Mitchelmore, H. Welch, Ryan Miller, R. Bhatnagar, J. Corcoran, Michael A. Gibbons, J. Fallon
Introduction: Trainee Research Networks (TRNs) are established in other specialities, producing high quality, greater impact work by collaborating across multiple sites [1]. South West England has a population of over 5 million [2], with 39 respiratory trainee doctors across 12 hospitals. Aim: To establish a trainee led respiratory research network across SW England, with representation in all regional hospitals. Method: A constitution was drafted based on existing successful TRNs. This was presented at a regional trainee meeting with senior representation from the SW Anaesthetics TRN. Trainees were invited to read the constitution and enrol. Committee positions were advertised to all members. Results: 21 respiratory trainees signed up to PRISM (Pulmonary Research Inter Site Matrix) representing 10/12 hospitals in the South West. The network is led by a committee of five trainees. Four Consultant Directors, with links to two university research centres, provide senior guidance. Acknowledging different levels of input from contributors and data ownership rights were the most contentious issues. A project evaluating outcomes from High Flow Nasal Oxygen therapy has launched the network. Conclusion: Trainees are enthusiastic to develop research networks. We initiated our first project within four weeks and recruited patients from ten sites. This model for collaborative research is widely applicable to other regions and specialties. Future challenges include the adoption of a suitable multisite, secure IT system and maintaining momentum for collaborative work. References: [1] RAFT:uniting trainees to undertake national projects RCoA Bulletin May 2014: 52-54 [2] Office for National Statistics ; 2011 Census aggregate data. UK Data Service
简介:实习生研究网络(trn)在其他专业中建立,通过跨多个站点的合作产生高质量,更有影响力的工作[1]。英格兰西南部人口超过500万,12家医院共有39名呼吸实习医生。目的:在英格兰西南部建立一个由实习生领导的呼吸研究网络,在所有地区医院都有代表。方法:在现有成功的trn的基础上,制定章程。这是在与SW麻醉学TRN高级代表的区域培训生会议上提出的。学员被邀请阅读宪法并报名。委员会的职位向全体成员登了广告。结果:21名呼吸学学员签约了PRISM (Pulmonary Research intersite Matrix),代表了西南地区10/12家医院。该网络由五名受训者组成的委员会领导。与两所大学研究中心有联系的四名顾问主任提供高级指导。承认贡献者不同程度的投入和数据所有权是最具争议的问题。一个评估高流量鼻氧治疗效果的项目已经启动了该网络。结论:学员发展科研网络的热情较高。我们在4周内启动了第一个项目,从10个地点招募了患者。这种合作研究模式广泛适用于其他地区和专业。未来的挑战包括采用合适的多站点、安全的IT系统和保持协作工作的势头。参考文献:[1]RAFT:联合受训者承担国家项目RCoA公报2014年5月:52-54 bb0国家统计局;2011年人口普查汇总数据。英国数据服务
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引用次数: 0
The center for distance learning and monitoring in education of tb specialists and medical students 远程学习和监测结核病专家和医学生教育中心
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa1470
Sanajr Sultanov, N. Parpieva, K. Mukhamedov
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引用次数: 0
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Medical education, web and internet
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