农村社区初级保健医师和家庭住院医师对脑震荡的认识、态度和信念如何?

Heather Galbraith, Jairus J. Quesnele, Shannon Kenrick-Rochon, S. Grenier, Tara Baldisera
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引用次数: 2

摘要

背景:初级保健医生和家庭医学住院医师报告说,在诊断和管理儿科脑震荡患者时,他们的知识仍然存在差距。方法采用横断面电子调查方法,对安大略省东北部地方卫生综合网络(LHIN)的130名初级保健医生和家庭医学住院医生进行调查。描述性统计,卡方Fisher精确检验,用于比较医师和住院医师,双尾p < 0.05(95%置信区间)。结果44%的医疗服务提供者在治疗脑震荡时没有使用任何特定的临床实践指南、标准化评估工具、无法回忆起特定工具/指南的来源或省略回答问题,回复率为48%。然而,61%的受访者会将部分或全部脑震荡患者转介给专科医生治疗。至少41%的医疗服务提供者表示,他们无法获得专门针对脑震荡的“医疗服务提供者决策支持工具”,25家医疗服务提供者中有88%无法获得出院指示。结论:与其他司法管辖区类似,安大略省东北部的初级保健医生和家庭医学住院医生报告在儿童脑震荡的诊断和管理方面存在知识差距。因此,他们没有使用当前的指导方针或最佳实践来指导管理。
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What are the knowledge, attitudes and beliefs regarding concussion of primary care physicians and family resident physicians in rural communities?
Background Primary care physicians and family medicine resident physicians report continued gaps in knowledge when diagnosing and managing pediatric patients with concussion. Methods A cross-sectional electronic survey of 130 primary care physicians and family medicine resident physicians in the Northeastern Ontario Local Health Integration Network (LHIN). Descriptive statistics, chi-squared Fisher exact tests, were used to compare physicians versus resident physicians with two-tailed p < 0.05 (with 95% confidence intervals). Results With a 48% response rate, when treating concussions 44% of providers either did not use any specific clinical practice guideline, standardized assessment tool, could not recall the source of a specific tool/guideline or omitted answering the question. However, 61% of all respondents would refer some or all concussion patients to a specialist for treatment. At least 41% of providers indicated they lacked access to a ‘Provider Decision Support Tool’ specific to concussion, and 88% of the 25 providers were without access to discharge instructions. Conclusion Similar to other jurisdictions, Northeastern Ontario primary care physicians and family medicine resident physicians report gaps in knowledge for both diagnosis and management of pediatric concussion. Consequently, they did not use current guidelines or best practices to guide management.
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