关键词: 肺疾病, 慢性阻塞性, 医师, 初级保健, 问卷调查, 北京市

Abstract:

Objective To evaluate the cognition and diagnosis and treatment on chronic obstructive pulmonary disease of physicians in Yanqing District Primary Hospital of Beijing in order to provide direction and basis for further improving the ability of diagnosis and treatment of COPD in primary hospitals. Methods The questionnaire was designed according to the relevant problems in the diagnosis and treatment of COPD, including doctors’ risk factors for COPD, comprehensive evaluation, education and management, initial treatment scheme recommendation, follow-up, oxygen therapy strategy, family noninvasive ventilation strategy, and understanding and application of the guidelines. After joint demonstration by experts, the final draft was formed by using the questionnaire star technology platform, then an anonymous questionnaire survey was conducted among 160 in-service physicians in 10 community hospitals in Yanqing District. A total of 160 questionnaires were collected, and the response rate was 100.0%. After removing 4 unqualified questionnaires, 156 valid questionnaires (97.5%). The results of 156 questionnaires were summarized and analyzed. Results The survey showed that most physicians in grass-roots hospitals (82.7%, 129/156) were familiar with the risk factors of COPD, but only a few (22.4%, 35/156) could correctly conduct comprehensive evaluation, and only 23.7% (37/156) could give a reasonable initial treatment plan according to the guidelines; Most (96.2%, 150/156; 76.9% (120/156) doctors did not pay much attention to the follow-up, education and management of COPD patients, and only 3.8% (6/156) doctors followed the guidelines strictly; Most doctors in primary hospitals (76.9%, 120/156) were familiar with oxygen therapy strategy, but only 23.7% (37/156) were familiar with the application of noninvasive ventilator. The survey data also showed that the cognition and mastery of COPD diagnosis and treatment knowledge of doctors with bachelor degree or above (37.1%, 23/62), intermediate title or above (33.3%, 23/69) and female (30.1%, 28/93) were significantly higher than those of doctors with lower academic qualifications (12.8%, 12/94), junior title or below (13.8%, 12/87) and male (11.1%, 7/63), respectively (χ²=12.709, P=0.001; χ ²=8.443, P=0.004; χ ²=7.788, P=0.005). Conclusion Physicians in most grass-roots hospitals can not accurately evaluate COPD; There are deficiencies in the follow-up, education and management of COPD patients, the use of family noninvasive ventilator, and the learning and implementation of guidelines. In view of the above problems, we need to strengthen the promotion of COPD knowledge and diagnosis and treatment technology, especially the training of physicians with low academic qualifications and low professional titles in grass-roots hospitals.

Key words: Pulmonary disease, chronic obstructive, Physicians, primary care, Questionnaires, Beijing City