Kemper Kathi J, Amata-Kynvi Andey, Dvorkin Lana, Whelan Julia S, Woolf Alan, Samuels Ronald C, Hibberd Patricia
Brenner Children's Hospital, Winston-Salem, NC, USA.
Altern Ther Health Med. 2003 May-Jun;9(3):42-9.
Herbs and other dietary supplements (H/DS) are frequently used by the public. They have significant health implications, yet little is known about health professionals' knowledge, attitudes, or clinical practices related to H/DS.
Cross-sectional survey of clinicians prior to participation in an Internet-based educational program on herbs and dietary supplements.
The 537 participants included 111 physicians (MD), 30 advanced practice nurses (RN), 46 pharmacists (PharmD), and 350 dietitians (RD). In addition to demographic information, participants were asked about their knowledge, attitudes, and practices related to H/DS.
Most participants were involved in direct patient care (85%), in practice or on faculty (84%), and from outside our local institutions (76%); 66% reported receiving professional education about H/DS in the past year. There were statistically significant differences between professional groups, with RDs scoring better than others, but even their average scores were less than 60% of possible. The average score on knowledge questions was 10/20; the average confidence score was 4 out of 10 possible, and the average communication score was 1.4 out of 4 possible. Most respondents knew the most common clinical uses of echinacea and St. John's wort, and felt confident that they knew more than their colleagues about H/DS. Key deficits were in knowledge about adverse effects, confidence in reporting side effects, routinely communicating with patients about H/DS, and recording H/DS information in the medical record.
Despite significant interest and previous training in H/DS, these clinicians had substantial room for improvement in knowledge, attitudes, and clinical practices about H/DS. Educational interventions and institutional policies are needed to improve the quality of patient care regarding H/DS, and such interventions should be rigorously evaluated to ensure that continuous improvements occur.
草药及其他膳食补充剂（H/DS）为公众所常用。它们对健康有着重大影响，但对于医疗保健专业人员有关H/DS的知识、态度或临床实践却知之甚少。
在参与一项关于草药和膳食补充剂的网络教育项目之前，对临床医生进行横断面调查。
537名参与者包括111名医生（医学博士）、30名高级执业护士（注册护士）、46名药剂师（药学博士）和350名营养师（注册营养师）。除人口统计学信息外，还询问了参与者有关他们对H/DS的知识、态度和实践情况。
大多数参与者参与直接的患者护理工作（85%），处于执业状态或在教职岗位（84%），且来自本地机构以外（76%）；66%的人报告在过去一年接受过关于H/DS的专业教育。不同专业群体之间存在统计学上的显著差异，注册营养师得分高于其他群体，但即使是他们的平均得分也不到满分的60%。知识问题的平均得分为10/20；平均信心得分为满分10分中的4分，平均沟通得分为满分4分中的1.4分。大多数受访者知道紫锥菊和圣约翰草最常见的临床用途，并认为自己比同事更了解H/DS。关键的不足之处在于对不良反应的了解、报告副作用的信心、与患者就H/DS进行常规沟通以及在病历中记录H/DS信息。
尽管对H/DS有着浓厚兴趣且之前接受过相关培训，但这些临床医生在H/DS的知识、态度和临床实践方面仍有很大的改进空间。需要开展教育干预和制定机构政策，以提高关于H/DS的患者护理质量，并且应对此类干预措施进行严格评估，以确保持续改进。
