Munday P E, Allan A, Hearne S, Gubbay A
Watford Sexual Health Centre, Watford General Hospital, Vicarage Road, Watford WD18 0HB, UK.
Int J STD AIDS. 2005 Apr;16(4):281-3. doi: 10.1258/0956462053654348.
We allocated 278 patients, who said they were asymptomatic and agreed to be randomized to a nurse or doctor clinic, to appointments using a random number system. In all, 35 patients did not attend and 16 were excluded because they did not meet the entry criteria. We used a screening protocol which excluded microscopy from the immediate assessment of patients. The outcome measures were completeness of documentation, proportion of patients accepting HIV tests, infections detected and patient satisfaction. Overall, 3% of items were not completed by doctors and 6% by nurses. HIV tests were carried out on 65% of patients who saw a doctor and 52% who saw a nurse. Thirteen infections were detected by doctors and 27 by nurses. No new cases of gonorrhoea, syphilis or HIV infection were identified. Eighty-eight patients completed a questionnaire after their attendance. Almost all patients were very satisfied with the service and most were prepared to see a nurse on a subsequent visit. We concluded that there are few differences between the performance of doctors and nurses in routine screening of asymptomatic patients.
我们将278名自称无症状且同意被随机分配至护士诊所或医生诊所的患者，通过随机数字系统安排就诊。总共有35名患者未就诊，16名患者因不符合入选标准而被排除。我们采用了一种筛查方案，在对患者的即时评估中不进行显微镜检查。结果指标包括文件记录的完整性、接受HIV检测的患者比例、检测到的感染情况以及患者满意度。总体而言，医生未完成3%的项目，护士未完成6%的项目。看过医生的患者中有65%接受了HIV检测，看过护士的患者中有52%接受了检测。医生检测出13例感染，护士检测出27例感染。未发现淋病、梅毒或HIV感染的新病例。88名患者就诊后填写了问卷。几乎所有患者对服务都非常满意，大多数患者愿意在后续就诊时看护士。我们得出结论，在对无症状患者的常规筛查中，医生和护士的表现几乎没有差异。
