Gupta Leena, Shah Sangeeta, Ward Jeanette E
Public Health Unit, Sydney South West Area Health Service, Camperdown, New South Wales, Australia.
J Gastroenterol Hepatol. 2006 Apr;21(4):694-9. doi: 10.1111/j.1440-1746.2006.04205.x.
There has been interest in recent years in the role of primary care practitioners in managing hepatitis C, but there has been minimal research to identify educational and health service needs. A national survey of Australian general practitioners (GPs) was therefore conducted to assess their needs and identify areas for service development.
A self-administered questionnaire was developed that included questions to assess caseload, confidence in patient management, educational needs and approaches to management and prevention. Questionnaires were sent to a random sample of Australian GPs. Returned questionnaires were coded, frequencies tabulated and significant associations identified.
A 70% response rate was achieved from 658 eligible GPs. A total of 76% of respondents had managed one patient in the previous year with hepatitis C. While 69% reported feeling more confident about their management of hepatitis C than 5 years previously, 55% identified a high level of need for hospital-based clinics. Financial benefits for case conferences and chronic case management were not considered useful by most GPs. Topics identified for further skills development included therapeutics and diagnostic testing. Only 39% were highly likely to discuss psychosocial issues as part of initial patient management and 37% reported finding it difficult to play a central role in the medical and psychosocial care of patients with hepatitis C.
These results have significant implications for policy and service development, as well as identifying areas where GPs need support. The findings invite further discussion between health authorities about the source and magnitude of funding for hospital-based services and further consideration of how to provide services to address patients' psychosocial needs.
近年来,人们对初级保健从业者在丙型肝炎管理中的作用颇感兴趣,但针对确定教育和卫生服务需求的研究却极少。因此,开展了一项针对澳大利亚全科医生的全国性调查,以评估他们的需求并确定服务发展领域。
设计了一份自填式问卷,其中包括用于评估工作量、对患者管理的信心、教育需求以及管理和预防方法的问题。问卷被发送给澳大利亚全科医生的随机样本。对回收的问卷进行编码,列出频率并确定显著关联。
658名符合条件的全科医生的回复率为70%。共有76%的受访者在前一年管理过一名丙型肝炎患者。虽然69%的人表示,与5年前相比,他们对丙型肝炎的管理更有信心,但55%的人认为对医院门诊服务有很高的需求。大多数全科医生认为病例讨论会和慢性病管理的经济收益并无用处。确定需要进一步技能发展的主题包括治疗学和诊断测试。只有39%的人极有可能在初次患者管理时讨论心理社会问题,37%的人表示难以在丙型肝炎患者的医疗和心理社会护理中发挥核心作用。
这些结果对政策和服务发展具有重要意义,同时也确定了全科医生需要支持的领域。这些发现促使卫生当局进一步讨论基于医院服务的资金来源和规模,并进一步考虑如何提供服务以满足患者的心理社会需求。