Pacheco R Daniel, Gatica R Héctor, Kaliski K Sonia
Unidad de Reumatología e Inmunología, Hospital Clínico San Borja Arriarán, Facultad de Medicina, Universidad de Chile, Chile.
Rev Med Chil. 2006 Jul;134(7):813-20. doi: 10.4067/s0034-98872006000700002. Epub 2006 Aug 29.
Rheumatologic diseases are common and frequently managed by primary care physicians.
To assess strengths, weaknesses and self confidence of primary care physicians in the management of rheumatic diseases.
A self assessment and anonymous questionnaire was mailed to primary care physicians of two Chilean regions. Using a 10 points Likert scale, they were asked about personal interest, undergraduate training, continuous medical education, availability of medical literature, complementary laboratory tests and consultation with a rheumatologist. Medical skills, knowledge, therapeutic approach and performance of rheumatologic procedures were evaluated under the item confidence.
Three hundred forty seven out of 763 physicians (45%) answered the questionnaire. Their age range extended from 25 to 75 years, 59% were male, 58% were Chilean and 74% worked in the Metropolitan region. The worst evaluated parameters were availability of literature with a score of 2.2+/-2, access to consultation with a rheumatologist (3.8+/-2.2) and to continuous medical education (4.3+/-2.7). Physicians had a better confidence in their knowledge (6.7+/-1.5) and in their therapeutic approach (6.1+/-1.5). The worst confidence score was for shoulder injection therapy (3.4+/-2.6). Continuous medical education correlated with knowledge but not with clinical skills.
Primary care physicians perform a bad assessment of their skills in rheumatology. They have a low level of confidence in their clinical skills to perform rheumatologic procedures. Continuous medical education improves confidence in knowledge but not in skills.
风湿性疾病很常见,且常常由初级保健医生进行管理。
评估初级保健医生在管理风湿性疾病方面的优势、劣势和自信心。
向智利两个地区的初级保健医生邮寄了一份自我评估且匿名的问卷。使用10分制的李克特量表,询问他们关于个人兴趣、本科培训、继续医学教育、医学文献的可获取性、辅助实验室检查以及与风湿病学家的会诊情况。在“信心”这一项下评估医学技能、知识、治疗方法以及风湿性疾病诊疗程序的执行情况。
763名医生中有347名(45%)回答了问卷。他们的年龄范围从25岁到75岁,59%为男性,58%是智利人,74%在首都地区工作。评估最差的参数是文献的可获取性,得分为2.2±2,与风湿病学家会诊的机会(3.8±2.2)以及继续医学教育(4.3±2.7)。医生们对自己的知识(6.7±1.5)和治疗方法(6.1±1.5)更有信心。信心得分最低的是肩部注射疗法(3.4±2.6)。继续医学教育与知识相关,但与临床技能无关。
初级保健医生对自己在风湿病学方面的技能评估较差。他们对执行风湿性疾病诊疗程序的临床技能信心较低。继续医学教育提高了对知识的信心,但未提高对技能的信心。