Al-Shammari S, Khoja T
Director General of Health Centres, Ministry of Health, and Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh Saudi Arabia.
Ann Saudi Med. 1996 Sep;16(5):534-8. doi: 10.5144/0256-4947.1996.534.
This study was conducted to review the present situation with regard to training, facilities and performance of minor surgical procedures in primary care, and to look at the way doctors perceive various minor surgical procedures in primary care. Randomly selected primary care doctors working in Riyadh health centers completed a predesigned confidential questionnaire, which was then mailed to the researchers. The questionnaire of data on health centers, such as geographic location, size of catchment area population and number and gender of doctors working there. In addition, demographic data of doctors who completed the questionnaire, as well as their exposure to minor surgery training and performance, were recorded. The doctors were then asked about their perception of the necessity of performing various minor surgical procedures in primary care centers. The study was conducted from June through December of 1994. The completed questionnaires were entered into a personal computer for statistical analysis using the chi-squared test. Of the 231 doctors who participated in the present study, 74% performed some sort of minor surgery during their day-to-day work in the health center. Doctors living in remote areas performed more minor surgery (MS) compared to other areas and male doctors performed more MS than female doctors (P = 0.05). As doctors gained confidence in certain skills such as resuscitation, venous cut-down and handling of trauma and fractures, they performed more MS compared to those who were not confident. A room allocated for MS only was available to 27.7% of doctors, but instruments and equipment were available for over 76% of doctors. The doctor's perception of the necessity for MS was statisticaly higher among MS performers only in cases of removal of benign skin lesions, sebaceous cysts and treatment of burns, compared with non-MS performers. There is a great need for provision of facilities and organized training courses in minor surgical procedures for primary care doctors and nurses.
本研究旨在回顾初级保健中小型外科手术的培训、设施及实施现状,并考察医生对初级保健中各种小型外科手术的认知方式。在利雅得健康中心工作的初级保健医生被随机选取,他们填写了一份预先设计的保密问卷,随后问卷被邮寄给研究人员。问卷涉及健康中心的数据,如地理位置、服务人口规模以及在该中心工作的医生数量和性别。此外,还记录了填写问卷的医生的人口统计学数据,以及他们接受小型外科手术培训和实施手术的情况。然后询问医生对在初级保健中心实施各种小型外科手术必要性的看法。该研究于1994年6月至12月进行。完成的问卷被录入个人电脑,使用卡方检验进行统计分析。在参与本研究的231名医生中,74%在健康中心的日常工作中实施了某种小型外科手术。与其他地区相比,居住在偏远地区的医生实施的小型外科手术更多,男性医生实施的小型外科手术比女性医生多(P = 0.05)。与那些没有信心的医生相比,当医生对某些技能(如复苏、静脉切开术以及创伤和骨折的处理)有信心时,他们实施的小型外科手术更多。只有27.7%的医生有专门用于小型外科手术的房间,但超过76%的医生有仪器和设备。与非小型外科手术实施者相比,仅在切除良性皮肤病变、皮脂腺囊肿和烧伤治疗方面,小型外科手术实施者对小型外科手术必要性的认知在统计学上更高。非常有必要为初级保健医生和护士提供小型外科手术的设施和有组织的培训课程。