Gani L, Arif H, Widjaja S K, Adi R, Prasadja H, Tampubolon L H, Lukito E, Jauri R
Atma Jaya Faculty of Medicine, Jakarta Utara, Indonesia.
J Diarrhoeal Dis Res. 1991 Sep;9(3):194-9.
Prescribing practices of physicians who treat acute childhood diarrhoea in Penjaringan, an urban district of Jakarta, were investigated utilising observations of clinical practice and interviews with physicians. One hundred thirty-four physicians registered in Penjaringan district in their practices; 122 physicians (91%) participated in the survey and 73 (55%) were included in the observational study. Reported and observed practices are compared. Results show that 78% of the physicians reported that they frequently prescribe Oralit, a solution for oral rehydration therapy (ORT). However, observation of clinical cases indicates that Oralit was prescribed less frequently than reported. Although most physicians believed viral infections were a common cause of diarrhoea, antibiotics were prescribed for children in 94 percent of observed cases. Antispasmodic drugs were also commonly prescribed. Factors associated with physicians' prescribing behaviour and practices regarding diarrhoeal diseases include type of practice, concepts about aetiology, perceptions about ORT and parental expectations. The observed discrepancy between knowledge and practice suggests the need for new ways to encourage physicians to prescribe Oralit and to limit use of antibiotics and antidiarrhoeals of doubtful efficacy.
通过临床实践观察和对医生的访谈，对雅加达市区彭贾林甘治疗儿童急性腹泻的医生的处方行为进行了调查。彭贾林甘地区有134名注册执业医生；122名医生（91%）参与了调查，73名（55%）被纳入观察性研究。对报告的和观察到的行为进行了比较。结果显示，78%的医生报告说他们经常开口服补液盐（Oralit），一种用于口服补液疗法（ORT）的溶液。然而，临床病例观察表明，口服补液盐的处方频率低于报告频率。尽管大多数医生认为病毒感染是腹泻的常见原因，但在94%的观察病例中，仍给儿童开了抗生素。解痉药也经常被开处方。与医生对腹泻疾病的处方行为和做法相关的因素包括执业类型、病因学概念、对口服补液疗法的认识以及家长的期望。观察到的知识与实践之间的差异表明，需要采用新的方法来鼓励医生开口服补液盐，并限制使用抗生素和疗效存疑的止泻药。
