Plaza Vicente, Bolívar Ignasi, Giner Jordi, Llauger María Antonia, López-Viña Antolín, Quintano José Antonio, Sanchis Joaquín, Torrejón Montserrat, Villa José Ramón
Departament de Pneumologia, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
Arch Bronconeumol. 2008 May;44(5):245-51.
Health care professionals' adherence to asthma guidelines is believed to be low. The aim of the present study was to determine the knowledge, attitudes, and adherence of Spanish health care professionals with respect to the Spanish Guidelines for Asthma Management (GEMA).
A multiple choice test with 15 questions was constructed. Items assessed knowledge of and opinions and adherence to asthma guidelines in general and the GEMA in particular. Test completion was voluntary, individual, and anonymous.
A total of 1,066 physicians and nurses took the test. The sample consisted of 241 (22.6%) respiratory medicine specialists and 244 (22.9%) nurses from the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR), 221 (20.7%) pediatric pulmonologists from the Spanish Society of Pediatric Pulmonology (SENP), 220 (20.6%) general practitioners from the Spanish Society of Family and Community Medicine (semFYC), 181 (17%) general practitioners from the Spanish Society of Rural and General Medicine (SEMERGEN), and 38 (3.6%) others. Asthma guidelines were considered useful or very useful by 805 (76%), and 771 (72%) stated they were familiar with the GEMA. However, 388 (36%) admitted that they followed guidelines seldom or never. The level of adherence to the GEMA was poor for 243 (30.3%) respondents. The multivariate analysis revealed that low adherence was associated with the following characteristics: coming from the geographic center or south of Spain; being a primary care physician, unfamiliar with guidelines, or unconvinced of their utility; and not being a user of spirometry.
Even though the majority of Spanish health care professionals surveyed seem to know of the GEMA, their adherence to those guidelines is very low. Educational programs that seek to improve knowledge of asthma guidelines should consider the profile of professionals with low adherence to the GEMA so as to include educational strategies that target them specifically.
医疗保健专业人员对哮喘指南的依从性据信较低。本研究的目的是确定西班牙医疗保健专业人员对《西班牙哮喘管理指南》(GEMA)的知识、态度和依从性。
构建了一个包含15个问题的多项选择题测试。题目评估了对哮喘指南总体以及特别是GEMA的知识、意见和依从性。测试完成是自愿、个人且匿名的。
共有1066名医生和护士参加了测试。样本包括来自西班牙肺科和胸外科协会(SEPAR)的241名(22.6%)呼吸内科专家和244名(22.9%)护士,来自西班牙儿科肺科协会(SENP)的221名(20.7%)儿科肺科医生,来自西班牙家庭和社区医学协会(semFYC)的220名(20.6%)全科医生,来自西班牙农村和普通医学协会(SEMERGEN)的181名(17%)全科医生,以及38名(3.6%)其他人员。805名(76%)认为哮喘指南有用或非常有用,771名(72%)表示他们熟悉GEMA。然而,388名(36%)承认他们很少或从不遵循指南。243名(30.3%)受访者对GEMA的依从性较差。多变量分析显示,低依从性与以下特征相关:来自西班牙地理中心或南部;是初级保健医生,不熟悉指南或不相信其效用;以及不是肺功能仪的使用者。
尽管接受调查的大多数西班牙医疗保健专业人员似乎知晓GEMA,但他们对这些指南的依从性非常低。旨在提高哮喘指南知识的教育项目应考虑对GEMA依从性较低的专业人员特点,以便纳入专门针对他们的教育策略。