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[家庭医生面对妊娠期糖尿病患者的临床能力]

[Family doctor clinical aptitude confronting gestational diabetes patients].

作者信息

Pivaral Carlos Enrique Cabrera, Clara Elizabeth Rivera, Peña Luz María Adriana Balderas, Centeno Mayari Cabrera, Reynoso Carlos Alonso

机构信息

Unidad Médica de Alta Especialidad, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, IMSS, México, DF.

出版信息

Ginecol Obstet Mex. 2008 Feb;76(2):97-106.

Abstract

BACKGROUND

Gestational diabetes mellitus complicates 7% of all pregnancies. Recognizing and treating this entity result in a diminished number of materno-fetal complications; this study explores the family physician clinical aptitude to identify risk factors, to diagnose and treat gestational diabetes.

OBJECTIVE

Identify clinical aptitude level of family physician to the treatment of diabetes gestational patients.

PARTICIPANTS AND METHODS

Transversal study to describe the level of clinical aptitude in 85 family physicians working in Guadalajara. Were studied: speciality, genre, work condition, working years, working hours, and place of work. The evaluation instrument was designed to this specific purpose and validated by an expert group; were evaluated four indicators: 1) identification of risk factors, 2) diagnosis, 3) use of therapeutic resources and 4) use of paraclinic resources. Confidence coefficient to the assessment instrument was (21 formula from Kuder-Richardson) 0.92 in global evaluation.

RESULTS

The global clinical aptitude in the four family medicine units studied was less than 21 points in 41% of physician population and very low (22 a 40 points) in 38% of the evaluated physicians.

CONCLUSIONS

The clinical aptitude from family physician in gestational diabetes is low, this situation represents an urgent need to design a system to provide to these groups of health providers specialized continuous education to enhance the attention quality to this group of patients in family medicine units.

摘要

背景

妊娠期糖尿病在所有妊娠中所占比例为7%。识别并治疗该疾病可减少母胎并发症的发生;本研究探讨家庭医生识别危险因素、诊断和治疗妊娠期糖尿病的临床能力。

目的

确定家庭医生对妊娠期糖尿病患者的临床治疗能力水平。

参与者与方法

采用横断面研究来描述在瓜达拉哈拉工作的85名家庭医生的临床能力水平。研究内容包括:专业、性别、工作条件、工作年限、工作时长和工作地点。评估工具是专门为此目的设计的,并经专家组验证;评估了四个指标:1)危险因素的识别,2)诊断,3)治疗资源的使用,4)辅助检查资源的使用。该评估工具在总体评估中的信度系数(库德-理查森公式21)为0.92。

结果

在所研究的四个家庭医学单位中,41%的医生总体临床能力低于21分,38%的被评估医生临床能力非常低(22至40分)。

结论

家庭医生对妊娠期糖尿病的临床能力较低,这种情况迫切需要设计一个系统,为这些医疗服务提供者群体提供专门的继续教育,以提高家庭医学单位对这类患者的医疗服务质量。

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