Jurcev Savicević Anamarija
Department of Tuberculosis Control, Epidemiology Service, Public Health Institute of Split and Dalmatian County, Split, Croatia.
Coll Antropol. 2009 Jun;33(2):481-6.
High level of tuberculosis (TB) knowledge among physicians is important in order to achieve high case-finding and efficient case-management. Few attempts on how to measure physicians' TB knowledge and understanding of national TB guidelines in middle-TB incidence countries such as Croatia have been reported. Related surveys were carried out mostly in high or low incidence countries. The aim of this study was to investigate TB knowledge among general practitioners (GPs) and paediatricians in Split and Dalmatian County, Croatia and need for TB education through cross-sectional survey based on anonymous questionnaire sent to all of them and completed by 160 (60.8%) subjects. Although the median percentage of correct responses was not low (70.3%), several areas of concern were revealed. Particularly low knowledge about normal breathing as usual physical chest examination finding in pulmonary TB (43.1%), proper drugs combination in initial phase of treatment (35%), and duration of treatment (61.9%) were found. Need for education in TB control was reported in 87.9% of physicians. TB knowledge score was obtained by the number of correct answers to 14 selected questions and it was 8.18 +/- 1.84. Scores according to years of experience, number of treated TB patients and need for education, were not different from each other. Higher score was correlated with paediatricians (p = 0.025) and familiarity with existence of National guidelines (p = 0.002). This study showed gaps in knowledge among physicians being the cornerstone of TB control in Croatia. Given that the most successful intervention in TB control is early detection and early and appropriate treatment, efforts should be done to increase TB knowledge. Majority of participants were willing to take a part in education. This could be a good starting point for organisation of education activities as one of the approaches to reduce tuberculosis burden in middle incidence countries.
为了实现高病例发现率和高效的病例管理，医生具备高水平的结核病（TB）知识至关重要。在克罗地亚等结核病发病率中等的国家，关于如何衡量医生对结核病的知识以及对国家结核病指南的理解的尝试报道较少。相关调查大多在高发病率或低发病率国家开展。本研究的目的是通过向克罗地亚斯普利特和达尔马提亚县的所有全科医生（GPs）和儿科医生发送匿名问卷并由160名（60.8%）受试者完成的横断面调查，来调查他们的结核病知识以及对结核病教育的需求。尽管正确回答的中位数百分比并不低（70.3%），但仍发现了几个令人担忧的领域。特别是对于肺结核中作为常规体格检查发现的正常呼吸（43.1%）、治疗初始阶段的正确药物组合（35%）以及治疗持续时间（61.9%）的知识了解特别低。87.9%的医生表示需要结核病控制方面的教育。结核病知识得分通过对14个选定问题的正确答案数量获得，为8.18±1.84。根据经验年限、治疗的结核病患者数量和教育需求得出的得分彼此没有差异。较高的得分与儿科医生（p = 0.025）以及对国家指南存在的熟悉程度（p = 0.002）相关。本研究表明，医生的知识存在差距，而医生是克罗地亚结核病控制的基石。鉴于结核病控制中最成功的干预措施是早期发现以及早期和适当的治疗，应努力增加结核病知识。大多数参与者愿意参加教育。这可以作为组织教育活动的一个良好起点，作为降低中等发病率国家结核病负担的方法之一。
