Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
BMC Fam Pract. 2010 Apr 21;11:28. doi: 10.1186/1471-2296-11-28.
Chronic fatigue syndrome (CFS) is a debilitating illness with particular difficulties for healthcare providers because there are no diagnostic signs or laboratory tests and because management aims to merely improve symptoms. Further complicating management, healthcare providers' awareness concerning CFS has not been rigorously assessed. The present study aimed to ascertain United States (U.S.) healthcare providers' awareness of CFS and to assess their knowledge, attitudes, and beliefs (KAB) related to diagnosis and management of the illness. This information forms the foundation for developing CFS educational strategies.
We combined convenience and probability samples to measure CFS KAB among healthcare providers. In the convenience sample, 1,255 healthcare providers (81% response rate) from 13 professional conferences completed a 12-item form. Descriptive statistics were reported for 9 KAB item responses and chi-square tests were performed for examining their association with giving a diagnosis of CFS. We used principal component analysis to construct multidimensional subscales and perform a general linear model to examine factors associated with subscales. The probability sample involved data on 15 CFS-specific questions from 2006 and 2007 DocStyles web-based panel surveys collected from 2,750 physicians (average response rate 55%). We calculated descriptive and chi-square statistics. The significance was set at two-tailed with the alpha level of 0.05.
Healthcare providers in both samples were aware of CFS and exhibited a high level of knowledge. Overall, 96% of respondents in the DocStyles (probability) sample had heard about CFS. Healthcare providers in the conference (convenience) sample demonstrated good KAB scores; physicians' scores were highest on KAB scales and lowest in perception. Nurses' scores were lowest in knowledge. More than 40% of physicians reported ever giving a CFS diagnosis and in the DocStyles (probability) sample more than 80% of physicians correctly identified CFS symptoms. Physicians reported professional journals, the Internet, and continuing education programs as the top 3 sources from which they obtain CFS information.
Findings from these combined samples fill a gap in the evidence-base of U.S. healthcare providers' and knowledge, attitudes, and beliefs concerning CFS. Importantly, respondents in both samples expressed similar knowledge, attitudes, beliefs and perceptions. Awareness was high and negative attitudes were low. The primary areas for future education should address diagnosis and management of CFS and should be delivered through those venues providers indicated they primarily use. Data from this study provide a benchmark for evaluation the success of these future efforts.
慢性疲劳综合征（CFS）是一种使人虚弱的疾病，给医疗保健提供者带来了特别的困难，因为没有诊断迹象或实验室检查，而且管理的目的只是改善症状。进一步使管理复杂化的是，医疗保健提供者对 CFS 的认识尚未经过严格评估。本研究旨在确定美国（U.S.）医疗保健提供者对 CFS 的认识，并评估他们在诊断和管理该病方面的知识、态度和信念（KAB）。这些信息构成了制定 CFS 教育策略的基础。
我们结合了便利样本和概率样本，以衡量医疗保健提供者的 CFS KAB。在便利样本中，来自 13 个专业会议的 1,255 名医疗保健提供者（81%的回应率）完成了一份包含 12 个项目的表格。报告了 9 个 KAB 项目回应的描述性统计数据，并进行了卡方检验以检验他们与 CFS 诊断相关的关联。我们使用主成分分析构建多维子量表，并使用一般线性模型检验与子量表相关的因素。概率样本涉及 2006 年和 2007 年 DocStyles 基于网络的面板调查中来自 2,750 名医生的 15 个 CFS 特定问题的数据（平均回应率为 55%）。我们计算了描述性和卡方统计数据。双侧检验的显著性水平为 0.05，alpha 水平为 0.05。
两个样本中的医疗保健提供者都了解 CFS，并表现出较高的知识水平。总体而言，DocStyles（概率）样本中 96%的受访者听说过 CFS。会议（便利）样本中的医疗保健提供者表现出良好的 KAB 评分；医生在 KAB 量表上的评分最高，在感知方面的评分最低。护士的分数最低。超过 40%的医生报告曾诊断过 CFS，在 DocStyles（概率）样本中，超过 80%的医生正确识别了 CFS 症状。医生报告说，专业期刊、互联网和继续教育计划是他们获取 CFS 信息的前三大来源。
这两个样本的研究结果填补了美国医疗保健提供者对 CFS 的知识、态度和信念的证据基础空白。重要的是，两个样本的受访者表达了相似的知识、态度、信念和看法。意识很高，负面态度很低。未来教育的主要领域应该针对 CFS 的诊断和管理，并通过提供者表示他们主要使用的途径提供。这项研究的数据为评估这些未来努力的成功提供了基准。
