埃及哮喘儿童的护理质量：临床医生对哮喘指南的遵循情况。
Quality of care of Egyptian asthmatic children: clinicians adherence to asthma guidelines.
机构信息
Department of Pediatrics, Faculty of Medicine, Ain Shams University, Abssia, Cairo, Egypt.
出版信息
Ital J Pediatr. 2010 Apr 21;36:33. doi: 10.1186/1824-7288-36-33.
BACKGROUND
Despite the development and dissemination of guidelines for the diagnosis and management of asthma, a gap remains between current recommendations and actual practice.
OBJECTIVES
To assess the physicians attitude towards asthma guidelines and their adherence to its recommendations.
METHODS
Three hundred and fifty two clinicians (101 General practitioners, 131 pediatric specialists, 35 pediatric consultants and 85 doctors did not report the qualification) engaged in direct childhood asthma care in Cairo, Egypt were subjected to a self-administered questionnaire with 35 questions of which most were multiple choices, aiming at assessment of three important aspects about the involved physicians; physician's knowledge, practice and attitude. 165 of the clinicians were working in governmental hospitals, 68 clinicians work in private clinics and 119 clinicians work in both.
RESULTS
Agreement with asthma guidelines was present in 76.2% of the studied physicians, however those who not in agreement with the guidelines claimed that this was mainly due to patient factors, firstly the poor socioeconomic standard of the patient (18.1%) and secondly due to poor patient compliance (16%). Poor knowledge was found in 28.5%, poor practice was found in 43.6% and poor attitude was found in 14.4% of the studied physicians. There was positive highly significant correlation between qualification and knowledge, (p<0.01), positive highly significant correlation between qualification and practice, (p<0.01), and positive highly significant correlation between qualification and attitude, (p<0.01).
CONCLUSION
The attitude of the studied physicians revealed agreement of their majority with the guidelines, while the disagreement was mainly explained by the poor socioeconomic standard of the patients. The degree of poor practice is more marked than that of poor knowledge or poor attitude reflecting resources limitations and applications obstacles in the physician's practice.
背景
尽管已经制定并发布了哮喘诊断和管理指南，但当前的推荐建议与实际实践之间仍然存在差距。
目的
评估医生对哮喘指南的态度及其对指南推荐的遵循程度。
方法
在埃及开罗，352 名从事儿童哮喘直接护理的临床医生（101 名全科医生、131 名儿科专家、35 名儿科顾问和 85 名未报告资质的医生）接受了一项 35 个问题的自我管理问卷，其中大多数是多项选择题，旨在评估涉及医生的三个重要方面；医生的知识、实践和态度。165 名医生在公立医院工作，68 名医生在私立诊所工作，119 名医生在公私诊所都工作。
结果
76.2%的研究医生同意哮喘指南，但不同意指南的医生认为，这主要是由于患者因素，首先是患者较差的社会经济状况（18.1%），其次是由于患者的依从性差（16%）。研究医生中发现 28.5%的人知识较差，43.6%的人实践较差，14.4%的人态度较差。医生的资质与知识之间存在显著正相关（p<0.01），与实践之间存在显著正相关（p<0.01），与态度之间存在显著正相关（p<0.01）。
结论
研究医生的态度表明，他们中的大多数人同意指南，但不同意的主要原因是患者较差的社会经济状况。实践较差的程度比知识或态度较差更为明显，反映了医生实践中的资源限制和应用障碍。
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