印度尼西亚日惹市初级保健中心全科医生对鼻咽癌的认知。
Knowledge of general practitioners about nasopharyngeal cancer at the Puskesmas in Yogyakarta, Indonesia.
机构信息
Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121 1066 CX, Amsterdam, The Netherlands.
出版信息
BMC Med Educ. 2010 Nov 18;10:81. doi: 10.1186/1472-6920-10-81.
BACKGROUND
Nasopharyngeal carcinoma (NPC) is one of the leading causes of cancer death in Indonesia. At initial diagnosis, 80% of the patients present with advanced stage disease. In Indonesia, primary medical care is generally provided by the health care centres; named Puskesmas. The lack of knowledge of various aspects of NPC of the General practitioners (GPs) working in these centers might contribute to the diagnostic delay. The aim of this study was to assess the knowledge of these GPs on different aspects of NPC including symptoms, risk factors and incidence.
METHODS
One hundred six GPs in the Puskesmas in the Yogyakarta province were subjected to a questionnaire on different aspects of NPC based on literature and interviews with Head and Neck Surgeons.
RESULTS
All GPs approached participated and in total 106 questionnaires were filled in. All participants were aware of NPC as a disease and 89% confirmed that it is a serious problem in Indonesia. However, 50% of the participants believed NPC has a low incidence in their region. The question on early symptoms gave a mean 4.2 answers of which 50% were incorrect.The GPs provided a total of 318 answers when asked for the risk factors of NPC, 75% of which were incorrect. Fifty seven GPs (54%) stated that they did not receive sufficient education on NPC at the university and insufficient knowledge was gained during daily practice. Ninety-two percent of the GPs were interested in additional education, preferably in form of lectures, meetings or folders.
CONCLUSION
This study revealed that GPs in the Puskesmas in Yogyakarta lack knowledge on all aspects of NPC. This is an important finding as NPC is endemic in Indonesia and the Puskesmas are the institutions which provide primary medical health care in the country. Further education of the GPs in these endemic areas could be a first step to increase the rate of early detection. Therefore, we suggest 1) to conduct a medical awareness campaign for GPs on the most important subjects concerning NPC, and 2) as soon as NPC awareness among GPs has risen, provide further education on the risk factors, the early symptoms and the incidence, education to the community. We propose to extend this study to other areas in Indonesia (i.e. Jakarta, Surabaya, Central Java), using models that have been developed in Yogyakarta.
背景
鼻咽癌（NPC）是印度尼西亚癌症死亡的主要原因之一。在初始诊断时，80%的患者处于晚期疾病。在印度尼西亚，初级医疗保健通常由卫生保健中心（称为 Puskesmas）提供。在这些中心工作的全科医生对 NPC 的各个方面缺乏了解，这可能导致诊断延误。本研究旨在评估这些全科医生对 NPC 不同方面的知识，包括症状、危险因素和发病率。
方法
对日惹省 Puskesmas 的 106 名全科医生进行了基于文献和与头颈外科医生访谈的 NPC 不同方面的问卷调查。
结果
所有被接触的全科医生都参与了调查，共填写了 106 份问卷。所有参与者都意识到 NPC 是一种疾病，89%的人确认 NPC 是印度尼西亚的一个严重问题。然而，50%的参与者认为他们所在地区 NPC 的发病率较低。关于早期症状的问题平均给出了 4.2 个答案，其中 50%是错误的。当被问及 NPC 的危险因素时，医生共提供了 318 个答案，其中 75%是错误的。57 名全科医生（54%）表示，他们在大学期间没有接受过足够的 NPC 教育，并且在日常实践中获得的知识也不足。92%的全科医生对额外的教育感兴趣，最好是通过讲座、会议或文件夹的形式。
结论
本研究表明，日惹 Puskesmas 的全科医生对 NPC 的所有方面都缺乏了解。这是一个重要的发现，因为 NPC 在印度尼西亚流行，Puskesmas 是该国提供初级医疗保健的机构。在这些流行地区对全科医生进行进一步教育可能是提高早期发现率的第一步。因此，我们建议：1）为全科医生开展关于 NPC 最重要主题的医学意识运动；2）一旦全科医生对 NPC 的认识有所提高，就提供有关危险因素、早期症状和发病率的进一步教育，对社区进行教育。我们建议将这项研究扩展到印度尼西亚的其他地区（即雅加达、泗水、中爪哇），使用在日惹开发的模型。
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