University of California San Francisco, San Francisco, CA, USA.
J Neurol Sci. 2011 Aug 15;307(1-2):92-6. doi: 10.1016/j.jns.2011.05.005. Epub 2011 Jun 11.
Recent efforts to improve neurological care in resource-limited settings have focused on providing training to non-physician healthcare workers.
A one-day neuro-HIV training module emphasizing HIV-associated dementia (HAD) and peripheral neuropathy was provided to 71 health care workers in western Kenya. Pre- and post-tests were administered to 55 participants.
Mean age of participants was 29 years, 53% were clinical officers and 40% were nurses. Self-reported comfort was significantly higher for treating medical versus neurologic conditions (p<0.001). After training, participants identified more neuropathy etiologies (pre=5.6/9 possible correct etiologies; post=8.0/9; p<0.001). Only 4% of participants at baseline and 6% (p=0.31) post-training could correctly identify HAD diagnostic criteria, though there were fewer mis-identified criteria such as abnormal level of consciousness (pre=82%; post=43%; p<0.001) and hallucinations (pre=57%; post=15%; p<0.001).
Healthcare workers were more comfortable treating medical than neurological conditions. This training significantly improved knowledge about etiologies of neuropathy and decreased some misconceptions about HAD.
最近在资源有限的环境中改善神经科护理的努力集中在为非医师医疗保健工作者提供培训。
为肯尼亚西部的 71 名医疗保健工作者提供了为期一天的神经 HIV 培训模块，重点是艾滋病毒相关痴呆（HAD）和周围神经病。对 55 名参与者进行了预测试和后测试。
参与者的平均年龄为 29 岁，53%为临床医生，40%为护士。自我报告的舒适度在治疗医学与神经疾病方面有显著差异（p<0.001）。培训后，参与者确定了更多的神经病病因（前=5.6/9 个可能的正确病因；后=8.0/9；p<0.001）。基线时有 4%的参与者和 6%（p=0.31）在培训后可以正确识别 HAD 诊断标准，尽管存在较少的错误识别标准，如意识水平异常（前=82%；后=43%；p<0.001）和幻觉（前=57%；后=15%；p<0.001）。
医疗保健工作者更愿意治疗医学病症而不是神经科病症。这项培训显著提高了对神经病病因的认识，并减少了对 HAD 的一些误解。
