Curtin Catherine M, Yao Jeffrey
Hand (N Y). 2010 Sep;5(3):278-85. doi: 10.1007/s11552-009-9256-x. Epub 2010 Jan 27.
Hand surgeons rely on referrals from general providers. Appropriate referral is dependent upon referring physicians having an understanding of the problem and available treatments. This study evaluates the referring physicians' knowledge and perceptions of basic hand problems and their treatment. This study also evaluates the impact of a brief lecture on our referring physicians' understanding of hand issues. A survey instrument was administered to referring physicians. The instrument addressed general hand knowledge and perceptions toward hand surgery. The physicians also attended a lecture on general hand problems and their treatments. The survey was repeated 2 weeks post-lecture. Subjects had a pre-lecture knowledge score of 65% correct and post-lecture a score of 85%, p < 0.05. The participants were knowledgeable about common hand problems, such as carpal tunnel syndrome. Knowledge gaps did exist, for example, only 37% recognized the symptoms of basilar thumb arthritis. Initially, the referring physicians had less positive views about surgical interventions, such as surgery to help the pain of basilar thumb arthritis. After the lecture, the responders had significantly more favorable attitudes toward surgery. This study found that referring physicians had variable knowledge about common hand problems, and they had doubts relating to the efficacy of some hand surgeries. This study also found that a directed lecture improved these providers' knowledge and their perceptions of hand surgical interventions. Hand surgeons can improve their referring physicians understanding and perceptions of hand surgery through a directed grand rounds type lecture.
手外科医生依赖于普通医疗提供者的转诊。恰当的转诊取决于转诊医生对手部问题及可用治疗方法的了解。本研究评估转诊医生对基本手部问题及其治疗的知识和认知。本研究还评估了一次简短讲座对我们的转诊医生对手部问题理解的影响。向转诊医生发放了一份调查问卷。该问卷涉及一般的手部知识以及对手部手术的认知。医生们还参加了一场关于一般手部问题及其治疗的讲座。讲座两周后重复进行了该调查。受试者讲座前的知识得分正确率为65%，讲座后的得分为85%，p<0.05。参与者对常见的手部问题，如腕管综合征有一定了解。但知识差距确实存在，例如，只有37%的人认识到基底节拇指关节炎的症状。最初，转诊医生对手术干预，如缓解基底节拇指关节炎疼痛的手术，看法不太积极。讲座后，应答者对手术的态度明显更为积极。本研究发现，转诊医生对常见手部问题的知识掌握程度参差不齐，并且他们对一些手部手术的疗效存在疑虑。本研究还发现，一场定向讲座提高了这些医疗提供者对手部问题的知识水平以及他们对手部手术干预的认知。手外科医生可以通过一场定向的大查房式讲座来提高转诊医生对手部手术的理解和认知。
