General Practice Department, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Xuhui District, Shanghai 200032, China.
BMC Fam Pract. 2013 Jan 28;14:16. doi: 10.1186/1471-2296-14-16.
Hypertension prevalence is high in China, while patients' levels of hypertension awareness, treatment and control are low. General practitioners' knowledge and training relating to hypertension prevention may be an important related factor. We aimed to investigate general practitioners' knowledge of hypertension prevention and potential training needs.
A questionnaire survey was conducted among all general practitioners at five community health service centers selected by convenience sampling. A total of 160 questionnaires were distributed and 147 were returned (response rate 91.9%) The questionnaire included general information; 12 subjective questions on health promotion, education and training needs; and 19 objective questions in 5 domains (epidemiology, diagnosis, treatment, referral and community management) measuring knowledge of hypertension prevention and treatment.
The major difficulties in health education practice for general practitioners were poor patient compliance (77.6%) and lack of medical consultation time (49.0%). The average accuracy rate of hypertension prevention knowledge was 49.2%, ranging from 10.5% to 94.7%. The factors associated with accuracy rate were physician's education level (medical university vs. professional school, β = 13.3, P = 0.003), and type of center (training base vs. community healthcare center, β = 12.3, P < 0.0001). Most physicians (87.8%) reported being willing to attend training courses regularly and the preferred frequency was once every 2 ~ 3 months (53.5%). The preferred course was medical treatment of hypertension (82.3%) and the most favored training approach was expert lectures (80.3%).
The knowledge level of hypertension prevention is low among general practitioners in urban settings. Physicians working in community clinics where they participate in a series of teaching, assessing and evaluating systems for hypertension prevention perform better than those in general healthcare centers who lack specific training. Continuing hypertension education is urgently needed to ensure that physicians in general practice are aware of and adhere to the national hypertension prevention guidelines.
高血压在中国的患病率很高，而患者的高血压知晓率、治疗率和控制率均较低。全科医生在高血压预防方面的知识和培训可能是一个重要的相关因素。本研究旨在调查全科医生对高血压预防的知识水平和潜在的培训需求。
采用便利抽样的方法，选取 5 家社区卫生服务中心的所有全科医生进行问卷调查。共发放问卷 160 份，回收有效问卷 147 份（有效回收率 91.9%）。问卷内容包括一般资料、健康促进、教育和培训需求的 12 个主观问题以及高血压防治知识的 5 个领域（流行病学、诊断、治疗、转诊和社区管理）的 19 个客观问题。
全科医生在健康教育实践中遇到的主要困难是患者依从性差（77.6%）和医疗咨询时间不足（49.0%）。高血压预防知识的平均准确率为 49.2%，范围为 10.5%94.7%。与准确率相关的因素是医生的教育水平（医学大学与专业学校，β=13.3，P=0.003）和中心类型（培训基地与社区卫生服务中心，β=12.3，P<0.0001）。大多数医生（87.8%）表示愿意定期参加培训课程，最理想的频率是每 23 个月一次（53.5%）。首选课程是高血压的药物治疗（82.3%），最受欢迎的培训方式是专家讲座（80.3%）。
城市地区全科医生的高血压防治知识水平较低。在参与一系列高血压防治教学、评估和评价体系的社区诊所工作的医生比缺乏特定培训的一般医疗中心的医生表现更好。迫切需要开展持续的高血压教育，以确保全科医生了解并遵守国家高血压防治指南。
