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针对医疗保健专业人员开展的关于使用马来西亚痴呆症管理临床实践指南的培训项目的初步评估。

Initial evaluation of the training programme for health care professionals on the use of Malaysian clinical practice guidelines for management of dementia.

作者信息

Yusoff S, Koh C T, Mohd Aminuddin M Y, Krishnasamy M, Suhaila M Z

机构信息

Department of Psychiatry and Mental Health, Hospital Sultan Ismail, Johor Bahru, Malaysia.

出版信息

East Asian Arch Psychiatry. 2013 Sep;23(3):91-101.

Abstract

OBJECTIVE

The Malaysian Clinical Practice Guidelines (CPG) for Management of Dementia (second edition) was launched in April 2010 by the Ministry of Health Malaysia. A training programme for the management of dementia, involving all categories of staff working at primary and secondary centres, was implemented to ensure that care delivery for people with dementia was in accordance with the guidelines. The study aimed to look into improving knowledge and understanding of dementia following training, and to evaluate the effectiveness of the training programme using a clinical audit indicator recommended in the guidelines.

METHODS

The study entailed 2 phases (at national and state levels). The first phase involved the CPG training programme run as a 1.5-day workshop, in which participants filled up pre- and post-workshop questionnaires. A second phase involved analysing all the referral letters to the memory clinic at the Hospital Sultan Ismail, Johor Bahru 1 year before and after the training programme.

RESULTS

There was a significant improvement in knowledge about dementia and its management among the health care professionals following training. The mean percentage score for the pre-workshop test was 63% while for the post-workshop test it was 78%, giving a difference of 15%. Although there was an overall improvement in knowledge gain following training in both specialist and non-specialist groups, these differences were not statistically significant (t = 1.32; 95% confidence interval, -2.61 to 9.61; p = 0.25). The proportion of referrals with a possible diagnosis of dementia from primary clinic referrals to the memory clinic also increased from 18% to 44% after training.

CONCLUSION

There was an overall improvement in the knowledge about dementia among the health care professionals following the training, which was reflected in the increase in referrals to the memory clinic. Although the initial results appeared to be promising, a multicentre study is warranted to conclude that the training had been effective.

摘要

目的

马来西亚卫生部于2010年4月发布了《痴呆症管理马来西亚临床实践指南》(第二版)。实施了一项针对痴呆症管理的培训计划,涵盖初级和二级医疗中心的各类工作人员,以确保为痴呆症患者提供的护理符合指南要求。该研究旨在调查培训后对痴呆症知识和理解的改善情况,并使用指南中推荐的临床审计指标评估培训计划的有效性。

方法

该研究分为两个阶段(国家和州层面)。第一阶段包括为期1.5天的临床实践指南培训工作坊,参与者在工作坊前后填写问卷。第二阶段涉及分析柔佛州新山市苏丹伊斯梅尔医院记忆门诊在培训计划前后1年收到的所有转诊信。

结果

培训后,医护人员对痴呆症及其管理的知识有显著提高。工作坊前测试的平均百分比分数为63%,工作坊后测试为78%,相差15%。尽管专科和非专科组培训后的知识增益总体有所改善,但这些差异无统计学意义(t = 1.32;95%置信区间,-2.61至9.61;p = 0.25)。从初级诊所转诊至记忆门诊且可能诊断为痴呆症的转诊比例在培训后也从18%增至44%。

结论

培训后医护人员对痴呆症的知识总体有所提高,这体现在转诊至记忆门诊的人数增加上。尽管初步结果似乎很有前景,但仍需进行多中心研究才能得出培训有效的结论。

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