加纳一家大型教学医院医生尸检的临床实用性及其对临床实践的影响。

Clinical utility and impact of autopsies on clinical practice among doctors in a large teaching hospital in Ghana.

机构信息

Department of Community Health, College of Health Sciences, University of Ghana Medical School, Korle-Bu, Accra, Ghana.

Department of Community Health, College of Health Sciences, University of Ghana Medical School, Korle-Bu, Accra, Ghana;

出版信息

Glob Health Action. 2014 Feb 3;7:23132. doi: 10.3402/gha.v7.23132. eCollection 2014.

DOI:10.3402/gha.v7.23132

PMID:24499743

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3914029/

Abstract

BACKGROUND

Autopsies can provide a good indication of the quality of patient care, in terms of the accuracy of clinical diagnosis and the quality of treatment given.

DESIGNS

This was a cross-sectional study among clinicians at the Korle-Bu Teaching Hospital (KBTH) in 2012. Data were collected with a 69-item, self-administered, structured questionnaire. A total of 215 questionnaires were sent out and 119 clinicians responded. Data were collected on the benefits and utility of autopsies for medical practice, care of patients, and management of clinical wards. Survey data were analyzed by simple descriptive statistics (i.e. proportions, ratios, and percentages). Data were analyzed using SPSS version 21.

OBJECTIVE

This study examined the views of clinicians regarding the utility of autopsies and their influence on clinical practice in a large teaching hospital in Ghana.

RESULTS

Overall, clinicians in KBTH agreed that autopsy reports are useful in answering clinical questions (55/119; 46.2%), confirming or verifying clinical diagnoses (54/119; 45.4%), providing information on unsuspected diagnoses (40/119; 33.6%), and for medical education (90/119; 75.6%). Overall, 70/119 (58.8%) of clinicians agreed that autopsy findings improve completeness and reliability of death certification and provide information on clinical effectiveness of treatment and patient management. However, only 23/119 (19.3%) of sampled clinicians had personal interactions with a pathologist during autopsy processes and 93/119 (78.2%) had not attended any autopsy demonstrations in the past 6 months. Attendance of pathologists at clinicopathological meetings of clinical departments of KBTH was minimal. Unfortunately, the use of autopsy reports for auditing clinical diagnostic performance was not seen as essential.

CONCLUSION

Strengthening the interaction between doctors and pathologists is essential in improving the autopsy process and utilization in the hospital. KBTH should create opportunities for doctors to attend autopsy demonstrations and for pathologists to attend clinicopathological meetings in the hospital.

摘要

背景

尸检可以很好地反映患者护理质量，包括临床诊断的准确性和治疗质量。

设计

这是 2012 年在科勒布教学医院（KBTH）的临床医生进行的一项横断面研究。研究使用一份 69 项的自我管理式结构化问卷收集数据。共发出 215 份问卷，119 名临床医生做出回应。数据收集内容包括尸检对医疗实践、患者护理和临床病房管理的益处和实用性。调查数据采用简单描述性统计（即比例、比率和百分比）进行分析。使用 SPSS 版本 21 进行数据分析。

目的

本研究调查了加纳一家大型教学医院的临床医生对尸检实用性及其对临床实践影响的看法。

结果

总体而言，KBTH 的临床医生认为尸检报告有助于回答临床问题（55/119；46.2%）、确认或验证临床诊断（54/119；45.4%）、提供未被怀疑的诊断信息（40/119；33.6%）以及医学教育（90/119；75.6%）。总体而言，70/119（58.8%）的临床医生认为尸检结果提高了死亡证明的完整性和可靠性，并提供了有关治疗和患者管理临床效果的信息。然而，仅有 23/119（19.3%）名被抽样的临床医生在尸检过程中有过与病理学家的个人互动，93/119（78.2%）在过去 6 个月中没有参加过任何尸检示范。KBTH 临床科室的病理学家很少参加临床病理会议。不幸的是，将尸检报告用于审核临床诊断表现并不被视为必要。