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在尼日利亚东南部资源有限的环境下,住院医师参与健康研究:观点、问题和挑战。对三个住院医师培训中心的横断面调查。

Trainee resident participation in health research in a resource-constrained setting in south-eastern Nigeria: perspectives, issues and challenges. A cross-sectional survey of three residency training centres.

机构信息

Department of Ophthalmology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria.

出版信息

BMC Med Educ. 2012 Jun 13;12:40. doi: 10.1186/1472-6920-12-40.

Abstract

BACKGROUND

The participation of trainers and trainees in health research is critical to advance medical science. Overcoming barriers and enhancing incentives are essential to sustain a research culture and extend the frontiers of medical education. In this study, we investigated the roles of individual and system factors influencing trainee resident participation in health research in Enugu, south-eastern Nigeria.

METHODS

This cross-sectional survey of trainee residents was conducted across three residency training centres in Enugu, Nigeria, between February and March, 2010. The number and speciality distribution of trainee residents were determined from personnel records at each centre. A 19-item questionnaire was used to record demographic characteristics, research training/experience, and attitudes toward and perceived barriers to health research. Data were analysed to yield frequencies, percentages and proportions. Values of p<0.05 were considered significant.

RESULTS

The response rate was 93.2%. The respondents (n=136) comprised 109 males and 27 females. Their mean±standard deviation age was 35.8±5.6 years (range: 25-53 years). Participation in research was significantly associated with previous research training [odds ratio (OR): 2.90; 95% confidence interval (CI): 1.35-6.25, p=0.003, β=22.57], previous research participation (OR: 2.21; 95% CI: 0.94-5.29, p=0.047, β=22.53) and research publication (OR: 2.63; 95% CI: 1.00-7.06, p=0.03, β=22.57). Attitude towards research was significantly influenced by perceived usefulness of research in patient care (OR: 7.10; 95% CI: 3.33-15.13, p=0.001), job promotion (OR: 8.97; 95% CI: 4.12-19.53, p=0.001) and better understanding of disease (OR: 21.37; 95% CI: 8.71-54.44, p=0.001). Time constraints (OR: 0.06; 95% CI=0.025-0.14, p=0.001), funding (OR: 0.028; 95% CI: 0.008-0.10, p=0.001) and mentorship (OR: 0.086; 95% CI: 0.36-0.21, p=0.001) were significant barriers to research participation.

CONCLUSIONS

System and individual factors are significant incentives to research participation, while system-derived factors are significant barriers. Pre-residency research, dedicated research time, adequate research funding and commensurate research mentorship rewards are instructive. Prospective longitudinal studies are warranted to confirm these findings.

摘要

背景

培训师和学员参与健康研究对于推进医学科学至关重要。克服障碍和增强激励对于维持研究文化和拓展医学教育的前沿至关重要。在这项研究中,我们调查了影响尼日利亚东南部埃努古培训生参与健康研究的个人和系统因素的作用。

方法

这是一项在尼日利亚埃努古的三个住院医师培训中心进行的培训生住院医师横断面调查,时间为 2010 年 2 月至 3 月。每个中心的人员记录确定了培训生住院医师的数量和专业分布。使用一份包含 19 个项目的问卷记录人口统计学特征、研究培训/经验以及对健康研究的态度和感知障碍。数据分析得出频率、百分比和比例。p 值<0.05 被认为具有统计学意义。

结果

应答率为 93.2%。受访者(n=136)包括 109 名男性和 27 名女性。他们的平均年龄±标准差为 35.8±5.6 岁(范围:25-53 岁)。研究参与与先前的研究培训[优势比(OR):2.90;95%置信区间(CI):1.35-6.25,p=0.003,β=22.57]、先前的研究参与(OR:2.21;95% CI:0.94-5.29,p=0.047,β=22.53)和研究出版物(OR:2.63;95% CI:1.00-7.06,p=0.03,β=22.57)显著相关。对研究的态度受到研究在患者护理中的有用性(OR:7.10;95% CI:3.33-15.13,p=0.001)、工作晋升(OR:8.97;95% CI:4.12-19.53,p=0.001)和更好地了解疾病(OR:21.37;95% CI:8.71-54.44,p=0.001)的显著影响。时间限制(OR:0.06;95% CI=0.025-0.14,p=0.001)、资金(OR:0.028;95% CI:0.008-0.10,p=0.001)和指导(OR:0.086;95% CI:0.36-0.21,p=0.001)是研究参与的显著障碍。

结论

系统和个人因素是研究参与的重要激励因素,而系统因素是研究参与的重要障碍。住院前研究、专门的研究时间、充足的研究资金和相应的研究指导奖励是有指导意义的。需要前瞻性的纵向研究来证实这些发现。

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