提高衣原体知识水平应能促使澳大利亚全科医生增加衣原体检测：一项关于全科医疗中衣原体检测接受情况的横断面研究。

Improving chlamydia knowledge should lead to increased chlamydia testing among Australian general practitioners: a cross-sectional study of chlamydia testing uptake in general practice.

作者信息

Yeung Anna, Temple-Smith Meredith, Spark Simone, Guy Rebecca, Fairley Christopher K, Law Matthew, Wood Anna, Smith Kirsty, Donovan Basil, Kaldor John, Gunn Jane, Pirotta Marie, Carter Rob, Hocking Jane

机构信息

Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, Victoria, Australia.

出版信息

BMC Infect Dis. 2014 Nov 7;14:584. doi: 10.1186/s12879-014-0584-2.

DOI:10.1186/s12879-014-0584-2

PMID:25409698

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4228271/

Abstract

BACKGROUND

Female general practitioners (GPs) have higher chlamydia testing rates than male GPs, yet it is unclear whether this is due to lack of knowledge among male GPs or because female GPs consult and test more female patients.

METHODS

GPs completed a survey about their demographic details and knowledge about genital chlamydia. Chlamydia testing and consultation data for patients aged 16-29 years were extracted from the medical records software for each GP and linked to their survey responses. Chi-square tests were used to determine differences in a GP's knowledge and demographics. Two multivariable models that adjusted for the gender of the patient were used to investigate associations between a GP and their chlamydia testing rates - Model 1 included GPs' characteristics such as age and gender, Model 2 excluded these characteristics to specifically examine any associations with knowledge.

RESULTS

Female GPs were more likely than male GPs to know when to re-test a patient after a negative chlamydia test (18.8% versus 9.7%, p = 0.01), the correct symptoms suggestive of PID (80.5% versus 67.8%, p = 0.01) and the correct tests for diagnosing PID (57.1% versus 42.6%, p = 0.01). Female GPs tested 6.5% of patients, while male GPs tested 2.2% (p < 0.01). Model 1 found factors associated with chlamydia testing were being a female GP (OR = 2.5, 95% CI: 1.9, 3.3) and working in a metropolitan clinic (OR = 3.2; 95% CI: 2.4, 4.3). Model 2 showed that chlamydia testing increased as knowledge of testing guidelines improved (3-5 correct answers - AOR = 2.0, 95% CI: 1.0, 4.2; 6+ correct answers - AOR = 2.9, 95% CI: 1.4, 6.2).

CONCLUSIONS

Higher rates of chlamydia testing are strongly associated with GPs who are female, based in a metropolitan clinic and among those with more knowledge of the recommended guidelines. Improving chlamydia knowledge among male GPs may increase chlamydia testing.

摘要

背景

女性全科医生（GP）的衣原体检测率高于男性全科医生，但尚不清楚这是由于男性全科医生知识欠缺，还是因为女性全科医生诊治和检测的女性患者更多。

方法

全科医生完成了一项关于其人口统计学详细信息和生殖器衣原体知识的调查。从每位全科医生的病历软件中提取16至29岁患者的衣原体检测和诊治数据，并将其与他们的调查回复相关联。采用卡方检验来确定全科医生在知识和人口统计学方面的差异。使用两个针对患者性别进行调整的多变量模型来研究全科医生与其衣原体检测率之间的关联——模型1纳入了全科医生的年龄和性别等特征，模型2排除了这些特征以专门检验与知识的任何关联。

结果

女性全科医生比男性全科医生更有可能知道衣原体检测结果为阴性后何时对患者进行重新检测（18.8%对9.7%，p = 0.01）、提示盆腔炎（PID）的正确症状（80.5%对67.8%，p = 0.01）以及诊断PID的正确检测方法（57.1%对42.6%，p = 0.01）。女性全科医生检测了6.5%的患者，而男性全科医生检测了2.2%（p < 0.01）。模型1发现与衣原体检测相关的因素是身为女性全科医生（比值比[OR] = 2.5，95%置信区间[CI]：1.9，3.3）以及在大都市诊所工作（OR = 3.2；95% CI：2.4，4.3）。模型2表明，随着对检测指南知识的提高，衣原体检测率增加（3至5个正确答案——校正后的OR = 2.0，95% CI：1.0，4.2；6个及以上正确答案——校正后的OR = 2.9，95% CI：1.4，6.2）。