Fles Renske, Indrasari Sagung R, Herdini Camelia, Martini Santi, Isfandiari Atoillah, Romdhoni Achmad C, Adham Marlinda, Mayangsari Ika D, van Werkhoven Erik, Wildeman Maarten A, Hariwiyanto Bambang, Hermani Bambang, Kentjono Widodo A, Haryana Sofia M, Schmidt Marjanka K, Tan I Bing
Department of Head and Neck Surgery and Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Department of Otorhinolaryngology, Dr. Sardjito General Hospital, Faculty of Medicine Gadjah Mada University, Yogyakarta, Indonesia.
BMJ Open. 2016 Mar 1;6(3):e008571. doi: 10.1136/bmjopen-2015-008571.
To evaluate the effectiveness of a nasopharyngeal carcinoma (NPC) awareness programme on the short-term and long-term improvement of knowledge and referral of patients with NPC by primary healthcare centres (PHCCs) staff in Indonesia.
The NPC awareness programme consisted of 12 symposia including a Train-The-Trainer component, containing lectures about early symptoms and risk factors of NPC, practical examination and the referral system for NPC suspects. Before and after training participants completed a questionnaire. The Indonesian Doctors Association accredited all activities.
1 representative general practitioner (GP) from each PHCC attended an NPC awareness symposium. On the basis of the Train-The-Trainer principle, GPs received training material and were obligated to train their colleagues in the PHCC.
703 GPs attended the symposia and trained 1349 staff members: 314 other GPs, 685 nurses and 350 midwives. After the training, respondents' average score regarding the knowledge of NPC symptoms increased from 47 points (of the 100) to 74 points (p<0.001); this increase was similar between symposium and Train-The-Trainer component (p=0.88). At 1½ years after the training, this knowledge remained significantly increased at 59 points (p<0.001).
The initial results of this NPC awareness programme indicate that the programme effectively increases NPC knowledge in the short and long term and therefore should be continued. Effects of the improved knowledge on the stage at diagnoses of the patients with NPC will still need to be scrutinised. This awareness programme can serve as a blueprint for other cancer types in Indonesia and for other developing countries.
评估一项鼻咽癌（NPC）认知项目对印度尼西亚初级医疗保健中心（PHCCs）工作人员在短期和长期内提高鼻咽癌知识水平及患者转诊情况的效果。
鼻咽癌认知项目包括12场研讨会，其中有一个培训培训师环节，内容涵盖鼻咽癌的早期症状和危险因素讲座、实践检查以及鼻咽癌疑似患者的转诊系统。培训前后，参与者需完成一份问卷。印度尼西亚医生协会认可了所有活动。
每个初级医疗保健中心的1名全科医生代表参加了鼻咽癌认知研讨会。基于培训培训师原则，全科医生获得了培训材料，并负责培训其所在初级医疗保健中心的同事。
703名全科医生参加了研讨会，并培训了1349名工作人员：314名其他全科医生、685名护士和350名助产士。培训后，受访者关于鼻咽癌症状知识的平均得分从（满分100分中的）47分提高到了74分（p<0.001）；研讨会和培训培训师环节的得分增长情况相似（p=0.88）。培训后1.5年，这一知识水平仍显著提高至59分（p<0.001）。
该鼻咽癌认知项目的初步结果表明，该项目在短期和长期内均有效提高了鼻咽癌知识水平，因此应继续开展。知识水平的提高对鼻咽癌患者诊断阶段的影响仍需进一步研究。该认知项目可为印度尼西亚其他癌症类型以及其他发展中国家提供蓝本。
