学术中心中医护专业人员的补充医学知识来源。
Healthcare professionals' sources of knowledge of complementary medicine in an academic center.
作者信息
Aveni Eleonore, Bauer Brent, Ramelet Anne-Sylvie, Decosterd Isabelle, Ballabeni Pierluigi, Bonvin Eric, Rodondi Pierre-Yves
机构信息
Institute for Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland.
Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States of America.
出版信息
PLoS One. 2017 Sep 29;12(9):e0184979. doi: 10.1371/journal.pone.0184979. eCollection 2017.
BACKGROUND
Complementary medicine (CM) is utilized in a growing number of academic centers despite the debate concerning its value, risks and benefits. Healthcare professionals often feel uncomfortable discussing CM with patients, and little is known about their sources of knowledge in the field of CM.
OBJECTIVE
To assess healthcare professionals' sources of knowledge and attitude toward CM in an academic hospital.
DESIGN AND PARTICIPANTS
The cross-sectional web-based survey took place from October to December 2013. A total of 4,925 healthcare professionals working at Lausanne University Hospital, Switzerland, were invited to answer the questionnaire.
MAIN MEASURES
Factors influencing healthcare professionals' opinion toward CM, knowledge and communication about CM.
KEY RESULTS
The questionnaire was answered by 1,247 healthcare professionals. The three key factors influencing professionals' opinion toward CM were personal experience, clinical experience and evidence demonstrating the physiological mechanism of CM. Personal experience was more associated with nurses' and midwives' opinion compared to physicians' (80.8% vs 57.1%, OR = 3.08, [95% CI: 2.35-4.05], P<0.001 and 85.3% vs 57.1%, OR = 3.83, [95% CI: 1.95-7.53], P<0.001, respectively) as well as with professionals trained in CM compared to non-trained professionals (86.0% vs 73.2%, OR = 2.60, [95% CI: 1.92-3.53], P<0.001). Physicians relied more on randomized controlled clinical trials compared to nurses (81.3% vs 62.9%, OR = 0.43, [95% CI: 0.33-0.57], P<0.001). A majority of the respondents (82.5%) agreed that they lacked knowledge about CM and 65.0% noted that it was the patient who initially started the discussion about CM.
CONCLUSIONS
Different professionals used different strategies to forge opinions regarding CM: physicians relied more on scientific evidence, while nurses and midwives were more influenced by personal experience. Regardless of preferred information source, most respondents did not feel prepared to address patient questions regarding CM. Enhancing interprofessional education opportunities is an important strategy to help providers become empowered to discuss CM with patients. This in turn will help patients making informed decisions in their healthcare.
背景
尽管对于补充医学（CM）的价值、风险和益处存在争议，但越来越多的学术中心开始使用补充医学。医护人员在与患者讨论补充医学时常常感到不自在，而且对于他们在补充医学领域的知识来源了解甚少。
目的
评估一家学术医院中医护人员关于补充医学的知识来源及态度。
设计与参与者
2013年10月至12月进行了基于网络的横断面调查。邀请了瑞士洛桑大学医院的4925名医护人员回答问卷。
主要测量指标
影响医护人员对补充医学看法、关于补充医学的知识及交流的因素。
关键结果
1247名医护人员回答了问卷。影响专业人员对补充医学看法的三个关键因素是个人经验、临床经验以及证明补充医学生理机制的证据。与医生相比，个人经验与护士和助产士的看法关联更大（分别为80.8%对57.1%，OR = 3.08，[95%CI：2.35 - 4.05]，P < 0.001；85.3%对57.1%，OR = 3.83，[95%CI：1.95 - 7.53]，P < 0.001），并且与接受过补充医学培训的专业人员相比，未接受过培训的专业人员的个人经验关联更大（86.0%对73.2%，OR = 2.60，[95%CI：1.92 - 3.53]，P < 0.001）。与护士相比，医生更依赖随机对照临床试验（81.3%对62.9%，OR = 0.43，[95%CI：0.33 - 0.57]，P < 0.001）。大多数受访者（82.5%）同意他们缺乏关于补充医学的知识，65.0%指出是患者最初开始讨论补充医学。
结论
不同专业人员在形成对补充医学的看法时采用了不同策略：医生更多依赖科学证据，而护士和助产士则更多受个人经验影响。无论偏好的信息来源如何，大多数受访者觉得没有准备好回答患者关于补充医学的问题。增加跨专业教育机会是帮助医护人员有能力与患者讨论补充医学的重要策略。这反过来将帮助患者在医疗保健中做出明智决策。
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