Qaddumi Jamal A S, Nazzal Zaher, Yacoub Allam, Mansour Mahmoud
Faculty of Medicine and Health Sciences, An-Najah National University, PO box 7, Nablus, Palestine.
Department of anesthesia, An-Najah National University Hospital, Nablus, Palestine.
BMC Health Serv Res. 2018 Jan 8;18(1):8. doi: 10.1186/s12913-017-2814-y.
Mortality data are essential for many aspects of everyday public health practices at both national and international levels. Despite the current developments in various aspects of the medical field, the apparent inability of physicians to complete death notification forms (DNF) accurately is still worldwide concern. The aim of this study is to assess the physicians' knowledge and practice on completing the DNF.
A self-administered questionnaire was distributed to 200 physicians in governmental and non-governmental hospitals in the North West-Bank in Palestine. Furthermore, a case scenario was included in the questionnaire and physicians were asked to fill the cause of death section. The percentage of errors committed while completing the cause of death section were computed. A Chi square test was used to assess the association between physicians' characteristics and their responses.
Only 40.6% of the participants completed the cause of death section correctly. The immediate and underlying causes of death were correctly identified by 48.7% and 71.3% of physicians, respectively. Almost one-fifth (17.3%) of physicians wrote the mechanism of death without reporting the underlying cause of death and 14.7% of them reported the sequence of events leading to death incorrectly.
Physicians' knowledge and practice on completing the DNF is poor and insufficient, which may seriously affect the accuracy of mortality data. Complicated cases, problems in the current design of the DNFs and lack of training were the most common factors contributing to inaccuracy in death certification. We recommend offering periodical training workshops on completing the DNF to all physicians, and developing a manual on completing the DNFs with clear instructions and guidelines.
死亡率数据对于国家和国际层面日常公共卫生实践的许多方面都至关重要。尽管医学领域目前在各个方面都有发展，但医生明显无法准确填写死亡通知单（DNF）仍是全球关注的问题。本研究的目的是评估医生在填写DNF方面的知识和实践情况。
向巴勒斯坦约旦河西岸政府和非政府医院的200名医生发放了一份自填式问卷。此外，问卷中包含一个病例情景，要求医生填写死因部分。计算填写死因部分时出现错误的百分比。使用卡方检验来评估医生特征与其回答之间的关联。
只有40.6%的参与者正确填写了死因部分。分别有48.7%和71.3%的医生正确识别了直接死因和根本死因。近五分之一（17.3%）的医生在未报告根本死因的情况下填写了死亡机制，14.7%的医生错误报告了导致死亡的事件顺序。
医生在填写DNF方面的知识和实践较差且不足，这可能严重影响死亡率数据的准确性。复杂病例、当前DNF设计存在的问题以及缺乏培训是导致死亡证明不准确的最常见因素。我们建议为所有医生提供关于填写DNF的定期培训讲习班，并编写一本关于填写DNF的手册，提供明确的说明和指导方针。
