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伊朗的吞咽障碍管理:医疗保健提供者的知识、态度和实践。

Dysphagia Management in Iran: Knowledge, Attitude and Practice of Healthcare Providers.

机构信息

Shiraz Geriatric Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Department of Physical Medicine and Rehabilitation, Bone and Joint Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, 7187719446, Iran.

出版信息

Dysphagia. 2019 Feb;34(1):105-111. doi: 10.1007/s00455-018-9919-2. Epub 2018 Jun 21.

Abstract

Despite the remarkable burden of dysphagia, appropriate multidisciplinary management is lacking in Iran and patients are often deprived of effective treatments. Obtaining a full understanding of knowledge, attitude and practice (KAP) of healthcare providers is necessary to determine the gaps in improvement of the quality of care for dysphagic patients. A questionnaire was designed covering demographic information and the parameters of KAP. Face and content validity were determined. Test-retest reliability confirmed that the questionnaire scores are stable over time (r = 0.77, p value < 0.01). Participants were healthcare providers employed in university-affiliated hospitals in three major cities of Iran; Tehran, Shiraz and Mashhad. In total, 312 healthcare professionals completed our survey. The majority (96.8%) were familiar with the term "dysphagia or swallowing disorders". Most of the participants believed their profession (88.5%), as well as other disciplines (92.3%) can play an important role in the management of dysphagia; and this problem should be recognized in a multidisciplinary manner (96.2%). Also, 60.9% had encountered a patient with dysphagia. 52.2% had used at least one assessment method, while 49.9% had applied at least one treatment method. However, very few participants were familiar with a standard test for screening and assessment of dysphagia (11.9%). 74.7% were willing to participate in a workshop on dysphagia. As the main pitfalls of care lie in diagnosis and treatment expertise, the policy of hospitals should prioritize educating and updating the skills of healthcare professionals, encourage multidisciplinary teamwork, establishing clear guidelines and facilitate access to advanced tools.

摘要

尽管吞咽困难带来了巨大的负担,但伊朗缺乏适当的多学科管理,患者往往无法接受有效的治疗。了解医疗保健提供者的知识、态度和实践(KAP)对于确定改善吞咽困难患者护理质量的差距是必要的。设计了一个涵盖人口统计学信息和 KAP 参数的问卷。确定了表面效度和内容效度。测试-重测可靠性证实,问卷评分在一段时间内是稳定的(r=0.77,p 值<0.01)。参与者是在伊朗三个主要城市德黑兰、设拉子和马什哈德的大学附属医院工作的医疗保健提供者。共有 312 名医疗保健专业人员完成了我们的调查。大多数(96.8%)熟悉“吞咽困难或吞咽障碍”这一术语。大多数参与者认为他们的专业(88.5%)以及其他学科(92.3%)可以在吞咽困难管理中发挥重要作用;并且应该以多学科的方式认识到这个问题(96.2%)。此外,60.9%的人遇到过吞咽困难的患者。52.2%的人使用了至少一种评估方法,而 49.9%的人使用了至少一种治疗方法。然而,很少有参与者熟悉用于筛查和评估吞咽困难的标准测试(11.9%)。74.7%的人愿意参加吞咽困难研讨会。由于护理的主要缺陷在于诊断和治疗专业知识,因此医院的政策应优先考虑教育和更新医疗保健专业人员的技能,鼓励多学科团队合作,制定明确的指导方针并为获得先进工具提供便利。

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