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初级保健医生在协助处理紧急情况时自我认知的局限性和困难。

Self-perceived limitations and difficulties by Primary Health Care Physicians to assist emergencies.

作者信息

Cernuda Martínez José Antonio, Castro Delgado Rafael, Arcos González Pedro

机构信息

Unit for Research in Emergency and Disaster, Faculty of Medicine and Health Sciences, University of Oviedo, Oviedo, Spain.

出版信息

Medicine (Baltimore). 2018 Dec;97(52):e13819. doi: 10.1097/MD.0000000000013819.

Abstract

The study was aimed to identify the training received in Emergency Medicine by physicians and the limitations and difficulties self-perceived by those physicians to assist in emergencies, as well as to analyze the differences according to the work context.Observational cross-sectional study made by a survey using a self-administered questionnaire to a representative simple random sample (with replacement) of 294 doctors (n) working at the Primary Health Care centers out of the total of 851 doctors (N) that form the staff of physicians of Primary Health Care system of Asturias (Spain).In rural areas, the most frequently mentioned reasons were the lack of practical skills (32.65%), absence of adequate material (20.41%), lack of theoretical knowledge (8.16%), and poor equipment conditions (4.08%). In the semi-urban area, the most common reasons were the lack of practical skills (19.61%), lack of theoretical knowledge (10.78%), absence of adequate material (8.82%), and poor equipment conditions (4.90%). Finally, in the urban area, the main reason was the lack of practical skills (23.40%), absence of adequate material (20.21%), lack of theoretical knowledge (9.57%), and poor equipment conditions (4.26%). The differences were significant (P = .003) among the 3 work context.The absence of practical skills is the most frequent cause referred by doctors of the 3 areas as a key to not act correctly in an emergency. The doctors of the rural area perceive that they are better prepared in general to solve emergencies and it is the professionals of 3 areas that report having carried out more basic cardiopulmonary resuscitation, advanced and attention to the polytraumatized patient courses.

摘要

这项研究旨在确定医生接受的急诊医学培训,以及这些医生自我感知到的在协助处理紧急情况时的局限性和困难,并分析不同工作环境下的差异。采用自我管理问卷对西班牙阿斯图里亚斯初级卫生保健系统的851名医生(N)中的294名医生(n)进行代表性简单随机抽样(可重复抽样)调查,开展观察性横断面研究。在农村地区,最常提到的原因是缺乏实践技能(32.65%)、缺乏足够的物资(20.41%)、缺乏理论知识(8.16%)和设备条件差(4.08%)。在半城市地区,最常见的原因是缺乏实践技能(19.61%)、缺乏理论知识(10.78%)、缺乏足够的物资(8.82%)和设备条件差(4.90%)。最后,在城市地区,主要原因是缺乏实践技能(23.40%)、缺乏足够的物资(20.21%)、缺乏理论知识(9.57%)和设备条件差(4.26%)。这三种工作环境之间的差异具有统计学意义(P = 0.003)。缺乏实践技能是这三个地区的医生提及的在紧急情况下无法正确行动的最常见原因。农村地区的医生认为他们总体上更有能力解决紧急情况,并且这三个地区的专业人员报告开展了更多的基本心肺复苏、高级和多创伤患者护理课程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/504d/6314741/7ac5727f249c/medi-97-e13819-g002.jpg

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