Herceg Marko, Kalcina Linda Lusic, Lusic Ivo
Phelps Hospital, Northwell Health, Sleepy Hollow, NY 10591 USA, School of Public Health, New York Medical College, Valhalla, NY 10595 USA.
Department of Neuroscience, University Hospital of Split, University of Split School of Medicine, Soltanska 2, 2100, Spilt, Croatia.
Concussion. 2018 Nov 19;3(4):CNC59. doi: 10.2217/cnc-2018-0002. eCollection 2018 Dec.
The objective of this study was to administer and analyze results of a survey targeting knowledge about concussion symptoms, diagnosis, treatment and expected recovery among family medicine specialists in the Split-Dalmatia County of Croatia.
An electronic survey questionnaire was developed utilizing concepts from previously published studies on concussion knowledge, attitudes and beliefs completed by physicians. The survey was intended to briefly and broadly assess concussion knowledge of Croatian healthcare providers. The first section of the survey included five questions clarifying professional practice, years of experience and experience with concussions; the second section included 15 questions about typical concussion symptoms; the third section included 12 questions focused upon three primary components of concussion knowledge: concussion diagnosis, treatment and recovery.
Out of 242 surveys mailed, 81 questionnaires (33%) were completed while 161 respondents (67%) did not answer. Out of the 81 completed surveys, 76 (94%) were returned by family physicians specialist and five (6%) by resident physicians in training. 39 (48%) had treated less than ten patients with concussion during last year: 40 (49%) treated 11-20 patients with concussion; and two (3%) treated greater than 20 patients with concussion during last year. While most responses did accurately reflect knowledge of common symptoms (90-100% correct), there was significant lack of knowledge in three areas: only 19% of participants stated that diagnosis of concussion does not require loss of consciousness; three quarters of respondents believed that a diagnosis of concussion requires direct contact to the head and 83% of the respondents believed that persistent subjective complaints are always the result of a more severe initial injury.
This is the first investigation conducted in Croatia to examine knowledge of concussion diagnosis, as well as the management practices held by medical professionals. Overall, the findings suggest that the knowledge and management practices among family doctors in the region are not consistent with current worldwide views and recommendations. There was not an accurate knowledge of concussion diagnosis, treatment, recovery and prognosis among family physicians. Continued education of medical staff to better identify concussion and increased reliance on objective methods for managing concussion will improve patient management and outcome.
本研究的目的是对克罗地亚斯普利特-达尔马提亚县的家庭医学专家进行一项关于脑震荡症状、诊断、治疗和预期恢复知识的调查，并分析结果。
利用先前发表的关于医生完成的脑震荡知识、态度和信念的研究中的概念，开发了一份电子调查问卷。该调查旨在简要广泛地评估克罗地亚医疗服务提供者的脑震荡知识。调查的第一部分包括五个问题，用于阐明专业实践、工作年限和脑震荡治疗经验；第二部分包括15个关于典型脑震荡症状的问题；第三部分包括12个问题，重点关注脑震荡知识的三个主要方面：脑震荡诊断、治疗和恢复。
在邮寄的242份调查问卷中，81份（33%）被完成，161名受访者（67%）未作答。在81份完成的调查问卷中，76份（94%）由家庭医生专家返回，5份（6%）由实习医生返回。39人（48%）去年治疗的脑震荡患者少于10例；40人（49%）治疗了11至20例脑震荡患者；2人（3%）去年治疗的脑震荡患者超过20例。虽然大多数回答确实准确反映了对常见症状的了解（正确率为90%-100%），但在三个方面存在明显的知识欠缺：只有19%的参与者表示脑震荡的诊断不需要意识丧失；四分之三的受访者认为脑震荡的诊断需要头部直接接触，83%的受访者认为持续的主观症状总是更严重的初始损伤的结果。
这是在克罗地亚进行的首次调查，以检查脑震荡诊断知识以及医疗专业人员的管理实践。总体而言，研究结果表明，该地区家庭医生的知识和管理实践与当前全球观点和建议不一致。家庭医生对脑震荡的诊断、治疗、恢复和预后没有准确的认识。持续对医务人员进行教育，以更好地识别脑震荡，并增加对管理脑震荡的客观方法的依赖，将改善患者管理和治疗结果。
