喀麦隆医生在急诊科急性疼痛管理方面的知识、态度和实践：一项多中心横断面研究。

Knowledge, attitudes, and practices of Cameroonian physicians with regards to acute pain management in the emergency department: a multicenter cross-sectional study.

机构信息

Department of Anesthesiology and Critical Care, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.

Department of Anesthesiology and Critical Care, Yaounde Central Hospital, Yaoundé, Cameroon.

出版信息

BMC Emerg Med. 2019 Aug 8;19(1):45. doi: 10.1186/s12873-019-0260-3.

DOI:10.1186/s12873-019-0260-3

PMID:31395007

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6688326/

Abstract

INTRODUCTION

Pain is the most frequent presenting complaint in patients consulting or admitted to the emergency department (ED). Thus, its acute management is often done by physicians working in the ED. These clinicians are often general practitioners and not emergency medicine physicians in resource-poor settings. Hence, a mastery of pain management by these physicians may be important in relieving acute pain. We aimed to assess the knowledge, to determine the attitudes and practices of physicians in the management of pain in EDs of Cameroon.

METHODS

We carried out a prospective cross-sectional study over 4 months in the year 2018. We enrolled all consenting physicians who were neither emergency medicine doctors nor anesthesiologists working at the EDs of five tertiary hospitals of Cameroon. Using a validated and pretested structured questionnaire, data on the knowledge, attitudes, and practices of acute pain management at the ED by these clinicians were studied. We used an externally validated score to assess the knowledge as either poor, insufficient, moderate or good.

RESULTS

A total of 58 physicians were included; 18 interns or residents and 39 general practitioners. Their mean age was 28.6 ± 3 years and their average number of years of practice was 2.9 years. The level of knowledge was rated "poor" in 77.6% of physicians. Being a general practitioner was significantly associated with a poor level of knowledge (p = 0.02; OR = 5.1). We found a negative and significant correlation between knowledge and years of practice (p = 0.04; r2 = 0.06). More than three-quarter (82.8%) of participants used a pain scale to evaluate the severity of pain. The most used scale was the Visual Analog Scale (56.9%). The most frequently used analgesic was paracetamol (98.3%), although only 3.5% of physicians correctly knew its half-life, delay of onset of action and duration of action.

CONCLUSION

These findings suggest that physicians in EDs of Cameroon have poor knowledge and suboptimal practices in pain management. General practice and a greater number of professional experience seemed to favour these attitudes. Overall, there is an urgent need for refresher courses in acute pain management for physicians working in these resource-limited EDs.

摘要

简介

疼痛是在急诊科就诊或住院的患者最常见的主诉。因此，其急性管理通常由在急诊科工作的医生进行。这些临床医生通常是全科医生，而不是资源匮乏环境下的急诊医学医生。因此，这些医生掌握疼痛管理可能对缓解急性疼痛很重要。我们旨在评估喀麦隆急诊科医生对疼痛管理的知识水平，确定他们的态度和实践。

方法

我们在 2018 年进行了为期 4 个月的前瞻性横断面研究。我们招募了所有同意参加研究的医生，这些医生既不是急诊医学医生，也不是在喀麦隆五所三级医院急诊科工作的麻醉师。使用经过验证和预测试的结构化问卷，研究了这些临床医生在急诊科急性疼痛管理方面的知识、态度和实践。我们使用外部验证评分来评估知识水平，分为差、不足、中等或良好。

结果

共有 58 名医生参与，其中 18 名实习生或住院医师和 39 名全科医生。他们的平均年龄为 28.6 ± 3 岁，平均行医年限为 2.9 年。77.6%的医生知识水平评为“差”。作为全科医生与知识水平差显著相关（p=0.02；OR=5.1）。我们发现知识水平与行医年限呈负相关（p=0.04；r2=0.06）。超过四分之三（82.8%）的参与者使用疼痛量表评估疼痛的严重程度。最常用的量表是视觉模拟量表（56.9%）。最常使用的镇痛药是对乙酰氨基酚（98.3%），尽管只有 3.5%的医生正确知道其半衰期、起效延迟和作用持续时间。