Servicio de Medicina Preventiva y Salud Pública, Hospital Universitario Ramón y Cajal, IRYCIS, CIBER Epidemiología y Salud Pública (CIBERESP), 28034 Madrid, Spain.
Servicio de Medicina Preventiva y Salud Pública, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain.
Int J Environ Res Public Health. 2020 May 19;17(10):3556. doi: 10.3390/ijerph17103556.
: To know the frequency and causes of low value surgical practices, according to the opinion of surgeons and anesthetists, and to determine their degree of knowledge about the Spanish "Choosing wisely" initiative. : Cross-sectional observational study, based on a self-administered online questionnaire through an opportunistic sample of 370 surgeons and anesthetists from three Spanish regions, contacted through Scientific Societies. The survey took part between July and December 2017. : A patient profile requesting unnecessary practices was identified (female, 51-65 years old and unaffiliated disease). The frequency of requests was weekly or daily for 50.0% of the professionals, of whom 15.1% acknowledged succumbing to these pressures. To dissuade the patient, clinical reasons (47%) were considered the most effective. To increase control and safety in the case was the main reason to indicate them. The greatest responsibility for overuse was attributed to physicians, defensive medicine and mass media. Assessing professionals' knowledge on unnecessary practices, an average of 5 correct answers out of 7 was obtained. Some 64.1% of the respondents were unaware of the Spanish "Choosing wisely" initiative. S: Low value surgical practices are perceived as a frequent problem, which requires an approach entailing intervention with patients and the media as well as professionals. Increase awareness on unnecessary surgical practices, and how to avoid them remain essential.
为了了解外科医生和麻醉师对低价值手术操作的看法及其发生频率和原因，以及确定他们对西班牙“明智选择”计划的了解程度。本研究为一项横断面观察性研究，通过机会性抽样，对来自西班牙三个地区的 370 名外科医生和麻醉师进行了在线问卷调查。调查于 2017 年 7 月至 12 月进行。确定了一个要求不必要手术的患者特征（女性，51-65 岁，无相关疾病）。50.0%的医生每周或每天都会要求进行这些手术，其中 15.1%的医生承认屈服于这些压力。为了劝阻患者，临床原因（47%）被认为是最有效的方法。为了提高病例的控制和安全性是指出这些操作的主要原因。过度治疗的最大责任归咎于医生、防御性医疗和大众媒体。评估医生对不必要手术的认知程度，得出的平均正确答案为 7 个中的 5 个。约 64.1%的受访者不知道西班牙的“明智选择”计划。S：低价值手术操作被认为是一个常见的问题，需要通过与患者、媒体以及专业人员进行干预来解决。提高对不必要手术操作的认识，并了解如何避免这些操作仍然至关重要。
