Magnusson Peter, Mörner Stellan
Center of Research and Development, Uppsala University/ Region Gävleborg, Gävle, SWE.
Medicine, Cardiology Research Unit, Karolinska Institutet, Stockholm, SWE.
Cureus. 2020 Dec 22;12(12):e12220. doi: 10.7759/cureus.12220.
Introduction Hypertrophic cardiomyopathy (HCM) is a common disorder with various manifestations, including sudden cardiac death. Patients with suspected or confirmed HCM may be encountered throughout the healthcare system, especially in internal medicine and cardiology. Thus, thorough knowledge of HCM is essential among healthcare providers. Methods A web-based questionnaire was developed to assess the cross-sectional evaluation of HCM knowledge. It covered aspects such as epidemiology and diagnosis, treatment, lifestyle, risk stratification of sudden cardiac death, and implantable cardioverter-defibrillator knowledge. Results In total, 123 subjects completed the survey. The mean age was 38.5 ±10.7 years and two-thirds (n=82) were females; 43.1% were physicians (non-specialist 24.4%, cardiologists 8.9%, specialist, other than cardiology 9.8%); and the remaining were nurses (nurses within cardiology 37.4%, nurses outside cardiology 19.5%). Almost all subjects had heard about the disease (95.9%) and the vast majority (77.2%) had taken part in the management of a patient with HCM. The total mean score was 15.9 ±3.9 credits and the 25th, 50th, and 75th percentiles were 14, 15, and 18 credits, respectively. The predefined arbitrary pass score of ≥60% was reached by 61.8%, and 20.3% were considered to pass with distinction. Physicians scored higher than nurses (70.7 ±17.0% vs 58.1 ±11.8; p<0.001). Within each professional category, there was a similar score with regard to gender. Conclusions There is a considerable lack of knowledge of HCM among healthcare professionals working within the field of internal medicine/cardiology. This insufficient knowledge may contribute to less implementation of evidence-based medicine and current guidelines, although further studies are needed to confirm this.
引言
肥厚型心肌病(HCM)是一种具有多种表现形式的常见疾病,包括心源性猝死。在整个医疗系统中,尤其是在内科和心脏病学领域,可能会遇到疑似或确诊为HCM的患者。因此,医疗服务提供者全面了解HCM至关重要。
方法
开发了一份基于网络的问卷,以评估对HCM知识的横断面评估。问卷涵盖了流行病学与诊断、治疗、生活方式、心源性猝死的风险分层以及植入式心脏复律除颤器知识等方面。
结果
共有123名受试者完成了调查。平均年龄为38.5±10.7岁,三分之二(n = 82)为女性;43.1%为医生(非专科医生24.4%,心脏病专家8.9%,非心脏病学专科医生9.8%);其余为护士(心内科护士37.4%,心内科以外的护士19.5%)。几乎所有受试者都听说过这种疾病(95.9%),绝大多数(77.2%)参与过HCM患者的管理。总平均得分为15.9±3.9分,第25、50和75百分位数分别为14分、15分和18分。61.8%的人达到了预先设定的任意及格分数≥60%,20.3%的人被认为成绩优异。医生的得分高于护士(70.7±17.0%对58.1±11.8;p<0.001)。在每个专业类别中,性别得分相似。
结论
在内科/心脏病学领域工作的医疗专业人员对HCM的了解相当不足。尽管需要进一步研究来证实这一点,但这种知识不足可能导致循证医学和现行指南的实施较少。