School of Public Health, Curtin University, Bentley, Australia.
Division of Surgery, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia.
BMC Fam Pract. 2021 Mar 2;22(1):46. doi: 10.1186/s12875-021-01384-1.
General Practitioners (GPs) may be called upon to assess patients who have sustained a concussion despite limited information being available at this assessment. Information relating to how concussion is actually being assessed and managed in General Practice is scarce. This study aimed to identify characteristics of current Western Australian (WA) GP exposure to patients with concussion, factors associated with GPs' knowledge of concussion, confidence of GPs in diagnosing and managing patients with concussion, typical referral practices and familiarity of GPs with guidelines.
In this cross-sectional study, GPs in WA were recruited via the RACGP WA newsletter and shareGP and the consented GPs completed an electronic survey. Associations were performed using Chi-squared tests or Fisher's Exact test.
Sixty-six GPs in WA responded to the survey (response rate = 1.7%). Demographics, usual practice, knowledge, confidence, identification of prolonged recovery as well as guideline and resource awareness of GPs who practised in regional and metropolitan areas were comparable (p > 0.05). Characteristics of GPs were similar between those who identified all symptoms of concussion and distractors correctly and those who did not (p > 0.05). However, 84% of the respondents who had never heard of concussion guidelines were less likely to answer all symptoms and distractors correctly (p = 0.039). Whilst 78% of the GPs who were confident in their diagnoses had heard of guidelines (p = 0.029), confidence in managing concussion was not significantly associated with GPs exposure to guidelines. It should be noted that none of the respondents correctly identified signs of concussion and excluded the distractors.
Knowledge surrounding concussion guidelines, diagnosis and management varied across GPs in WA. Promotion of available concussion guidelines may assist GPs who lack confidence in making a diagnosis. The lack of association between GPs exposure to guidelines and confidence managing concussion highlights that concussion management may be an area where GPs could benefit from additional education and support.
全科医生（GP）在评估遭受脑震荡的患者时，可能会根据有限的信息进行评估。关于脑震荡实际评估和管理的信息在全科实践中很少。本研究旨在确定当前西澳大利亚（WA）全科医生接触脑震荡患者的特征、与全科医生对脑震荡的认识相关的因素、全科医生诊断和管理脑震荡患者的信心、典型转诊实践以及全科医生对指南的熟悉程度。
在这项横断面研究中，通过 RACGP WA 时事通讯和 shareGP 招募 WA 的全科医生，同意参与的全科医生完成了电子调查。使用卡方检验或 Fisher 精确检验进行关联。
WA 有 66 名全科医生对调查做出了回应（回应率=1.7%）。在地区和大都市地区执业的全科医生的人口统计学特征、常规实践、知识、信心、确定延长恢复期以及对指南和资源的认识是可比的（p>0.05）。在那些正确识别脑震荡的所有症状和干扰因素的全科医生和那些不正确识别的全科医生之间，全科医生的特征相似（p>0.05）。然而，84%的从未听说过脑震荡指南的受访者不太可能正确回答所有症状和干扰因素（p=0.039）。尽管 78%有信心诊断的全科医生听说过指南（p=0.029），但对管理脑震荡的信心与全科医生接触指南没有显著关联。值得注意的是，没有一个受访者正确识别脑震荡的迹象并排除了干扰因素。
WA 全科医生对脑震荡指南、诊断和管理的知识各不相同。推广现有的脑震荡指南可能有助于对诊断缺乏信心的全科医生。全科医生接触指南与管理脑震荡的信心之间缺乏关联突出表明，脑震荡管理可能是全科医生需要额外教育和支持的领域。
