Hill M N, Levine D M, Whelton P K
Department of Behavioral Sciences and Health Education, Johns Hopkins School of Hygiene and Public Health, Baltimore, Maryland.
Am J Public Health. 1988 Sep;78(9):1190-4. doi: 10.2105/ajph.78.9.1190.
A random sample of Maryland physicians stratified by practice specialty (family, general, internal medicine, cardiology, and nephrology) was surveyed before and one year after dissemination of the 1984 Report of the Third Joint National Committee on the Detection, Evaluation, and Treatment of High Blood Pressure (The JNC III Report). Fourty-four per cent of the total eligible sample responded to both questionnaires. One year after publication, 62 per cent of physicians participating in both parts of the study were aware of the report. Although availability of a copy (58 per cent), familiarity with the recommendations (81 per cent), and the extent to which care was based on the guidelines (65 per cent) were high, use of the report in practice (17 per cent) and the amount of change in practice behavior required to adhere to the guidelines (18 per cent) were low. Prior to publication of the report, more than two-thirds of responding physicians were found to be practicing in a manner congruent with nine of ten treatment recommendations studied. One year after JNC III's release, they reported practice behavior which was not significantly different. It seems that this consensus report codified, rather than changed, practice behavior in this sample.
在1984年《全国高血压检测、评估与治疗联合委员会第三次报告》（《JNC III报告》）发布之前及发布一年后，对马里兰州按执业专科（家庭医学、普通医学、内科、心脏病学和肾脏病学）分层的医生进行了随机抽样调查。符合条件的样本中，44%的人回复了两份问卷。报告发布一年后，参与该研究两个阶段的医生中有62%知晓该报告。尽管报告的获取率（58%）、对建议的熟悉程度（81%）以及诊疗基于指南的程度（65%）都很高，但该报告在实际中的使用率（17%）以及为遵循指南所需的实际行为改变量（18%）却很低。在该报告发布之前，发现超过三分之二的回复医生的诊疗方式与所研究的十条治疗建议中的九条相符。在JNC III发布一年后，他们报告的实际行为没有显著差异。在这个样本中，这份共识报告似乎是对实际行为进行了编纂，而非改变。
