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沙特医生和物理治疗师对良性阵发性位置性眩晕最新临床实践指南的依从性评估:一项横断面研究

Assessment of Saudi Physicians and Physical Therapists' Adherence to the Updated Clinical Practice Guideline for Benign Paroxysmal Positional Vertigo: A Cross-Sectional Study.

作者信息

Alhakami Bushra Ahmad, Almarwani Maha Mohammed

机构信息

Department of Physical Therapy, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.

Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.

出版信息

Int Arch Otorhinolaryngol. 2022 Jun 17;27(1):e67-e76. doi: 10.1055/s-0042-1742775. eCollection 2023 Jan.

Abstract

Variations in clinical practice regarding the management of benign paroxysmal positional vertigo (BPPV) among clinicians have been noted in previous studies. Such variations might be related to the different adherence to clinical practice guidelines.  To evaluate clinicians' adherence to BPPV guidelines and investigate the variations in the adherence between different specialties and qualifications.  This is a cross-sectional study with a vignettes-based survey conducted between June and August, 2020. We included clinicians engaged in managing BPPV that had at least one year of clinical experience. We excluded students, and clinicians who were not involved in the management of individuals with BPPV. Participants were asked to make their management choices based on four hypothetical patient vignettes. The sample ranged from 77 participants for the first vignette to 45 participants for the last vignette.  We included 77 clinicians in the study, with the majority being Otolaryngologists (31.2%). The respondents' mean adherence to the guideline was of 63.3%. Result showed that Otolaryngologists' adherence was higher than that of clinicians from different specialties (  = 0.006,  = 0.72). Furthermore, clinicians with a postgraduate degree were more likely to adhere than those with a bachelor's degree only (  = 0.014,  = 0.58) and participants who were aware of the guideline were more likely to adhere to it (  < 0.001,  = 1.05). Lastly, regression analysis exhibited that adherence was affected by postgraduate degree and guideline awareness.  Otolaryngologists were more likely to adhere to the guideline than other specialties. Among all specialties, higher adherence was associated with guideline awareness and postgraduate degrees.

摘要

先前的研究已经注意到临床医生在良性阵发性位置性眩晕(BPPV)管理方面的临床实践存在差异。这种差异可能与对临床实践指南的不同遵循情况有关。

为了评估临床医生对BPPV指南的遵循情况,并调查不同专业和资质之间在遵循情况上的差异。

这是一项横断面研究,于2020年6月至8月进行了基于病例 vignette 的调查。我们纳入了从事BPPV管理且至少有一年临床经验的临床医生。我们排除了学生以及未参与BPPV患者管理的临床医生。参与者被要求根据四个假设的患者病例 vignette 做出他们的管理选择。样本数量从第一个病例 vignette 的77名参与者到最后一个病例 vignette 的45名参与者不等。

我们在研究中纳入了77名临床医生,其中大多数是耳鼻喉科医生(31.2%)。受访者对指南的平均遵循率为63.3%。结果显示,耳鼻喉科医生的遵循率高于其他不同专业的临床医生(P = 0.006,I² = 0.72)。此外,拥有研究生学位的临床医生比仅拥有本科学位的临床医生更有可能遵循指南(P = 0.014,I² = 0.58),并且知晓该指南的参与者更有可能遵循它(P < 0.001,I² = 1.05)。最后,回归分析表明遵循情况受研究生学位和指南知晓情况的影响。

耳鼻喉科医生比其他专业更有可能遵循指南。在所有专业中,更高的遵循率与指南知晓情况和研究生学位相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3286/9879653/ba42a56ee198/10-1055-s-0042-1742775-i210670-1.jpg

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