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初级保健中的外周动脉疾病(PAD)-英格兰 PAD 初级保健教育经验-一项混合方法研究。

Peripheral artery disease (PAD) in primary care-educational experiences for PAD primary care in England-a mixed-method study.

机构信息

Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom.

出版信息

Fam Pract. 2023 Dec 22;40(5-6):820-826. doi: 10.1093/fampra/cmad048.

Abstract

BACKGROUND

Peripheral artery disease (PAD), the pathophysiologic narrowing of arterial blood vessels of the lower leg due to atherosclerosis, is a highly prevalent disease, with sharp increases in prevalence with age. Primary care is ideally located to identify and manage PAD.

OBJECTIVES

This study aims to identify the educational experiences, opinions, and confidence of primary care clinicians (PCCs) regarding PAD.

METHOD

This mixed-method study was conducted within primary care in England. An online survey was completed with follow-on semistructured interviews, between January and September 2021, with PCCs, namely GPs, practice nurses, and allied professionals (survey n = 874, interviews n = 50).

RESULTS

PCCs report variation in PAD education received, where the content could not often be recalled. Patient-focussed experiential and self-directed learning, formed the largest method to gain PAD education. All PCCs recognized that they have an important role in recognizing PAD yet confidence in recognizing and diagnosing PAD was lacking. PCCs acknowledged that late or missed PAD diagnosis resulted in significant patient morbidity and mortality. Yet many did not recognize PAD as a common disease.

CONCLUSION

As "specialist-generalists" with finite resources, education provided to primary care needs to be applicable for the multimorbid patient presentations often seen, utilizing resources available in primary care, with consideration to the time constraints endured.

摘要

背景

外周动脉疾病(PAD)是由于动脉粥样硬化导致小腿动脉血管病理性变窄的一种疾病,具有很高的发病率,且随着年龄的增长发病率急剧上升。初级保健是识别和管理 PAD 的理想场所。

目的

本研究旨在确定初级保健临床医生(PCCs)对 PAD 的教育经验、意见和信心。

方法

这项混合方法研究在英格兰的初级保健中进行。在 2021 年 1 月至 9 月期间,使用在线调查和后续半结构化访谈,对 PCCs(包括全科医生、执业护士和联合专业人员)进行了调查(调查 n=874,访谈 n=50)。

结果

PCCs 报告称他们接受的 PAD 教育存在差异,其中内容往往无法回忆起来。以患者为中心的体验式和自我指导式学习是获得 PAD 教育的最大方法。所有 PCCs 都认识到他们在识别 PAD 方面具有重要作用,但在识别和诊断 PAD 方面的信心不足。PCCs 承认,PAD 的晚期或漏诊会导致患者出现严重的发病率和死亡率。然而,许多人并没有将 PAD 视为一种常见疾病。

结论

作为“专科通才”,初级保健所提供的教育必须适用于经常出现的多病种患者表现,利用初级保健中可用的资源,并考虑到所承受的时间限制。

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