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私营医疗机构医生结核病护理实践:来自越南的横断面研究。

Practice regarding tuberculosis care among physicians at private facilities: A cross-sectional study from Vietnam.

机构信息

Hanoi Medical University, Hanoi, Vietnam.

Vietnam National Hospital of Traditional Medicine, Hanoi, Vietnam.

出版信息

PLoS One. 2023 Apr 27;18(4):e0284603. doi: 10.1371/journal.pone.0284603. eCollection 2023.

Abstract

OBJECTIVES

To evaluate the practice of TB care among physicians at private facilities.

METHODS

A cross-sectional study was conducted using questionnaires on knowledge, attitude, and practice related to TB care. The responses to these scales were used to explore latent constructs and calculate the standardized continuous scores for these domains. We described the percentages of participant's responses and explored their associated factors using multiple linear regression.

RESULTS

A total of 232 physicians were recruited. The most important gaps in practice included requesting chest imaging to confirm TB diagnosis (80%), not testing HIV for confirmed active TB cases (50%), only requesting sputum testing for MDR-TB cases (65%), only requesting follow-up examination at the end of the treatment course (64%), and not requesting sputum testing at follow-up (54%). Surgical mask was preferred to N95 respirator when examining TB patients. Prior TB training was associated with better knowledge and less stigmatizing attitude, which were associated with better practice in both TB management and precautions.

CONCLUSION

There were important gaps in knowledge, attitude, and practice of TB care among private providers. Better knowledge was associated with positive attitude towards TB and better practice. Tailored training may help to address these gaps and improve the quality of TB care in the private sector.

摘要

目的

评估私人医疗机构医生的结核病护理实践情况。

方法

采用结核病护理相关知识、态度和实践的问卷进行横断面研究。利用这些量表的回答来探索潜在结构,并计算这些领域的标准化连续分数。我们描述了参与者回答的百分比,并使用多元线性回归探索了相关因素。

结果

共招募了 232 名医生。实践中最重要的差距包括要求进行胸部影像学检查以确认结核病诊断(80%)、未对确诊活动性结核病患者进行 HIV 检测(50%)、仅对耐多药结核病患者要求进行痰培养检测(65%)、仅在治疗结束时要求进行随访检查(64%)、以及不在随访时要求进行痰培养检测(54%)。检查结核病患者时,医生更倾向于使用外科口罩而不是 N95 口罩。既往结核病培训与更好的知识水平和较少的污名化态度相关,这与结核病管理和预防方面的更好实践相关。

结论

私人医疗机构医生在结核病护理的知识、态度和实践方面存在重要差距。更好的知识与对结核病的积极态度和更好的实践相关。有针对性的培训可能有助于解决这些差距,提高私营部门的结核病护理质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/38d1/10138252/2fec364049a1/pone.0284603.g001.jpg

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