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医生对运动和运动医学作为一门专业的困惑:澳大利亚多学科、横断面调查。

Confusion among doctors regarding sports and exercise medicine as a specialty: an Australian multidisciplinary, cross-sectional survey.

机构信息

Ballarat Orthopaedics & Sports Medicine, Ballarat, Victoria, Australia

Novar Musculoskeletal Research Institute, Ballarat, Victoria, Australia.

出版信息

BMJ Open. 2023 Sep 25;13(9):e072979. doi: 10.1136/bmjopen-2023-072979.

Abstract

OBJECTIVES

This cross-sectional study aims to characterise the understanding and attitudes medical practitioners have towards sports and exercise medicine (SEM). By identifying knowledge gaps, misunderstandings and barriers to SEM referral, interventions may be suggested to improve the integration of SEM within a multidisciplinary approach to healthcare.

DESIGN

A survey was constructed with a multidisciplinary expert panel. Refinement and consensus were achieved through a modified Delphi method. Both quantitative and qualitative data were analysed and intergroup comparisons made using χ test of independence and post-hoc paired comparisons.

SETTING

The questionnaire was distributed across Australian public and private health sectors, in community and hospital-based settings.

PARTICIPANTS

Australian medical doctors practising in specialties likely to intersect with SEM were invited; including general practice, orthopaedics, emergency, rheumatology and anaesthetics/pain. Invitation was uncapped with no reportable response rate. A total of 120 complete responses were collected RESULTS: The minority (42.5%) of respondents understood the role and scope of sports and exercise physicians. SEM was poorly recognised and comprehended, with the most common misconception being that SEM is solely for elite athletes and performance. Few (20%) doctors were familiar with referral pathways to SEM services. Lack of awareness, clear scope and public presence were seen as major barriers. There was near unanimous (92.5%) agreement that 'exercise is medicine'. A strong majority felt SEM would be valuable to collaborate with more in their current practice (63.3%) and as a part of the Australian public health system (82.5%). There were some significant differences among subgroups, including that junior doctors were more likely to express confusion about SEM.

CONCLUSIONS

Among non-SEM doctors, there is significant lack of clarity regarding the role of SEM and its optimal integration. Interdisciplinary education and addressing misconceptions may improve the contribution of SEM to community healthcare.

摘要

目的

本横断面研究旨在描述医生对运动医学(SEM)的理解和态度。通过识别知识差距、误解和 SEM 转诊障碍,可以提出干预措施,以改善 SEM 在多学科医疗保健方法中的整合。

设计

使用多学科专家小组构建了一份调查问卷。通过修改后的德尔菲法达成了改进和共识。分析了定量和定性数据,并使用独立性 χ 检验和事后配对比较进行了组间比较。

设置

问卷调查分布在澳大利亚公共和私营卫生部门,包括社区和医院环境。

参与者

邀请了在可能与 SEM 交叉的专业中执业的澳大利亚医生,包括全科医学、骨科、急诊、风湿病学和麻醉/疼痛。邀请是无限制的,没有可报告的回复率。共收集到 120 份完整的回复。

结果

少数(42.5%)受访者了解运动和锻炼医师的角色和范围。 SEM 认识和理解程度较差,最常见的误解是 SEM 仅适用于精英运动员和表现。很少(20%)的医生熟悉 SEM 服务的转诊途径。缺乏认识、明确的范围和公众存在被视为主要障碍。几乎一致(92.5%)认为“运动就是医学”。绝大多数人认为 SEM 在他们目前的实践中会很有价值(63.3%),并且作为澳大利亚公共卫生系统的一部分(82.5%)也会很有价值。在亚组之间存在一些显著差异,包括初级医生更可能对 SEM 感到困惑。

结论

在非 SEM 医生中,对于 SEM 的作用及其最佳整合存在明显的不明确性。跨学科教育和解决误解可能会提高 SEM 对社区医疗保健的贡献。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/31d8/10533687/38eed0dec43e/bmjopen-2023-072979f01.jpg

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