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初级保健中对长期新冠患者的护理:比利时和马耳他全科医生的知识、看法和经验的横断面研究。

Caring for Long Covid patients in primary healthcare: a cross-sectional study on general practitioners' knowledge, perception and experience in Belgium and Malta.

机构信息

Health Services Research (Primary Care unit), Epidemiology and Public Health Sciensano Brussels - Belgium (Europe), Rue Juliette Wytsmanstraat 14, 1050, Brussel, Belgium.

Department of Anatomy, Faculty of Medicine & Surgery, University of Malta, Msida, Malta.

出版信息

BMC Prim Care. 2024 Oct 21;25(1):375. doi: 10.1186/s12875-024-02617-9.

Abstract

BACKGROUND

At least 10% of Covid-19 recovered individuals experience persistent symptoms (Long Covid). Primary healthcare and general practitioners (GPs) are at the forefront in their care. In this study, GPs' knowledge, perceptions and experiences with Long Covid, and the definition used in two countries, are investigated to provide insight into GPs' care for Long Covid patients at a cross-country level.

METHODS

A cross-sectional study targeted towards GPs was conducted in Belgium and Malta during spring and early summer 2022. An online survey consisting of 15 questions on Long Covid was disseminated. Additionally, country-specific practice and demographic characteristics were collected. Descriptive and logistic regression analyses were performed.

RESULTS

A total of 150 GPs (Belgium = 105; Malta = 45) responded. Female GPs represented 58.0%, median age was 49 years (IQR: 37-61). Concerning GPs' knowledge and perception on Long Covid, in both countries, most GPs reported insufficient scientific knowledge and information on Long Covid diagnosis and treatment. Access to educational material was limited and an awareness-rising campaign on Long Covid was deemed necessary. Moreover, two out of three GPs stated that Long Covid patients were not well followed up by primary healthcare in mid-2022. For diagnosing Long Covid, 54.7% required a positive Covid-19 test, more often among Belgian GPs than Maltese (64.3% vs. 45.2%, p = 0.036). To assess Long Covid, GPs mainly applied diagnostic criteria by themselves (47.3%) in combination with persistent symptoms (4 weeks to 5 months). Most GPs had experience with Long Covid patients in their practice, regardless of practice type and GPs' country, sex or age (p = 0.353; p = 0.241; p = 0.194; p = 0.058). Although most GPs (94.7%) stated that Long Covid patients should follow multidisciplinary approach, 48.3% reported providing care for these patients themselves or with GP colleagues and only 29.8% by multidisciplinary cooperation.

CONCLUSIONS

GPs frequently provide (multidisciplinary) care to Long Covid patients and GPs' care showed similarities at cross-country level. Although GPs perceive lack of scientific knowledge and educational material on Long Covid, similar diagnostic criteria among GPs were noted. Uniform evidence-based guidelines, scientific support and training for GP across Europe must be a priority to enhance their treatment approach to Long Covid.

摘要

背景

至少有 10%的新冠康复患者会出现持续症状(长新冠)。初级保健医生和全科医生(GP)在他们的治疗中处于前沿。在这项研究中,我们调查了全科医生对长新冠的知识、看法和经验,以及两国使用的定义,以提供对全科医生在跨国层面上治疗长新冠患者的深入了解。

方法

2022 年春季和初夏,在比利时和马耳他针对全科医生开展了一项横断面研究。通过在线调查,向全科医生分发了 15 个关于长新冠的问题。此外,还收集了国家特定的实践和人口统计学特征。进行了描述性和逻辑回归分析。

结果

共有 150 名全科医生(比利时 105 名;马耳他 45 名)做出了回应。女性全科医生占 58.0%,中位年龄为 49 岁(IQR:37-61)。关于全科医生对长新冠的知识和看法,在两个国家中,大多数全科医生报告说,他们对长新冠的诊断和治疗缺乏足够的科学知识和信息。获取教育材料的途径有限,需要开展提高认识的长新冠宣传活动。此外,三分之二的全科医生表示,2022 年年中,初级保健医生对长新冠患者的随访不够。诊断长新冠时,54.7%的人需要新冠病毒检测阳性,比利时的这一比例高于马耳他(64.3%比 45.2%,p=0.036)。为了评估长新冠,全科医生主要应用自己的诊断标准(47.3%),结合持续症状(4 周到 5 个月)。大多数全科医生在实践中都有长新冠患者的经验,无论实践类型、全科医生的国家、性别或年龄如何(p=0.353;p=0.241;p=0.194;p=0.058)。尽管大多数全科医生(94.7%)表示,长新冠患者应该接受多学科方法治疗,但 48.3%的人报告自己或与全科医生同事为这些患者提供护理,只有 29.8%的人通过多学科合作提供护理。

结论

全科医生经常为长新冠患者提供(多学科)护理,而且全科医生的护理在跨国层面上表现出相似性。尽管全科医生认为他们对长新冠缺乏科学知识和教育材料,但他们注意到了全科医生之间相似的诊断标准。在整个欧洲,为全科医生提供统一的基于证据的指南、科学支持和培训必须成为当务之急,以提高他们对长新冠的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/983c/11494861/8f2b5d5c2a9d/12875_2024_2617_Fig1_HTML.jpg

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