Faculty of Medicine, Islamic University of Gaza, P.O. Box 108, Gaza, State of Palestine.
Health Services, United Nations Relief and Works Agency (UNRWA), Gaza, State of Palestine.
BMC Health Serv Res. 2024 Oct 23;24(1):1274. doi: 10.1186/s12913-024-11792-5.
Status epilepticus (SE) is a top neurological and medical emergency. Adequate staff knowledge and sufficient hospital resources are mandatory for timely management and better outcomes. This study aims to evaluate Palestinian ER doctors' knowledge and beliefs towards SE and assess the state and availability of hospital resources needed to manage SE appropriately.
This cross-sectional study surveyed all ER doctors working in the six governmental hospitals in the Gaza Strip during June 2022. A questionnaire assessed the knowledge and beliefs toward SE and the practice of SE knowledge acquisition. Simultaneous field surveys determined the availability of essential medications and resources at each hospital and doctors' actual awareness about the status of these resources. Linear regression determined predictors of higher knowledge scores.
137 doctors participated (response rate 81%). Most were males, had graduated within six years of data collection, and 45.3% worked at Shifa Medical Complex. 63.5% of participants recognized the correct operational definition of status epilepticus. 85.4 and 83.9% recognized that it might cause permanent brain damage or death, respectively. Only 10.9% recognized the average mortality rate of a single convulsive SE episode. 44.5% believed that awaiting spontaneous SE resolution is a valid approach to management. Significant defects were noted in the awareness of subclinical SE, including its recognition and prevalence in ciritcally ill patients. Having a higher qualification and graduating from local medical schools predicted higher scores. In field surveys, EEG was unavailable at all hospitals, while CT scans and a neurologist physician were unavailable at two hospitals. IV phenytoin was the only second-line treatment available at all hospitals. IV valproate and levetiracetam were universally unavailable.
The survey revealed significant defects in Palestinian ER doctors' knowledge and beliefs towards SE. Several hospitals also demonstrated a critical lack of resources to manage this condition appropriately. This should be addressed by the local health authorities to avoid potentially preventable SE-related mortality and morbidity.
癫痫持续状态（SE）是一种顶级的神经和医学急症。及时管理和更好的结果需要医生具备充足的专业知识和足够的医院资源。本研究旨在评估巴勒斯坦急诊医生对 SE 的认识和信念，并评估适当管理 SE 所需的医院资源的状态和可用性。
这是一项 2022 年 6 月在加沙地带六家政府医院工作的所有急诊医生参与的横断面研究。问卷调查评估了医生对 SE 的知识和信念，以及获取 SE 知识的实践情况。同时进行实地调查，以确定每家医院基本药物和资源的可用性，以及医生对这些资源状况的实际了解程度。线性回归确定了更高知识得分的预测因素。
共有 137 名医生参与（应答率为 81%）。大多数是男性，毕业于数据收集后六年内，45.3%在 Shifa 医疗中心工作。63.5%的参与者正确识别了癫痫持续状态的操作定义。85.4%和 83.9%的人分别认识到它可能导致永久性脑损伤或死亡。只有 10.9%的人认识到单次惊厥性 SE 发作的平均死亡率。44.5%的人认为等待自发 SE 缓解是一种有效的管理方法。在对亚临床 SE 的认识方面，包括对其在危重病患者中的识别和流行程度的认识方面，存在显著缺陷。更高的资质和毕业于当地医学院校预测得分更高。在实地调查中，所有医院都没有脑电图，两家医院没有 CT 扫描和神经科医生。所有医院都只有静脉注射苯妥英钠作为二线治疗。所有医院都普遍没有静脉注射丙戊酸钠和左乙拉西坦。
调查显示，巴勒斯坦急诊医生对 SE 的认识和信念存在重大缺陷。几家医院也明显缺乏适当管理这种疾病的资源。这应由地方卫生当局解决，以避免潜在的可预防的 SE 相关死亡率和发病率。
