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医疗保健专业人员在高血压合并支气管哮喘患者管理中的知识、态度和实践:中国黄河三角洲地区的一项横断面研究

Knowledge, attitudes and practices of healthcare professionals in the management of patients with hypertension and concurrent bronchial asthma: a cross-sectional study in the Yellow River Delta region of China.

作者信息

Yu Fei, Xu Wenwen, Ma Xingbin, Yang Yang, Gao Jinxiang, Yan Xiaohong

机构信息

Binzhou Medical University Hospital, Binzhou, Shandong, China.

Binzhou Medical University Hospital, Binzhou, Shandong, China

出版信息

BMJ Open. 2025 Jan 21;15(1):e088743. doi: 10.1136/bmjopen-2024-088743.

Abstract

OBJECTIVE

To assess the Knowledge, Attitudes and Practices (KAP) among healthcare professionals in managing patients with coexisting hypertension and bronchial asthma.

DESIGN

A cross-sectional survey. The reporting of this study followed the Strengthening the Reporting of Observational Studies in Epidemiology checklist.

SETTING

From 30 March to 15 April 2024 at 66 various level hospitals and community health service centres.

PARTICIPANTS

Physicians and nurses specialising in clinical internal medicine, each with over 2 years of practice and who provided informed consent.

PRIMARY AND SECONDARY OUTCOME MEASURES

The demographic characteristics of the healthcare professionals and their KAP towards the Management of Patients with Hypertension and Concurrent Bronchial Asthma were collected using a self-administered questionnaire. The primary outcome was the KAP scores. The secondary outcomes were the factors associated with the KAP scores and how the KAP dimensions interacted among them.

RESULTS

The study involved 586 valid questionnaires collected from participants. Participants' median KAP scores were as follows: knowledge - 8 (IQR: 6-9), attitude - 31 (29-34) and practice - 41 (36-46) on scales ranging from 0 to 12, 7 to 35 and 12 to 60, respectively. Multivariate logistic regression analysis showed having a Bachelor's degree or higher education (OR=0.614; 95% CI (0.421, 0.896); p=0.011), and a knowledge score ≥8 (OR=2.130; 95% CI (1.527, 2.973); p<0.001) significantly predicted adherence to recommended practices. Structural equation modelling revealed significant direct effects between knowledge and attitude (β=0.578, p=0.010) and between knowledge and practice (β=0.221, p=0.010). However, the direct link between attitude and practice (β=0.162, p=0.052) and indirect effect of knowledge on practice via attitude (β=0.094, p=0.052) were not statistically significant.

CONCLUSIONS

Healthcare professionals exhibited limited knowledge, positive attitudes but suboptimal practices when managing patients with comorbid hypertension and bronchial asthma. It is crucial to develop targeted educational interventions and continuous professional development programmes to improve clinical outcomes in this patient population.

摘要

目的

评估医疗保健专业人员在管理同时患有高血压和支气管哮喘患者方面的知识、态度和实践(KAP)情况。

设计

横断面调查。本研究的报告遵循了加强流行病学观察性研究报告清单。

地点

2024年3月30日至4月15日期间,在66家各级医院和社区卫生服务中心。

参与者

专门从事临床内科的医生和护士,每人都有超过2年的从业经验且提供了知情同意书。

主要和次要结局指标

使用自填式问卷收集医疗保健专业人员的人口统计学特征及其对高血压合并支气管哮喘患者管理的KAP情况。主要结局是KAP得分。次要结局是与KAP得分相关的因素以及KAP维度之间的相互作用方式。

结果

该研究共收集到586份来自参与者的有效问卷。参与者的KAP得分中位数如下:知识——8分(四分位间距:6 - 9分),态度——31分(29 - 34分),实践——41分(36 - 46分),评分范围分别为0至12分、7至35分和12至60分。多因素逻辑回归分析显示,拥有学士学位或更高学历(比值比=0.614;95%置信区间(0.421, 0.896);p = 0.011)以及知识得分≥8分(比值比=2.130;95%置信区间(1.527, 2.973);p < 0.001)显著预测了对推荐实践的依从性。结构方程模型显示知识与态度之间存在显著的直接效应(β = 0.578,p = 0.010)以及知识与实践之间存在显著的直接效应(β = 0.221,p = 0.010)。然而,态度与实践之间的直接联系(β = 0.162,p = 0.052)以及知识通过态度对实践的间接效应(β = 0.094,p = 0.052)在统计学上并不显著。

结论

医疗保健专业人员在管理合并高血压和支气管哮喘的患者时知识有限,态度积极但实践欠佳。制定有针对性的教育干预措施和持续专业发展计划对于改善这一患者群体的临床结局至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90cb/11784232/176b669db974/bmjopen-15-1-g001.jpg

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