评估初级医生在住院患者心脏骤停管理方面的准备情况：一项在大学医院开展的横断面研究。

Assessing junior doctors' preparedness in inpatient cardiac arrest management: a cross-sectional study at a university hospital.

作者信息

Sukor Muhammad Azmi Bin, Sabardin Dazlin Masdiana Binti

机构信息

Department of Emergency Medicine, Hospital Canselor Tuanku Muhriz, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia.

出版信息

BMC Med Educ. 2025 Jul 1;25(1):932. doi: 10.1186/s12909-025-07532-w.

DOI:10.1186/s12909-025-07532-w

PMID:40598147

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12210825/

Abstract

BACKGROUND

Cardiac arrest is an emergency that requires immediate and effective intervention. Junior doctors, who are often the first responders, play an important role in the initial management of in-hospital cardiac arrest (IHCA). However, there are still concerns about their preparedness in managing this critical event. Thus, this study aimed to evaluate the knowledge, attitude, and confidence level to manage IHCA among junior doctors in a tertiary university hospital.

METHODOLOGY

A cross-sectional study using a self-administered validated questionnaire covering demographics, knowledge, attitude, and confidence related to CPR over one year from August 2023 to December 2024 involving 115 junior doctors. Data were analyzed using Statistical Package for Social Science (SPSS) version 29. Descriptive statistics were used to characterize the study population, and Spearman's correlation was used to assess the relationships between knowledge, attitude, and confidence scores.

RESULTS

The median age was 27 years (IQR 26,28) with 50 (43.5%) males and 65 (56.5%) females. Most had completed BLS training (N = 104, 90.4%) and nearly all(N = 110,95.7%) had prior CPR experience, with 56.5% having performed CPR within the past month. The median knowledge score was 77.77% (IQR 72.22%, 83.33%). Knowledge gaps were identified in airway adjunct use (22.6% correct) and bag-mask ventilation selection (36.5% correct). Attitudes toward CPR were generally positive, with 98.2% (N = 113) believing CPR could save lives. However, 40% (N = 46) expressed concern about unintentionally causing patient harm and legal implications when initiating CPR. Confidence was highest in basic CPR tasks: chest compressions (N = 112, 97.4%) and bag-mask ventilation (N = 108, 94.0%). However, lower confidence was noted for advanced skills such as defibrillation (N = 87, 75.7%) and drug administration (N = 91, 79.1%). A significant positive correlation was found between knowledge-attitude (ρ = 0.272, p = 0.003) and attitude-confidence (ρ = 0.552, p < 0.001). The knowledge-confidence correlation was weak and not statistically significant (ρ = 0.180, p = 0.054).

CONCLUSION

The knowledge of CPR among junior doctors in HCTM was found to be adequate. However, concerns and insecurities in managing cardiac arrest were still observed. Additional training and simulations are recommended to address this issue.

CLINICAL TRIAL NUMBER

not applicable.

摘要

背景

心脏骤停是一种需要立即进行有效干预的紧急情况。初级医生通常是第一响应者，在医院内心脏骤停（IHCA）的初始管理中发挥着重要作用。然而，人们仍然担心他们在处理这一危急事件时的准备情况。因此，本研究旨在评估一所三级大学医院的初级医生对IHCA的管理知识、态度和信心水平。

方法

采用横断面研究，使用一份经过验证的自填问卷，涵盖2023年8月至2024年12月一年期间与心肺复苏相关的人口统计学、知识、态度和信心，涉及115名初级医生。使用社会科学统计软件包（SPSS）29版进行数据分析。描述性统计用于描述研究人群的特征，Spearman相关性用于评估知识、态度和信心得分之间的关系。

结果

中位年龄为27岁（四分位间距26,28），男性50人（43.5%），女性65人（56.5%）。大多数人完成了基础生命支持培训（N = 104，90.4%），几乎所有人（N = 110，95.7%）都有过心肺复苏经验，56.5%的人在过去一个月内进行过心肺复苏。中位知识得分为77.77%（四分位间距72.22%，83.33%）。在气道辅助工具的使用（正确回答率22.6%）和面罩通气选择（正确回答率36.5%）方面发现了知识差距。对心肺复苏的态度总体上是积极的，98.2%（N = 113）的人认为心肺复苏可以挽救生命。然而，40%（N = 46）的人表示担心在开始心肺复苏时无意中对患者造成伤害以及法律影响。在基本心肺复苏任务方面信心最高：胸外按压（N = 112，97.4%）和面罩通气（N = 108，94.0%）。然而，对于除颤（N = 87，75.7%）和药物给药（N = 91，79.1%）等高级技能，信心较低。知识与态度之间存在显著正相关（ρ = 0.272，p = 0.003），态度与信心之间也存在显著正相关（ρ = 0.552，p < 0.001）。知识与信心的相关性较弱且无统计学意义（ρ = 0.180，p = 0.054）。