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中国中部地区患者康复服务需求的临床医生与专家评估比较

Comparison of the clinicians' and experts' assessments of rehabilitation service needs for patients in the middle of China.

作者信息

Zhou Xinyue, Ye Ruixue, Cao Longyao, Huang Meiling, Shan Linlin, Ma Yaqi, Xu Ying, Wang Wentao, Wang Yulong

机构信息

Rehabilitation Medicine School of Shandong University of Traditional Chinese Medicine, Jinan, 250355, Shandong, China.

Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital, Shenzhen University School of Medicine, No. 3002, Sungang Road, Futian District, Shenzhen, 518035, Guangdong, China.

出版信息

Sci Rep. 2025 Jul 24;15(1):26950. doi: 10.1038/s41598-025-09359-3.

Abstract

Clinicians' assessments of patients' rehabilitation needs are crucial, as they directly influence the continuity of care. However, the ability of clinicians to accurately assess these needs remains unclear. The purpose of the study is to compare the assessments of rehabilitation service needs for patients made by clinicians and experts, and to examine any differences across various levels of healthcare institutions. A total of 40 clinical vignettes were used to evaluate the consistency between clinicians and experts. The final analysis included 167 participants, consisting of 164 clinicians from 112 healthcare institutions and three rehabilitation experts from tertiary care hospital in China. The measurements included the general characteristics of the clinicians, the current status of tiered service assessments, and consistency with expert assessments. Kendall's W test was used to analyze the consistency of rehabilitation service needs assessments between clinicians and experts. Among the overall sample, the consistency rate between clinicians and experts was found to be 35.2% (Kendall's W = 0.140, p < 0.001). Compared with county hospitals (consistency rate: 40.4%; Kendall's W = 0.439, p < 0.001), township health centers (consistency rate: 36.1%; Kendall's W = 0.209, p < 0.001) and village health centers (consistency rate: 34.2%; Kendall's W = 0.104, p < 0.001) showed relatively lower consistency between clinicians and experts. The findings indicate that clinicians' ability to assess patients' rehabilitation needs remains suboptimal, particularly in primary healthcare settings such as township and village health centers. Therefore, it is imperative to enhance and standardize clinicians' capabilities in assessing the need for rehabilitation services.

摘要

临床医生对患者康复需求的评估至关重要,因为它们直接影响护理的连续性。然而,临床医生准确评估这些需求的能力仍不明确。本研究的目的是比较临床医生和专家对患者康复服务需求的评估,并检查不同级别医疗机构之间的差异。总共使用了40个临床案例来评估临床医生和专家之间的一致性。最终分析包括167名参与者,其中有来自112家医疗机构的164名临床医生和来自中国三级医院的三名康复专家。测量内容包括临床医生的一般特征、分级服务评估的现状以及与专家评估的一致性。使用肯德尔W检验来分析临床医生和专家之间康复服务需求评估的一致性。在整个样本中,临床医生和专家之间的一致率为35.2%(肯德尔W = 0.140,p < 0.001)。与县级医院相比(一致率:40.4%;肯德尔W = 0.439,p < 0.001),乡镇卫生院(一致率:36.1%;肯德尔W = 0.209,p < 0.001)和村卫生室(一致率:34.2%;肯德尔W = 0.104,p < 0.001)显示临床医生和专家之间的一致性相对较低。研究结果表明,临床医生评估患者康复需求的能力仍不理想,尤其是在乡镇和村卫生室等基层医疗机构。因此,必须加强和规范临床医生评估康复服务需求的能力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/922f/12289945/c374c7c8d5e1/41598_2025_9359_Fig1_HTML.jpg

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