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牙医对风湿性心脏病患者推荐预防方案的知识水平的预测因素。

Predictors of dentists' level of knowledge regarding the recommended prophylactic regimen for patients with rheumatic heart disease.

作者信息

Sadowsky D, Kunzel C, Frankel M

出版信息

Soc Sci Med. 1985;21(8):899-907. doi: 10.1016/0277-9536(85)90146-7.

Abstract

Maintaining knowledge of clinical practices, conforming to the latest scientific information, is a major challenge for health professionals. The study aims were to measure clinicians' knowledge and to determine what social factors could best explain and predict those dental clinicians who are most knowledgeable about current expert recommendations for the use of appropriate antibiotic regimens for patients at risk for bacterial endocarditis. Telephone interviews were conducted with 322 New York State dentists, assigned to the study by a computer-generated randomization procedure from lists of oral surgeons, urban general practitioners and rural general practitioners. Data demonstrated extraordinary differences in level of knowledge between oral surgeons and general practitioners, while the level of knowledge between urban and rural general practice groups was quite similar. General Linear Model (GLM)-based analyses indicated that practice size, rationalization of practice, and practice setting and affiliations contributed to the explanation of knowledge level among general practitioners, when adjusted for age. R2s for each of those variables and age, ranged from a low of 0.132 to a high of 0.334. Age made a significant contribution to the explanation of knowledge level in all of the models presented, while the explanatory power of the practice structure variables varied according to respondent's locale (urban vs rural) and age (younger vs older). In order to assess the impact of these structural variables, they were dichotomized (high-low) and entered into a GLM program which accounted for age and locale. Differences in excess of 20 points (on a 0-100 knowledge scale) were sometimes noted.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

紧跟临床实践知识,符合最新科学信息,这对医疗专业人员来说是一项重大挑战。该研究的目的是衡量临床医生的知识水平,并确定哪些社会因素能够最好地解释和预测那些对当前关于有细菌性心内膜炎风险患者使用适当抗生素治疗方案的专家建议最为了解的牙科临床医生。通过电话访谈了322名纽约州的牙医,这些牙医是通过计算机生成的随机程序从口腔外科医生、城市全科医生和农村全科医生名单中挑选出来参与研究的。数据表明,口腔外科医生和全科医生的知识水平存在显著差异,而城市和农村全科医生群体之间的知识水平相当相似。基于一般线性模型(GLM)的分析表明,在对年龄进行调整后,诊所规模、诊所合理化程度以及诊所环境和所属机构有助于解释全科医生的知识水平。这些变量以及年龄的R²值范围从低至0.132到高至0.334。在所有呈现的模型中,年龄对知识水平的解释都有显著贡献,而诊所结构变量的解释力则根据受访者的所在地(城市与农村)和年龄(年轻与年长)而有所不同。为了评估这些结构变量的影响,将它们进行二分法划分(高 - 低)并输入到一个考虑了年龄和所在地的GLM程序中。有时会注意到(在0 - 100知识量表上)超过20分的差异。(摘要截断于250字)

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