Newton J, Knight D, Woolhead G
Division of Employment Studies, Faculty of Social Sciences, University of Northumbria at Newcastle, Newcastle Upon Tyne.
Br J Gen Pract. 1996 Sep;46(410):513-7.
Clinical practice guidelines are being developed for a variety of reasons. To date, there has been little investigation of the perspectives of those who are recommended to use them.
The survey reported here set out to investigate how familiar general practitioners are with a range of published guidelines, to assess whether they have used them, and to describe their attitudes to the guidelines and the methods of implementing them.
A postal questionnaire was sent to a random sample of 559 general practitioners in the North and Yorkshire region in March 1995. Questions were organized around the topics of: knowledge; use; practice change; beliefs; pressure felt to use the guidelines; and methods of implementation. Basic classificatory data on gender; year of qualification; partnership and fundholding status were also collected.
Replies were received from 300 doctors (54%). Knowledge and use of the three selected guidelines varied, but was generally towards the 'high' end of the scale. Doctors showed a high degree of homogeneity in their attitudes to guidelines, which were generally positive. Only single-handed practitioners varied from this pattern of responses. Most of the pressure to use the guidelines was felt to come from the Department of Health, and the least pressure from patients. Doctors felt that the methods of implementation that involved them in educational events and discussion with colleagues were most likely to have an impact on them.
General practitioners are receptive to guideline initiatives, and their views are in line with existing or proposed implementation strategies. More investigation of the concept of 'use' is needed.
临床实践指南的制定有多种原因。迄今为止，对于那些被推荐使用这些指南的人的观点，几乎没有进行过调查。
本文报告的这项调查旨在研究全科医生对一系列已发表指南的熟悉程度，评估他们是否使用过这些指南，并描述他们对这些指南及其实施方法的态度。
1995年3月，向北部和约克郡地区的559名全科医生随机抽取的样本邮寄了一份调查问卷。问题围绕以下主题组织：知识；使用；实践改变；信念；使用指南所感受到的压力；以及实施方法。还收集了关于性别、资格年份、合伙关系和基金持有状况的基本分类数据。
收到了300名医生的回复（54%）。对所选三项指南的知识和使用情况各不相同，但总体处于量表的“较高”端。医生们对指南的态度高度一致，总体上是积极的。只有个体执业医生的回答模式与此不同。使用指南的压力大多被认为来自卫生部，而来自患者的压力最小。医生们认为，让他们参与教育活动并与同事讨论的实施方法最有可能对他们产生影响。
全科医生接受指南倡议，他们的观点与现有或提议的实施策略一致。需要对“使用”概念进行更多调查。
