Kimura S, Pacala J T
Department of Family Practice and Community Health, University of Minnesota, Minneapolis, USA.
J Fam Pract. 1997 Apr;44(4):361-8.
Little is known about physicians' knowledge, attitudes, and practice preferences with regard to pressure ulcers. Clinical practice guidelines on pressure ulcers from the Agency for Health Care Policy and Research (AHCPR) have been publicized, but their impact on family physicians has not been assessed.
A questionnaire was sent to a random sample of active members of the Minnesota Academy of Family Physicians. Information was collected on respondent demographics practice characteristics, training, and awareness of AHCPR guidelines. Knowledge about pressure ulcers was assessed with a 43-item test. Attitudes about pressure ulcer treatment were measured on a Likert-type scale. Four case scenarios were used to explore preferences.
Of 292 potential respondents after exclusion, 155 (53.1%) returned questionnaires. Regression analysis revealed that taking care of more elderly patients, completing a residency, being board-certified, and being aware of the AHCPR guidelines were independently associated with higher knowledge scores. Virtually all (99%) the respondents felt that it was the family physician's role to provide pressure ulcer care, whereas 70% felt that they had not been adequately trained to do so. There was a wide variety of practice preferences. Approximately 70% of physicians were not aware of the AHCPR guidelines.
Most family physicians fell ill-prepared to manage pressure ulcers, suggesting a need to increase educational efforts for this important problem. Knowledge about pressure ulcers could possibly be enhanced by more clinical exposure to older patients, rigorous residency training, and review of AHCPR guidelines.
关于医生对压疮的知识、态度及实践偏好，我们了解得很少。医疗保健政策与研究机构（AHCPR）发布了压疮临床实践指南，但尚未评估其对家庭医生的影响。
向明尼苏达家庭医生学会的在职成员随机抽样发送问卷。收集了受访者的人口统计学信息、实践特征、培训情况以及对AHCPR指南的知晓情况。通过一项包含43个项目的测试评估对压疮的知识。用李克特量表测量对压疮治疗的态度。使用四个病例场景来探究偏好。
排除292名潜在受访者后，155人（53.1%）返回了问卷。回归分析显示，照顾更多老年患者、完成住院医师培训、获得委员会认证以及知晓AHCPR指南与更高的知识得分独立相关。几乎所有（99%）受访者认为提供压疮护理是家庭医生的职责，而70%的人觉得他们没有接受过足够的相关培训。存在各种各样的实践偏好。约70%的医生不了解AHCPR指南。
大多数家庭医生对处理压疮准备不足，这表明需要针对这个重要问题加大教育力度。通过更多接触老年患者、严格的住院医师培训以及复习AHCPR指南，可能会增强对压疮的知识了解。
