医生对社区获得性肺炎基本知识的评估:KNOCAP研究

R. Bontsevich, A. Gavrilova, G. Prozorova, O. Myronenko, T. M. Shagieva, O. Kompaniets, V. Barysheva, G. Ketova, E. Luchinina, E. Miliutina, T. Filinichenko, O. Osipova
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引用次数: 5

摘要

目的:了解临床医师对社区获得性肺炎(CAP)的临床知识、诊治知识及与国家临床标准的比较。材料和方法:多中心研究(KNOCAP研究)于2017-2018年在俄罗斯和乌克兰城市别尔哥罗德、萨拉托夫、第聂伯罗、沃罗涅日、车里雅宾斯克、坦波夫、利佩茨克和库班地区进行。我们通过要求255名医生完成一份问卷(14个问题)来评估他们对CAP基础知识的了解。结果:平均答对率为49.6%,不同中心答对率在39.9% ~ 58.2%之间。最难回答的问题为:在CAP治疗积极动态的基础上进行对照(重复)x线检查的最佳时间(20.5%)、CAP主要诊断特征(38.2%)、无危险因素患者的最佳初始CAP治疗(24.9%)和有危险因素患者的最佳初始CAP治疗(17.5%);仅34.9%的受访医师正确报告了非严重CAP治疗中的典型错误,正确回答最多的是以下问题:延迟CAP抗生素治疗的原因(85.8%)、肺炎球菌和流感疫苗接种的效率(82.9%)、CAP主要病原体(63.8%)和在没有x线检查的情况下对CAP的“不准确/模棱两可”诊断(62.6%)。结论:调查结果显示,医生在CAP患者管理方面的知识水平不足,一方面需要认真考虑一些问题,另一方面需要对医疗和预防治疗机构的医生进行教育活动。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The assessment of physicians’ knowledge of community-acquired pneumonia basics: KNOCAP study
Objective: To assess physicians’ level of knowledge in clinical picture, diagnosis and treatment of community-acquired pneumonia (CAP) and its comparison with national clinical standards. Material and Methods: Multicenter research (KNOCAP study) was conducted in Russian and Ukrainian cities Belgorod, Saratov, Dnipro, Voronezh, Chelyabinsk, Tambov, Lipetsk and Kuban’ Region during 2017-2018. We assessed 255 physicians in the knowledge of CAP basics by asking them to complete a questionnaire (14 questions). Results: The average level of correct answers totaled 49.6%, and varied from 39.9% to 58.2% in different centers. The most difficult questions were related to an optimal time for control (repeated) X-ray examination on top of positive dynamics of CAP treatment (20.5% of correct answers), CAP main diagnostic character (38.2%), optimal initial CAP therapy in patients without risk factors (24.9%) and patients with risk factors (17.5%); only 34.9% of the physicians surveyed correctly reported typical mistakes in the treatment of a non-severe CAP. The maximum numbers of correct answers were given on the following questions: postpone reasons for CAP antibiotic therapy (85.8%), the efficiency of pneumococcal and influenza vaccination (82.9%), CAP main pathogens (63.8%) and “inaccurate/ amphibolic” diagnosis of CAP in the absence of X-ray examination (62.6%). Conclusions: The results gained in the survey revealed the insufficient level of physicians’ knowledge in management of patients with CAP. On the one hand, a number of issues need to be considered more carefully, on the other hand, educational activities have to be conducted among physicians of medical and preventive treatment facilities.
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