美国住院医师产科肛门括约肌损伤修复的经验与培训

Q4 Medicine
S. Narayanamoorthy, K. Balhotra, M. Silver, Rodney McLaren Jr., E. Mckay
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引用次数: 0

摘要

随着产科肛门括约肌损伤(OASIS)病例的减少,尚不清楚在美国妇产科(OBGYN)住院医师期间,学习和接触肛门括约肌修复是否受到损害。本研究的目的是评估美国妇产科住院医师对OASIS修复的暴露程度和置信度。居民对绿洲修复的教育程度也进行了评估。这是一项横断面在线调查,收集了居民的人口统计数据、居住计划的特征、交付和OASIS维修的数量、OASIS维修的地点和技术、提供的修复后护理、居民对OASIS维修的信心水平以及他们对维修的了解。采用描述性分析、Fisher精确检验、序数回归模型和Spearman相关分析。获得了160名居民的回复(11%的回复率)。随着培训水平的提高(OR= 3.442, 95%CI, 2.473-4.791, p<0.004),更多的分娩(OR=2.672, 95%CI, 1.511-4.723, p<0.001),三级修复(OR=5.522, 95%CI, 3.67-8.308, p<0.001)和四级修复(OR=4.364, 95%CI, 2.785-6.837, p<0.001),置信度更高。接触讲座或/和模拟比不接触任何一种都提高了信心(or = 0.225, 95% CI, 0.092-0.545, p<0.001)。居民的信心水平随着模拟次数的增加而增加(r=0.368, p< 0.001)。讲座及模拟活动提高居民对绿洲维修的知识和技能。尽管OASIS病例不断减少,但外科技能课程对于保持高质量的培训,及时识别和细致的会阴修复在妇产科医生中是必不可少的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Residents’ experience and training in obstetric anal sphincter injury repair in the United States
With the reduction in obstetric anal sphincter injuries (OASIS) cases, it is unknown if learning and exposure to their repair is compromised during obstetrics and gynecology (OBGYN) residency in the United States (US). The aim of this study was to evaluate the exposure and confidence level of the US OBGYN residents to OASIS repair. Residents’ education on OASIS repair was also assessed. This was a cross sectional online survey that collected residents’ demographics, characteristics of residency program, the number of deliveries and OASIS repairs performed, the site and technique of OASIS repair, post-repair care provided, residents’ confidence level in OASIS repair and their education on the repair. Descriptive analyses, Fisher’s Exact tests, Ordinal regression models and Spearman’s correlation were performed. Response from 160 residents (11% response rate) was obtained. Confidence was higher with increasing level of training (OR = 3.442, 95% CI, 2.473-4.791, p<0.004), a greater number of deliveries (OR=2.672, 95% CI, 1.511-4.723, p<0.001), third-degree repairs (OR=5.522, 95%CI, 3.67-8.308, p<0.001) and fourth-degree repairs (OR=4.364, 95% CI, 2.785-6.837, p<0.001) performed. Exposure to lecture or/and simulation improved confidence than no exposure to either (OR= 0.225, 95% CI, 0.092-0.545, p<0.001). Residents’ confidence level increased with a greater number of simulations attended (r=0.368, p< 0.001). Lectures and simulations enhance residents’ knowledge and skills in OASIS repair. Surgical skill curriculum is essential to maintain good quality training, prompt recognition, and meticulous perineal repair among OBGYN physicians despite the declining OASIS cases.
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来源期刊
Urogynaecologia International Journal
Urogynaecologia International Journal Medicine-Obstetrics and Gynecology
CiteScore
0.20
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0.00%
发文量
10
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