脊髓性肌萎缩症儿科医生和儿科住院医师的知识、态度和实践评估

Özlem Yayıcı Köken
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摘要

脊髓性肌萎缩症(SMA)是最常见的神经肌肉疾病之一,是常染色体隐性遗传病中第二大致死率的疾病,本研究旨在调查儿科医生和儿科住院医师对脊髓性肌萎缩症的知识水平和态度。方法:要求儿科住院医师和儿科医生回答一份由作者准备的包含27个问题的问卷。该问卷调查了有关SMA的遗传、病理生理和实验室特征的知识水平和态度,以及随访和管理特点。问卷使用Google Forms (Google LLC, Mountain View, CA, USA)分发。结果:93名医生(48.4% (n=45)儿科医生,15.1% (n=14)研究员,36.6% (n=34)儿科住院医师)参与问卷调查。其中,56人(60.2%)有在儿科诊所工作超过5年的经验,95.7% (n=89)有跟踪SMA患者的经历。68名(73.1%)的参与者知道95%以上的患者的外显子7-8缺失是导致SMA的原因,83名(89.2%)的参与者知道其特征是前角运动神经元的进行性丢失,86名(92.5%)的参与者知道SMA的分类是基于症状的发病时间和遗传特征,92名(98.9%)的参与者认为SMA亚型可以定义预后。90例(96.8%)认为副呼吸肌受累是最重要的死亡原因。讨论与结论:本研究显示,医生对SMA疾病的症状、诊断方法和随访特征的了解程度令人满意,随着治疗方法的发展,SMA疾病越来越受欢迎,可以延长生存期,提高生活质量。现代治疗方案有望改变疾病的自然进程,儿科医生也有望在诊断、随访和治疗方面跟上不断变化的算法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
An Assessment of the Knowledge, Attitudes, and Practices of Pediatricians and Pediatric Residents in Spinal Muscular Atrophy
Introduction: This study aims to investigate the knowledge levels and attitude of pediatricians and pediatric residents toward spinal muscular atrophy (SMA), which is one of the most frequent neuromuscular diseases and the second most common cause of mortality among autosomal recessive diseases. Methods: Pediatric residents and pediatricians were asked to answer a questionnaire consisting of 27 questions prepared by the authors. The questionnaire investigated knowledge levels and attitudes concerning genetic, pathophysiologic, and laboratory characteristics, in addition to follow-up and management features of SMA. The questionnaire was distributed using Google Forms (Google LLC, Mountain View, CA, USA). Results: Ninety-three physicians (48.4% (n=45) pediatricians, 15.1% (n=14) fellows, and 36.6% (n=34) pediatric residents) responded to the questionnaire. Of these, 56 (60.2%) had experience of working in a pediatric clinic for more than 5 years and 95.7% (n=89) had followed an SMA patient. Sixty-eight (73.1%) of the participants knew that a deletion in exon 7–8 was the cause of SMA in more than 95% of patients, 83 (89.2%) knew that it was characterized by progressive loss of motor neurons in the anterior horn, 86 (92.5%) knew that SMA classification was made based on the onset time of symptoms and genetic features, and 92 (98.9%) believed that SMA subtypes could define the prognosis. Ninety (96.8%) stated that the most important cause of mortality was the involvement of accessory respiratory muscles. Discussion and Conclusion: This study revealed that physicians possess a satisfactory level of knowledge concerning the symptomatology, diagnostic algorithm, and follow-up features of SMA disease, which has become more popular following the development of treatments that could prolong survival and improve the quality of life. Modern treatment options are expected to change the natural course of the disease, and pediatricians are expected to stay up-to-date with the changing algorithms for diagnosis, follow-up, and treatment.
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