论著

全科规培医师高血压慢病管理知识现状评估及改进策略

  • 王贞贞 ,
  • 童建菁 ,
  • 张晨莉 ,
  • 蒋婕
展开
  • 上海交通大学医学院附属瑞金医院全科医学科,上海 200025
蒋婕 E-mail:jj11472@rjh.com.cn

收稿日期: 2023-11-22

  网络出版日期: 2024-09-09

Current situation of knowledge of hypertension management among general practice residents and improvement strategies

  • WANG Zhenzhen ,
  • TONG Jianjing ,
  • ZHANG Chenli ,
  • JIANG Jie
Expand
  • Department of General Practice, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Received date: 2023-11-22

  Online published: 2024-09-09

摘要

目的:通过评估全科规培住院医师的高血压诊治水平及慢病管理能力,并识别存在的不足,以期为改进规范化培训提供依据。方法:对参与我院全科住院医师规范化培训的34名全科规培医师进行高血压相关知识的问卷调查及考核评价,包括高血压诊断、风险分层、社区转诊条件、随访要求、血压管理与非药物干预5个方面;分析不同因素对考核结果的影响,包括性别、轮转年份和是否参与过高血压相关科室的轮转培训。结果:34名全科规培医师本次考核的总体合格率为76.5%,其中血压管理与非药物干预部分仅有23.5%的学员达到合格标准,且平均分[(12.18±1.42)分]明显低于诊断标准[(14.24±1.69)分]、风险分层[(15.00±3.79)分]、社区转诊[(14.00±3.48)分]和随访要求[(13.65±3.17)分] 4部分成绩(F=4.441, P=0.002)。不同性别、轮转年份及相关科室是否轮转间差异无统计学意义。结论:全科规培医师对高血压具备基本的诊治能力,但在高血压的持续随访管理和非药物干预措施上仍有明显欠缺。在慢性病的长期管理及综合干预策略上仍需进一步培训和加强。

本文引用格式

王贞贞 , 童建菁 , 张晨莉 , 蒋婕 . 全科规培医师高血压慢病管理知识现状评估及改进策略[J]. 内科理论与实践, 2024 , 19(03) : 180 -184 . DOI: 10.16138/j.1673-6087.2024.03.05

Abstract

Objective To evaluate the ability of general practice residents in diagnosing and treating hypertension and managing chronic diseases, identify existing deficiencies, and provide a basis for improving standardized training. Methods A questionnaire survey and assessment on hypertension-related knowledge were conducted among 34 general practice residents participating in standardized training at our hospital. The assessment covered five aspects: hypertension diagnosis, risk stratification, conditions for community referral, follow-up requirements, blood pressure management and non-pharmacological interventions. The influence of different factors on the assessment results was analyzed, including gender, year of rotation, and participation in rotation training in hypertension-related departments. Results The overall pass rate for the assessment among the 34 general practice residents was 76.5%. However, only 23.5% of the residents met the passing criteria in the blood pressure management and non-pharmacological interventions section, and the mean score (12.18±1.42) was significantly lower than the diagnostic criteria (14.24±1.69), risk stratification (15.00±3.79), community referral (14.00±3.48) and follow-up (13.65±3.17) (F=4.441, P=0.002). There was no significant difference between different genders, rotation years and related departments. Conclusions General practice residents have already acquired basic professional skills in the diagnosis and treatment of hypertension, but showed significant deficiencies in chronic disease management, particularly in non-pharmacological interventions. General practitioners still need further training and improvement on long-term chronic disease management and comprehensive intervention strategy to better serve for community and patients.

参考文献

[1] 《中国心血管健康与疾病报告2022》编写组. 《中国心血管健康与疾病报告2022》要点解读[J]. 中国心血管杂志, 2023, 28(4):297-312.
[2] Wang Z, Chen Z, Zhang L, et al. Status of hypertension in China: results from the China hypertension survey, 2012-2015[J]. Circulation, 2018, 137(22):2344-2356.
[3] GBD 2017 DALYs and HALE Collaborators. Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2017[J]. Lancet, 2018, 392(10159):1859-1922.
[4] 中共中央国务院印发《“健康中国2030”规划纲要》[EB/OL]. 2016. https://www.gov.cn/zhengce/2016-10/25/content_5124174.htm.
[5] 国务院. 国务院关于实施健康中国行动的意见[EB/OL]. 2019. https://www.gov.cn/zhengce/zhengceku/2019-07/15/content_5409492.htm.
[6] 王海青, 郑志红, 赵春燕, 等. 北京市全科医师骨干暨转岗全科医生培训学员对高血压相关知识的掌握与培训现状调查[J]. 中华全科医师杂志, 2014(5):405-408.
[7] 张向杰, 王天浩, 顾杰, 等. 上海市徐汇区社区全科医师对基层版《中国高血压防治指南》的掌握情况调查[J]. 中华全科医师杂志, 2014, 13(4):289-292.
[8] 李保国, 刘端菊. 高血压患者血压控制不良原因及对策[J]. 中国实用医刊, 2009, 36(2):60-61.
[9] 贾妍娜, 赵冬, 曾哲淳, 等. 基层医生高血压相关知识和临床诊治能力对就诊高血压患者的影响[J]. 中华流行病学杂志, 2003, 24(12):1078-1081.
[10] 杨森, 王俊鹏, 张含之, 等. 西藏日喀则地区基层医疗机构全科医生培训需求分析[J]. 中华医学教育杂志, 2023, 43(5):381-385.
文章导航

/