北京市城区全科医生对循证医学的认识、态度及需求的现况分析

目的 探讨北京市城区全科医生对循证医学的认知及实践现状。 方法 采取按比例分层随机整群抽样方法随机抽取148家北京城区社区卫生服务中心中的26家社区,共计调查26家社区卫生服务中心及下属108个社区卫生服务站,共问卷调查477名全科医生,有效问卷439份。 结果 ①全科医生对于循证医学的概念相对其他条目理解程度稍好,知晓程度为"好"的全科医生占29.2%;对于循证医学实施步骤理解程度相对最低。不同年龄、学历、执业类别、工作时间、职称的全科医生对于循证医学知识的知晓程度差异有统计学意义(P<0.05)。②全科医生对循证医学的态度积极,其中全科医生对于Q3(临床经验与循证证据的重要性)、Q10(应用指南的重要作用)认可度最高,82.2%的全科医生认同最佳证据的重要作用,82.2%的全科医生认同临床实践指南对患者个体化治疗的重要作用;不同学历的全科医生对循证医学态度的差异有统计学意义(P<0.05)。③全科医生对循证医学有很大需求,其中全科医生在实际工作中最迫切的需求是希望定期参加循证医学相关知识、技能培训(77.9%),其次社区应当为医务人员提供循证实践的条件(77.4%)。 结论 北京市城区全科医生对循证医学知识的知晓程度一般,但其已经逐渐认识到循证医学的重要性,对循证医学相关需求也较迫切。因此,应充分利用现有的资源等途径在基层加强开展与推广循证医学,改善全科医生应用循证医学的现状。 

Understanding,attitudes and demand on evidence-based medicine among general practitioner in Beijing urban area

Objective To investigate the cognition and practice on evidence-based medicine (EBM) among the general practitioners (GPs) in Beijing urban area. Methods A proportioned stratified random sampling method was used to sample among 148 community health service centers in Beijing urban area, and 26 community health service centers and 108 attached community health service stations were surveyed. A total of 477 GPs were investigated and 439 questionnaires were available. Results ①29.2% of the GPs were with a good understanding of the concept of EBM than other items, and relatively poor understanding of the procedures of EBM. Their understanding of EBM was significantly different among GPs with different ages, academic qualifications, licensed types, years of service and professional titles (P<0.05). ②The GPs had a positive attitude toward EBM. Eighty-two point two percent of the GPs agreed that the best evidence might played an important role in clinical practice, 82.2% of the GPs agreed on the important role of clinical practice guidelines for individual treatment. There was a statistically difference in the attitude of the GPs with different degrees in EBM (P<0.05). ③The GPs had a great demand for EBM. The most urgent need of GPs was to regularly participate in EBM knowledge and skills training (77.9%). Secondly, The community should provide the medical staff with the facilities for evidence-based practice (77.4%). Conclusion GPs have gradually realized the importance of EBM, and their need for EBM is also urgent. Therefore, in order to improve the current situation of GPs in practicing EBM, we should make full use of existing resources to promote EBM.