临床医师对儿童阻塞性睡眠呼吸暂停低通气综合征的认知度调查  

Knowledge and attitude of clinicians to pediatric obstructive sleep apnea hypopnea syndrome

作　　者：许风雷[1] 张瑞兰[1] 蔡晓岚[1] 魏伟[2] 

机构地区：[1]山东大学齐鲁医院耳鼻咽喉头颈外科,济南250012 [2]山东大学齐鲁医院儿科,济南250012

出　　处：《中华耳鼻咽喉头颈外科杂志》2011年第8期632-637,共6页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：山东省自然科学基金（Y2008C45）

摘　　要：目的分析与儿童阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea hypopnea syndrome，OSAHS）诊治关系最为密切的临床专科医师OSAHS知识水平和自我评估。方法采用经原作者授权翻译的美国儿童阻塞性睡眠呼吸暂停低通气综合征知识及态度问卷（Obstructive sleep apneaknowledge and attitudes questionnaire in children，OSA—KIDS）中文版，以邮寄方式对山东省43所公立医院的耳鼻咽喉科和小儿内科医师进行问卷调查。结果OSA—KIDS中文版经30名医师重测，r=0．92。回收有效问卷391份，占87．7％。18个知识条目平均正确率（面±s）为64．1％±19．1％，克朗巴赫d系数=0．76。耳鼻咽喉科与小儿内科医师知识条目总得分差异无统计学意义，但耳鼻咽喉科医师对“大约有2％的儿童患有OSAHS”判断正确率较高，小儿内科医师对“儿童OSAHS可以导致肺动脉高压”判断正确率较高（P值均〈0．05）。仅有24．3％的医师知晓儿童打鼾的强弱程度与OSAHS的严重程度无关；正确回答婴幼儿心脏呼吸监测不能作为中枢性与阻塞性呼吸暂停的可靠鉴别手段只有16．1％。自我评估5个条目的克朗巴赫d系数=0．72。90％以上的医师认为儿童OSAHS作为一种临床疾病具有重要意义，但仅有约36％的医师对儿童OSAHS的诊断与治疗感到自信。知识总得分与医师性别、学历等无关（P值均〉0．05），但随着医师年龄及执业年限的增加而增加（P〈0．05）。医师对疾病重要性的认识及诊治自信心的自我评估等级呈正相关趋势（r=0．384，P〈0．0001）。结论对山东省部分耳鼻咽喉科和小儿内科医师的调查发现，临床专科医师对儿童OSAHS重要性认识不足，相关知识水平的掌握仍有待提高。Objective To investigate the knowledge and attitude of clinicians in the departments of pediatrics and otolaryngology to pediatric obstructive sleep apnea hypopnea syndrome （OSAHS）, since in China, the clinicians in these two departments had closest relationship with the diagnosis and treatment of OSAHS in children. Methods A validated questionnaire from USA which was the obstructive sleep apnea knowledge and attitudes questionnaire in children （OSAKA-KIDS） was used and permissioned by original author. The questionnaire was mailed to ENT doctors and pediatricians in 43 public hospitals in Shandong province. Results OSA-KIDS in Chinese version was re-tested by 30 physicians, r = 0. 92. Totally, 391 valid questionnaires （87.7%） were returned. Average of correct rate （x± s） in 18 knowledge items was 64. 1% ＋ 19. 1%. Cronbaeh＇s α coefficient was 0. 76. There was no difference between ENT doctors and pediatrics in total knowledge score. However, there was significant difference in below 2 questions： ENT doctors had more correction in answer ＂ nearly 2% of children have OSAHS＂ and pediatrics had more correction in answer ＂pediatric OSAHS may be associated with pulmonary hypertension＂. Only 24. 3% clinicians correctly know the degree of snoring （mild to severe） was not correlated with the severity of obstructive apnea in children. Only 16. 1% could correctly answer the question about cardio-respiratory monitor could not reliably detect both central and obstructive apnea in infant. Cronbach＇s α coefficient was 0. 72 in 5 items which was about importance of disease and self-evaluation in confidence. While more than 90% clinicians stated that ＂As a clinical disorder OSAHS is important or very, extremely important＂. However, among them, only about 36% felt confident in identifying or managing children with OSAHS. Total knowledge score about OSAHS was not different by gender or specialty （ P 〉 0.05 ）, but more knowledge was associated with more positive attitudes overall （P

关 键 词：睡眠呼吸暂停 阻塞性 儿童 问卷调查 

分 类 号：R766[医药卫生—耳鼻咽喉科]