辽宁省县级以上医院医务人员循证医学认知现状及循证实践情况调查  

Background of cognition and practice of EBM in clinical staff from hospital at or above the county level in Liaoning province:aquestionnaire survey

作　　者：纪超[1] 孙晓[2] 张曼[3] 郑黎强[1] 徐昕[1] 高明宇 颜鸿飞[5] 李济强[6] 

机构地区：[1]中国医科大学附属盛京医院图书馆,沈阳110004 [2]沈阳市妇婴医院内科 [3]沈阳医学院附属中心医院循环内科 [4]辽宁省卫生和计划生育委员会保健处 [5]沈阳市第五人民医院胸外科 [6]沈阳市口腔医院正畸科

出　　处：《山西医药杂志》2015年第10期1107-1110,共4页Shanxi Medical Journal

摘　　要：目的了解辽宁省县级以上临床医务人员对循证医学的观点态度、知识来源和循证实践的影响因素,从而更好地将循证医学应用于临床提供支持。方法采用自填写式的调查问卷对辽宁省63家三级甲等医院共1 510人进行了调查,主要包括循证医学的一般情况,循证实践知识、态度、行为和循证实践影响因素三方面。结果筛选信息较完整的930人进行分析,其中临床医生784人,护士101人,医辅45人,中位年龄为33岁。调查人群的32.1%熟悉循证医学。随着医务人员职称、学历的升高,他们的认知情况也逐渐改善,差异均有统计学意义(χ2学历=128.6,P<0.01;χ2职称=79.6,P<0.01)。参加过循证医学的培训比例为40.5%(341人)。同样随着职称和学历的升高,培训比例也不断升高(χ2学历=36.657,P<0.01,χ2职称=27.338,P<0.01)。90.8%(838人)的被调查者认为在临床工作中有必要开展循证医学。仅23.8%的人开展了循证医学实践。多因素分析结果显示是否开展循证实践与年龄、学历、职称并不相关,是否参加循证医学培训和对循证医学的认知情况是其影响因素:OR参加培训(是或否)为2.193,95%CI(1.500,3.207),P<0.01;OR认知(听说过或未听说)为7.610,95%CI(1.607,36.046),P<0.05;OR认知(比较熟悉与未听说)为21.469,95%CI(4.411,104.502),P<0.01;OR认知(非常熟悉与未听说)为46.574,95%CI(8.634,251.217),P<0.01。结论目前循证医学培训比例较低,知晓情况有待改善。是否在临床工作中开展循证实践不受年龄、学历、职称等限制。是否参加循证医学培训、对循证医学的熟悉程度才是开展循证实践的关键因素。Objective To characterize the clinical staff′s recent status of cognition,source of professional knowledge,and the obstacles of evidence-based practice.So we could provide more support for evidence-based practice.Methods A self-administered questionnaire including status of cognition,source of professional knowledge,and the obstacles of evidence-based practice was sent to 1 510 clinical staff from 63 hospitals at or above the county level.Results Nine hundred and thirty study subjects,whose information was more complete,were screened in our analysis.Among them,784 were doctors,101 were nurses,and 45 were other relevant personnel.The median age was thirty two point one percent of them were familiar with EBM（evidence based medicine）.Along with the increase of personnel title and educational background,their cognitive situation also gradually improved significantly（χ2personnel title=79.6,P〈0.01;χ2educational background=128.6,P〈0.01）.Forty point five percent of them attended EBM training.In the same,along with the increase of personnel title and educational background,the percentage of clinical staff who attended the EBM training was increased（χ2educational background=36.657,P〈0.01,χ2personnel title=27.338,P〈0.01）.Ninty point eight percent of the respondents thought that it was necessary to conduct evidence-based medicine in clinical work,and actually,only 23.8% of them had implement EBM in their clinical work.Results of multivariate analysis showed that implement EBM practice or not was not related to age,personnel title and educational background.That was only related to participant in EBM training and cognition of EBM knowledge.The ORparticipating EBMtraining（yes vs no）value was 2.193,95%CI（1.500,3.207）,P0.01;ORcognition（heard vs no）was 7.610,95%CI（1.607,36.046）,P〈0.05;OR cognition（familiar vs no）was21.469,95%CI（4.411,104.502）,P〈0.01;ORcognition（very familiar vs no）was 46.574,95%CI（8.634,251.217）,P〈0.01.Conclusion The proportion of EBM training is not

关 键 词：循证医学 实践 影响因素 观点 态度 

分 类 号：R-03[医药卫生]