中国20个城市社区卫生服务中心临床医生对性传播疾病检测的态度调查  

Survey on attitude to sexually transmitted disease testing among physicians in community health service centers of 20 cities in China

作　　者：彭明辉 祝墡珠 江孙芳 黄志威[2] 

机构地区：[1]复旦大学附属中山医院全科医学科,上海200032 [2]香港大学家庭医学和初级保健科,中国香港999077

出　　处：《中华全科医师杂志》2018年第1期14-20,共7页Chinese Journal of General Practitioners

基　　金：上海市公共卫生优秀学科带头人培养计划（全科医学）（No.GWDTR201210）;上海市公共卫生重点学科建设（No.12GWZX1001）;RGC Seed Fund for Basic Research,University Grant Council,HK SAR Government（No.201411159004）

摘　　要：目的 调查中国20个城市社区卫生服务中心（CHC）临床医生对性传播疾病（STD）检测的态度,探索在CHC开展STD检测的可行性和存在的障碍.方法 2015年9—12月,采用横断面调查的方法在中国内地随机分层抽样抽取6个省和2个直辖市,共20个城市的CHC在职临床医生进行STD检测态度的问卷调查.结果 共有158家CHC接受了调查,回收有效问卷1734份.接受调查的医生平均年龄（39.7 ±10.6）岁,从事目前专业年限（15.8 ±11.5）年,其中全科医生占47.0%（799/1700）.调查前1个月内,8.1%（138/1699）的医生接触过STD特定人群（性工作者、男男性交者、吸毒者等）,18.3%（313/1706）的医生诊断、治疗STD患者或接诊过疑似 STD 患者.既往有62.0%（1048/1689）的医生接受过STD诊治的相关培训.46.5%（784/1686）的医生认为在CHC开展STD检测最大的障碍是缺乏相关的培训.如果在CHC对特定人群进行STD检测,73.4%（1241/1692）的临床医生认为是有意义的,但临床医生最大的顾虑是＂担心临床诊断难以应对＂,比例为62.0%（1043/1683）.而对该人群有厌恶感的医生仅占5.8%（97/1683）.结论 目前社区医生在观念上不歧视STD患者及特定人群,大部分医生同意把STD检测作为常规检测项目.临床医生缺乏有效的STD相关培训是CHC开展STD检测的主要障碍.在社区卫生服务中心开展STD检测必须加强相关知识和技能的培训.Objective To survey the attitude to sexually transmitted disease（STD）testing among physicians in community health service centers（CHC）of 20 cities in China.Methods A cross-sectional survey using stratified random sample was conducted in September to December 2015, among 1 734 physicians from 158 CHCs in 20 cities of 6 provinces and 2 municipalities.Results The average age of participants was（39.7 ±10.6）years, the time for present position was（15.8 ±11.5）years, and 47.0%（799/1 700）were general practitioners（GPs）.The survey showed that in the last month,8.1%（138/1 699）of the physicians contacted with the specific population of STD（sex worker,MSM,drug user, etc）, and 18.3%（313/1 706）of them managed STD patients or provided services to suspected STD patients;62.0%（1 048/1 689）of them received the STD-related training previously;46.5%（784/1 686） thought the lack of training in STD testing as the biggest barrier for carrying out STD testing in CHC.As for the specific populations, 73.4%（1 241/1 692）of physicians thought that it was meaningful, 62.0%（1 043/1 683）of them worried about＂have difficulty to deal with their STD clinically＂, and only 5.8%（97/1 683）of them expressed their＂dislike of specific population＂.Conclusions Most physicians in CHCs believe that STD testing should be included in the routine tests, and it is feasible to carry out STD testing in CHCs.Lack of training is the main barrier for STD testing, so it is necessary to conduct STD testing related trainings in CHCs.

关 键 词：性传播疾病 社区卫生中心 医务工作者的态度 

分 类 号：R181[医药卫生—流行病学]