基层医疗机构从业人员尘肺病远程会诊的使用意愿  

Willingness to order remote pneumoconiosis consultation among physicians in primary health care institutions

作　　者：王晶[1] 李涛[1] 蒋兆强[1] 陈钧强[1] 楼建林[1] 张幸[1] WANG Jing;LI Tao;JIANG Zhao-qiang;CHEN Jun-qiang;LOU Jian-lin;ZHANG Xing(Institute of Occupational Diseases,Zhejiang Academy of Medical Sciences,Hangzhou,Zhejiang 310013,China)

机构地区：[1]浙江省医学科学院职业病防治研究所,浙江杭州310013

出　　处：《环境与职业医学》2020年第5期492-496,共5页Journal of Environmental and Occupational Medicine

基　　金：浙江省医学支撑学科劳动卫生学(11-ZC02);浙江省公益技术应用研究项目(2017C33048);浙江省医药卫生科技计划创新人才支持计划项目(2020RC006)。

摘　　要：[背景]尘肺病诊断存在各地诊断水平参差不齐等问题,使用尘肺病远程会诊符合社会发展趋势,但目前从业人员对尘肺病远程会诊的使用态度尚不明确。[目的]了解基层医疗机构从业人员对尘肺病远程会诊的使用意愿,为提高我国尘肺病诊断水平提供基础性调研数据。[方法]2015年1月—2016年12月选择参加浙江省职业病防治培训中心尘肺病诊断相关培训的216家基层医疗机构的282名医师作为调查对象,采用自制调查问卷对尘肺病远程会诊的使用意愿进行调查,共发放问卷282份。问卷包括基本情况、尘肺病远程会诊的使用意愿、对尘肺病远程会诊的期望和主观意见,比较远程会诊使用意愿及期望得分差异。[结果]回收有效问卷282份,有效回收率100%。共有258名调查对象(91.5%)报告其所在单位有数字X线摄影(DR)机。高级职称调查对象的其他疾病远程会诊参与率(40.3%),以及对远程会诊了解率(87.1%)高于其他职称的调查对象(P <0.05)。259名(91.8%)的调查对象愿意使用尘肺病远程会诊。不同专业方向调查对象对远程会诊在病例学习、疑难病例讨论、远程教育中的作用期望差异均有统计学意义(P <0.05)。初级和高级职称调查对象的使用意愿和对远程会诊在疑难病例讨论中的作用期望高于中级职称的调查对象(P <0.05)。共有85名(30.1%)调查对象反馈了对尘肺病远程会诊的建议,其中:24名调查对象认为法律、法规和会诊管理制度是最重要的问题;16名调查对象认为应加强主管部门的支持,加大软件、硬件设备的支持投入;13名调查对象认为应上传完善的临床资料、现场调查信息,避免图像失真,固化电子图像禁止修改,提高传输速度;9名调查对象强调要确保会诊时间,并做到及时反馈。[结论]基层医疗机构从业人员对尘肺病远程会诊的使用意愿较高。尘肺病远程会诊相关的法律法规和会诊管[Background]Physician’s diagnostic ability of pneumoconiosis varies across China;therefore,remote pneumoconiosis consultation may be acquired.However,the attitude to remote pneumoconiosis consultation is not clear among health professionals.[Objective]The purpose of this study is to understand the willingness of practitioners in primary health care institutions to order remote pneumoconiosis consultation,and provide basic survey data for improving the pneumoconiosis diagnosis ability of physicians in China.[Methods]Between January 2015 and December 2016,a total of 282 physicians from 216 primary hospitals who participated in training sessions of pneumoconiosis diagnosis in Zhejiang Education Center for Occupational Disease Prevention and Control were selected as study subjects.A total of 282 self-designed questionnaires were distributed to investigate the willingness to order remote pneumoconiosis consultation.The questionnaire included basic information,willingness to order remote pneumoconiosis consultation,and expectations and subjective opinions on remote pneumoconiosis consultation,and the differences in the willingness to order and expectations of remote consultation were compared.[Results]A total of 282 valid questionnaires were returned,and the valid return rate was 100%.Of the 282 investigated physicians,258(91.5%)respondents reported digital radiography(DR)machines in their hospitals.The participation rate of remote consultation for other diseases(40.3%)and the awareness rate of remote consultation(87.1%)were higher among those with senior professional titles than among those of other titles(P<0.05).The questionnaire survey showed that 259(91.8%)respondents were willing to order remote pneumoconiosis consultation.There were significant differences in the expectation of remote consultation on case study,discussion of difficult cases,and distance education among physicians with different professional backgrounds(P<0.05).Those with junior and senior professional titles had higher willingness to order rem

关 键 词：尘肺病 远程会诊 数字X线摄影 意愿 态度 

分 类 号：R13[医药卫生—劳动卫生]