社区全科医生与专科医生对全科医生学习超声的观点差异及未来便携式超声向基层普及的意见与建议  

General Practitioners'Learning Ultrasound Techniques and Future Applicability of Portable Ultrasound Device in Primary Care:Perspectives from General Practitioners and Sonographers

作　　者：傅晓红[1] 贾瑱熙 赵峰 黄国倩 张韬 FU Xiaohong;JIA Zhenxi;ZHAO Feng;HUANG Guoqian;ZHANG Tao(Department of Ultrasound,Pudong Gongli Hospital,Shanghai 200135,China;Department of Ultrasound,Pudong New Area Jinyang Community Health Center,Shanghai 200136,China;Department of Ultrasound,Pudong New Area Guangming Hospital of Traditional Chinese Medicine,Shanghai 201300,China;Department of Ultrasound,Huashan Hospital,Fudan University,Shanghai 200040,China;Medical Affairs Department,Pudong New Area Jinyang Community Health Center,Shanghai 200136,China)

机构地区：[1]上海市浦东新区公利医院超声科,200135 [2]上海市浦东新区金杨社区卫生服务中心超声科,200136 [3]上海市浦东新区光明中医医院超声科,201300 [4]复旦大学附属华山医院超声科,上海市200040 [5]上海市浦东新区金杨社区卫生服务中心院部,200136

出　　处：《中国全科医学》2021年第22期2832-2837,共6页Chinese General Practice

基　　金：浦东新区卫生系统领先人才培养计划(PWRl2017-05);上海市卫生健康委员会科研课题(202040022)。

摘　　要：背景超声医学与全科医学作为两个迅猛发展的学科,随着超声技术中便携式超声的不断升级和普及,便携式超声技术能否为全科医生所用,助力全科发展?超声医学能否抓住全科医学的人文关怀、早筛查、广泛基层和控费等特征,找到可以加速超声技术在基层普及和多途径培养超声人才的新思路和新方法?目的 了解社区基层全科医生、社区超声医师和综合医院超声医师对于全科医生学习超声并应用便携式超声的观点、意见,以及具体操作过程要求和目标的实施建议。方法 2019年10—12月,采用目的抽样法,从2018年度“社区超声医学学科建设专题学习班”参培人数最多的一家社区卫生服务机构抽取全科医生和超声医生进行一对一半结构化访谈,访谈提纲主要围绕两类人群对于社区全科医生学习并进行超声操作的态度、意愿和对全科医生知识储备要求,以及全科医生在技术超声流程中执行的具体程度。在此基础上邀请国内综合医院工作10年以上的17位超声影像从业者参与咨询,咨询采用两轮德尔菲法方式进行,咨询内容主要为超声影像数据的采集、保存、传递、诊断等全过程中对社区全科医生的要求。结果 最终访谈了6名全科医生和3名超声科医师,结果显示社区全科医生对超声技术有兴趣,关心学习后的技术应用问题,社区超声医师认为全科医生可以执行筛查环节,从体表的、简单的器官探查开始,如甲状腺和颈动脉。两轮咨询专家积极系数为100.0%,权威程度>0.7,结果显示综合医院超声医学专家对社区全科医师参与超声技术影像数据采集对执行人要求为最低本科学历、临床医学专业、至少从事3年临床工作,具有全科执业医师和超声上岗证,每年至少参加2次继续教育;其余对社区全科医生进行超声数据采集部位、需掌握的数据采集操作技术(包括常见的仪器调节,患�Background Both ultrasound imaging and general medicine are developing rapidly.But it is still unknown that whether the advancement and popularization of portable ultrasound imaging can be used by general practitioners(GPs)to promote the development of general medicine,and what innovative ideas and methods can be used to accelerate the popularization of ultrasound imaging in primary care and to train ultrasound professionals with humanistic care,early disease screening,high service accessibility,and medical insurance expense control in primary care under consideration.Objective To explore the perspectives of multiple healthcare providers(community GPs,community sonographers,and general hospital sonographers)on GPs'learning ultrasound techniques and applying portable ultrasound devices,and their suggestions on the implementation goals and specific operation requirements.Methods The study was implemented from October to December 2019.In-person interviews using a semi-structured format were conducted with GPs and sonographers from Pudong New Area Jinyang Community Health Center,a community hospital that has trained the most GPs in China so far in terms of ultrasound learning and practice(two authors'current affiliation)for investigating their attitude and willingness regarding learning ultrasound techniques and delivering ultrasound services,and their opinions on the required ultrasound knowledge and level of actual performance.And two rounds of consultation using the Delphi technique were carried out with 17 sonographers with an experience of working at least 10 years in the general hospital for investigating their opinions on the specific requirements for community GPs to perform the ultrasound examination,such as collecting,storing and transmitting ultrasound imaging data,and making an ultrasound-based diagnosis.Results Altogether,six community GPs and three community sonographers attended the interviews.The results showed that community GPs had interests in learning ultrasound techniques,and expressed their conc

关 键 词：社区卫生服务 医院 综合 全科医生 超声医师 便携式超声 

分 类 号：R197[医药卫生—卫生事业管理]