基于全科培训联合紧密医联体的基层医生房颤抗凝治疗模式的干预效果研究  

The impact factors of standardized training and effectiveness of anticoagulation in primary care doctors with atrial fibrillation under the model of general practice training combined with close medical association

作　　者：杨晓芳 沙莎 郑学斌 YANG Xiaofang;SHA Sha;ZHENG Xuebin(Department of Cardiovascular Medicine,Changsha Fourth Hospital,Changsha 410005,China;Department of General Medicine,Changsha Fourth Hospital,Changsha 410005,China)

机构地区：[1]长沙市四医院心血管内科,长沙410005 [2]长沙市四医院全科医学科,长沙410005

出　　处：《湖南师范大学学报（医学版）》2024年第4期156-160,174,共6页Journal of Hunan Normal University(Medical Sciences)

基　　金：湖南省卫生健康委科研项目“全科培训联合紧密医联体模式下的基层房颤抗凝治疗体系的构建”(202216003050)。

摘　　要：目的:探讨全科培训联合紧密医联体的基层医生房颤抗凝治疗模式的干预效果,以期提升社区基层医生抗凝知识掌握水平。方法:选取长沙观沙岭社区医院、望月湖社区医院、西湖社区医院3家医院共100名医务人员为干预对象,实施全科培训联合紧密医联体的基层医生房颤抗凝治疗模式干预方案。通过比较干预前后基层医生房颤抗凝知识掌握率、抗凝处方率和接受程度,探讨干预效果,并进一步分析干预满意度的相关影响因素。结果:干预后,社区基层医生的房颤抗凝知识掌握率、抗凝药物处方率均较干预前有明显提升;共有70名(占70.0%)基层医生表示对干预方案的接受程度良好;卡方检验和二元Logistic回归分析结果显示年龄、最高学历、职称、工作年限和科室为全科培训联合紧密医联体的基层医生房颤抗凝治疗模式干预满意度的影响因素。结论:实施全科培训联合紧密医联体的基层医生房颤抗凝治疗模式有利于提升社区基层医生对房颤抗凝知识掌握率和抗凝处方率,且接受度良好;同时,应考虑多种因素对该模式干预效果的影响。Objective To explore the intervention effect of the combination of general practice training and close medical alliances on anticoagulation therapy for atrial fibrillation (AF) among grassroots doctors, in order to improve their knowledge of anticoagulation in the community. Methods A total of 100 medical staff from three hospitals, including Changsha Guanshaling Community Hospital, Wangyuehu Community Hospital, and Xihu Community Hospital, were included as intervention subjects. The knowledge mastery rate, anticoagulation prescription rate, and training acceptance level of primary care doctors before and after the training were compared, and the influencing factors of the training satisfaction were analyzed. Results After intervention, the mastery rate of atrial fibrillation anticoagulation knowledge and the prescription rate of anticoagulants among community grassroots doctors were significantly improved compared to before intervention (P<0.05);70 grassroots doctors (70.0%) expressed a good acceptance of the intervention plan;The results of chi square test and binary logistic regression analysis showed that age, highest education level, professional title, years of work experience, and department were the influencing factors of the intervention satisfaction of anticoagulation therapy for atrial fibrillation among grassroots doctors trained in general practice and closely affiliated with medical consortia. Conclusion The implementation of the comprehensive training and close medical alliance model for primary care doctors in AF anticoagulation treatment is beneficial for improving the community's primary care doctors' mastery of atrial fibrillation anticoagulation knowledge and prescription rates, and has a good acceptance rate;Multiple factors affect the effectiveness of standardized anticoagulation training for atrial fibrillation.

关 键 词：全科培训联合紧密医联体模式 基层医生 房颤抗凝 

分 类 号：R5[医药卫生—内科学]