老年医学继续教育对社区医务人员“知信行”的影响

Effect of continuing medical education on geriatrics on knowledge, attitude, belief and practice in community medical staffs

摘要:

目的 调查社区医务人员对老年医学理念的理解及知晓程度，探讨老年医学继续教育及相应的工作指导对社区医务人员老年医学知识接受及应用的影响。方法 入选2013年11月至2015年9月期间在岗的社区上门服务机构医务人员70人。采用“知信行”（KABP）调查问卷，对社区医务人员在老年医学继续教育培训前后的KABP行为进行调查评估，并比较培训前后的变化。结果 培训前调查回收有效问卷58人；培训后调查回收有效问卷70人。培训后与培训前比较，医务人员对老年共病、老年综合征、前列腺增生、良性位置性眩晕、骨质疏松、肿瘤筛查、营养不良、肌少症、跌倒、痴呆、谵妄、尿失禁、睡眠障碍及压疮认知程度的提高均达到统计学意义（P<0.05），对于便秘、营养不良、多重用药、尿失禁、睡眠障碍、肌少症、痴呆和谵妄的处理及行为均得到显著提升（P<0.05）。结论 社区医务工作者对老年医学知识掌握普遍不足，有针对性的老年医学继续教育，以及对社区进行的老年医学实践指导，可以有效提高社区医务人员的认知水平和实践能力。

Abstract:

Objective To survey the community medical staffs for their understanding of the concepts about geriatrics, and investigate the effect of continuing medical education on geriatrics on their ability in acceptance and application of geriatric knowledge. Methods A total of 70 medical staffs who were on duty in house-call facility of community medical services from November 2013 to September 2015 were recruited in this study. They were invited to fill out a KABP (knowledge, attitude, belief and practice) questionnaire before and after continuing medical education, and the changes were compared. Results There were 58 valid questionnaires obtained before training and 70 after training. Compared with pre-training, acquaintances and knowledge about comorbidity, geriatric syndrome, benign prostate hyperplasia, benign paroxysmal positional vertigo, osteoporosis, cancer screening, malnutrition, sarcopenia, fall, dementia, delirium, urinary incontinence, sleeping disorder, and pressure sores were improved significantly after training (P<0.05). Their professional attitude and practice for constipation, malnutrition, polypharmacy, urinary incontinence, sleeping disorders, sarcopenia, dementia and delirium were improved obviously after training (P<0.05). Conclusion The community medical staffs do not have enough knowledge on geriatrics. So targeted continuing medical education on geriatrics and practice guidance will effectively improve their knowledge, attitude belief and practice behaviour.