Ontario doctors' attitudes toward and use of clinical practice guidelines in oncology
Ontario doctors' attitudes toward and use of clinical practice guidelines in oncology
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DOI：
10.1111/j.1365-2753.2006.00670.x
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发表时间：
2007-08-01
影响因子：
2.4
通讯作者：
Tetroe, Jacqueline
中科院分区：
文献类型：
--
作者：
Graham, Ian D.;Brouwers, Melissa;Tetroe, Jacqueline
临床实践指南旨在改善患者护理和预后。关于指南的效用和医生对指南的态度存在争议。调查的目的是确定安大略省医生对实践指南的总体态度，对安大略省癌症护理实践指南倡议及其制定的循证指南的认识和态度，指南的自我报告使用以及与指南使用相关的因素。方法我们对安大略1034名治疗癌症的医生进行了横断面、自我管理的邮政调查。主要结果测量是对一般实践指南的态度，对安大略省癌症护理实践指南倡议制定的态度，以及对实践指南使用情况的自我报告。调查结果共有520名医生回应，调查回应率为57%。安大略的医生对一般的实践指南和安大略癌症护理中心制定的指南持相当积极的态度。44%的人报告说他们经常或大部分时间使用指导方针。对总体指南和安大略癌症指南的积极态度与更频繁地报告指南的使用有关。与经常报告使用指南有关的其他因素包括：作为肿瘤内科医生，治疗妇科癌症而不是其他类型的癌症。安大略医生对实践指南持积极态度，并报告他们经常使用。通过了解医生对特定指南的看法和他们随后对指南的遵守之间的关系，指南的制定者将更有能力制定出医生可以接受的高质量循证指南，从而更倾向于使用。
Background Clinical practice guidelines are intended to improve patient care and outcomes. Controversy exists about the utility of guidelines and doctors' attitudes toward them. The purpose of the survey was to determine Ontario doctors' attitudes toward practice guidelines in general, awareness of, and attitudes about, Cancer Care Ontario's Practice Guideline Initiative and the evidence-based guidelines it produces, self-reported use of guidelines and, factors related to guideline use.Methods We conducted a cross-sectional, self-administered postal survey of 1034 Ontario doctors who treat cancer. Main outcome measures were attitudes toward practice guidelines in general, attitudes towards those developed by Cancer Care Ontario's Practice Guideline Initiative, and self-reported use of practice guidelines.Findings A total of 520 doctors responded producing a 57% survey response rate. Ontario doctors are quite positive about practice guidelines in general and those developed by Cancer Care Ontario. Forty-four per cent reported using guidelines routinely or most of the time. Positive attitudes towards guidelines in general and the Ontario cancer guidelines specifically were related to more frequent reported use of guidelines. Other factors related to frequent reported use of guidelines included being a medical oncologist, treating gynaecological cancers and not other types of cancers.Interpretation Ontario doctors have positive attitudes toward practice guidelines and report frequent use of them. By understanding the relationship between doctors' perceptions of specific guidelines and their subsequent adherence to them, guideline developers will be better positioned to produce quality evidence-based guidelines that doctors will find acceptable, and therefore, be more predisposed to use.