Neurologists' knowledge of and attitudes toward epilepsy surgery A national survey
Neurologists' knowledge of and attitudes toward epilepsy surgery A national survey
复制标题
DOI：
10.1212/wnl.0000000000001127
复制
发表时间：
2015-01-13
期刊：
影响因子：
9.9
通讯作者：
Jette, Nathalie
中科院分区：
文献类型：
--
作者：
Roberts, Jodie I.;Hrazdil, Chantelle;Jette, Nathalie
目的：在当前的研究中，我们旨在评估加拿大神经科医生癫痫手术的潜在神经科相关障碍。方法：邮寄给所有在加拿大注册执业的神经科医生一份包含29项的问卷。调查项目包括：(1)医疗实践类型，(2)对手术风险和益处的认知，(3)对现有实践指南的了解，以及(4)癫痫患者手术的障碍。在第一次邮寄后未完成问卷的神经科医生通过电子邮件、传真或电话第二次联系。在这个提醒之后，调查问卷被第二次邮寄给所有没有回应的人。结果：796名神经科医师中，共有425人回复问卷，回复率为53.5%。受访者包括327名在实践中跟踪癫痫患者的神经科医生。超过一半（56.6%）的神经科医生要求患者耐药并在考虑手术前每年至少发作一次，近一半（48.6%）未能正确定义耐药癫痫。超过75%的神经科医生认为，医疗资源不足是癫痫患者接受手术的最大障碍。结论：相当大比例的加拿大神经科医生不知道癫痫手术的推荐实践标准。可及性似乎也是癫痫手术和手术评估的一个重大障碍。因此，我们担心癫痫患者得不到充分的护理。必须更加重视知识传播，并确保基础设施和人员到位，使患者能够及时获得这种循证治疗。
Objectives: In the current study, we aim to assess potential neurologist-related barriers to epilepsy surgery among Canadian neurologists.Methods: A 29-item, pilot-tested questionnaire was mailed to all neurologists registered to practice in Canada. Survey items included the following: (1) type of medical practice, (2) perceptions of surgical risks and benefits, (3) knowledge of existing practice guidelines, and (4) barriers to surgery for patients with epilepsy. Neurologists who did not complete the questionnaire after the initial mailing were contacted a second time by e-mail, fax, or telephone. After this reminder, the survey was mailed a second time to any remaining nonresponders.Results: In total, 425 of 796 neurologists returned the questionnaire (response rate 53.5%). Respondents included 327 neurologists who followed patients with epilepsy in their practice. More than half (56.6%) of neurologists required patients to be drug-resistant and to have at least one seizure per year before considering surgery, and nearly half (48.6%) failed to correctly define drug-resistant epilepsy. More than 75% of neurologists identified inadequate health care resources as the greatest barrier to surgery for patients with epilepsy.Conclusions: A substantial proportion of Canadian neurologists are unaware of recommended standards of practice for epilepsy surgery. Access also appears to be a significant barrier to epilepsy surgery and surgical evaluation. As a result, we are concerned that patients with epilepsy are receiving inadequate care. A greater emphasis must be placed on knowledge dissemination and ensuring that the infrastructure and personnel are in place to allow patients to have timely access to this evidence-based treatment.