Medical training fails to prepare providers to care for patients with chronic hepatitis B infection
Medical training fails to prepare providers to care for patients with chronic hepatitis B infection
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DOI：
10.3748/wjg.v21.i22.6914
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发表时间：
2015-06-14
影响因子：
4.3
通讯作者：
So, Samuel K.
中科院分区：
文献类型：
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作者：
Chao, Stephanie D.;Wang, Bing-Mei;So, Samuel K.
目的：调查医生的知识，包括慢性B型肝炎（CH B）的诊断，筛查和管理在不同阶段的培训。方法：一个自愿的20个问题的调查，在圣克拉拉县，加利福尼亚州，亚洲和太平洋岛民（API）占三分之一的人口。在219名参与者中，有63名实习医生，60名第二年的居民，26名总居民和70名主治医生。调查询问了关于受访者人口统计学、一般B型肝炎病毒知识问题（即，传播、患病率、诊断检测、预防和治疗选择），以及自我报告的实践行为和对知识的信心。只有24%的人确定了筛查CHB的正确测试，13%的人知道CHB测试阳性患者的下一步，18%的人知道API的高患病率，31%的人知道如何筛查肝癌Wald卡方分析确定了培训水平对知识的影响;在所有情况下，除了肝癌筛查知识（p = 0.0032），知识并没有显着增加住院医师培训或完成residence.CONCLUSION：即使在高风险地区，医学院和住院医师培训没有充分准备的医生在筛查和管理慢性乙型肝炎。
AIM: To investigate physicians' knowledge including chronic hepatitis B (CHB) diagnosis, screening, and management in various stages of their training.METHODS: A voluntary 20-question survey was administered in Santa Clara County, CA where Asian and Pacific Islanders (API) account for a third of the population. Among the 219 physician participants, there were 63 interns, 60 second-year residents, 26 chief residents and 70 attending physicians. The survey asked questions regarding respondents' demographics, general hepatitis B virus knowledge questions (i.e., transmission, prevalence, diagnostic testing, prevention, and treatment options), as well as, self-reported practice behavior and confidence in knowledge.RESULTS: Knowledge about screening and managing patients with CHB was poor: only 24% identified the correct tests to screen for CHB, 13% knew the next steps for patients testing positive for CHB, 18% knew the high prevalence rate among API, and 31% knew how to screen for liver cancer. Wald chi-square analysis determined the effect of training level on knowledge; in all cases except for knowledge of liver cancer screening (p = 0.0032), knowledge did not significantly increase with length in residency training or completion of residency.CONCLUSION: Even in a high-risk region, both medical school and residency training have not adequately prepared physicians in the screening and management of CHB.