Perceived barriers in the use of ultrasound in developing countries.
Perceived barriers in the use of ultrasound in developing countries.
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DOI：
10.1186/s13089-015-0028-2
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发表时间：
2015-12
影响因子：
--
通讯作者：
Sajed D
中科院分区：
文献类型：
--
作者：
Shah S;Bellows BA;Adedipe AA;Totten JE;Backlund BH;Sajed D
在包括发展中国家在内的资源有限的环境中，超声波的使用已大大增加;然而，发展中国家仍然缺乏超声波教育和受过超声波培训的医生支持。为了进一步调查这一潜在的知识差距，我们的主要目标是通过调查在低收入和中等收入环境中执业的护理提供者来评估在资源有限的环境中使用超声的感知障碍。向低收入和中等收入国家（LMIC）使用超声机的医疗保健提供者提供了一项25个问题的在线调查，包括医生，护士，技术人员和临床官员。这是从超声和放射学会的列表服务中获得的方便样本。对调查进行了分析，并获得了描述性结果。来自非洲、南美洲和亚洲等44个中低收入国家的138名受访者完成了调查，回复率为9.6%。91%的受访者是医生，9%是护士或其他提供者。超声的应用多种多样，包括产科（75%）、DVT评估（51%）、脓肿评估（54%）、心脏评估（64%）、下腔静脉（IVC）评估（49%）、创伤聚焦超声评估（FAST）检查（64%）、胆道树评估（54%）和其他应用。受访者确定了以下使用超声的障碍：缺乏培训（60%），缺乏设备（45%），超声机故障（37%）和缺乏超声维护能力（47%）。74%的受访者希望接受进一步的超声培训，82%的受访者愿意接受远程学习或超声造影培训。受试者使用包括Skype、Dropbox、电子邮件照片和图片存档和通信系统（PACS）在内的通信工具进行通信并接收超声图像反馈。发展中国家的医疗保健提供者认为，缺乏培训是在实践中定期使用超声波的主要障碍。虽然设备要求（包括机器的维护和成本）也是重要因素，但未来的研究需要对培训方法的最佳实践进行研究，包括超声造影和远程学习，以提高超声在低资源环境中的使用。
Access to ultrasound has increased significantly in resource-limited settings, including the developing world; however, there remains a lack of sonography education and ultrasound-trained physician support in developing countries. To further investigate this potential knowledge gap, our primary objective was to assess perceived barriers to ultrasound use in resource-limited settings by surveying care providers who practice in low- and middle-income settings. A 25-question online survey was made available to health care providers who work with an ultrasound machine in low- and middle-income countries (LMICs), including doctors, nurses, technicians, and clinical officers. This was a convenience sample obtained from list-serves of ultrasound and radiologic societies. The survey was analyzed, and descriptive results were obtained. One hundred and thirty-eight respondents representing 44 LMICs including countries from the continents of Africa, South America, and Asia completed the survey, with a response rate of 9.6 %. Ninety-one percent of the respondents were doctors, and 9 % were nurses or other providers. Applications for ultrasound were diverse, including obstetrics (75 %), DVT evaluation (51 %), abscess evaluation (54 %), cardiac evaluation (64 %), inferior vena cava (IVC) assessment (49 %), Focused Assessment Sonography for Trauma (FAST) exam (64 %), biliary tree assessment (54 %), and other applications. The respondents identified the following barriers to use of ultrasound: lack of training (60 %), lack of equipment (45 %), ultrasound machine malfunction (37 %), and lack of ultrasound maintenance capability (47 %). Seventy-four percent of the respondents wished to have further training in ultrasound, and 82 % were open to receiving distance learning or telesonography training. Subjects used communication tools including Skype, Dropbox, emailed photos, and picture archiving and communication system (PACS) as ways to communicate and receive feedback on ultrasound images. Health care providers in the developing world identify lack of training as a primary barrier to regular use of ultrasound in their practice. While equipment requirements including maintenance and cost of machines are also important factors, future research is warranted on best practices for training methods, including telesonography and distance learning to enhance ultrasound use in low-resource settings.