安宁疗护医生麻醉药品相关知识掌握分析——基于上海市社区卫生服务中心的调查
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摘要
采用问卷自填法研究上海市社区卫生服务中心安宁疗护医生麻醉药品相关知识掌握的情况,为提升基层安宁疗护医生服务能力,更好开展安宁疗护工作提供参考依据。结果发现关于疼痛评估的题目正确率总体较低,动态评估、剂量换算、阿片类药物耐受定义等知识正确率最低。麻醉药品相关知识测试及格率与上一年度培训天数、职称、社区卫生服务中心所在区县有关。提示基层安宁疗护医生麻醉药品相关知识掌握不足。应加强针对性的知识培训;加强激励提升医生工作态度;适当给予郊区社区卫生服务中心优惠政策,吸引优秀人才,均衡配置医疗资源。
The authors conducted a questionnaire survey to study the acquirement of knowledge on narcotic drugs of doctors who provide palliative care in community health service centers in Shanghai, in order to improve the service capacity of doctors at primary level, and to provide reference for further effective development of palliative care. The results showed that the correct rates of pain assessment were generally low, while the rates of dynamic assessment, dose conversion and definition of opioid tolerance were the lowest. The doctors' passing rate of narcotic drug related knowledge test was related to the number of training days in the last year, their professional titles and the districts and counties where the community health service centers are located. The results showed that narcotic drug-related knowledge of doctors provided palliative care at primary level was insufficient. We should strengthen targeted knowledge training, strengthen incentives to enhance doctors' working attitude, and give appropriate preferential policies to suburban community health service centers to attract talented people and allocate medical resources in a balanced manner.
The authors conducted a questionnaire survey to study the acquirement of knowledge on narcotic drugs of doctors who provide palliative care in community health service centers in Shanghai, in order to improve the service capacity of doctors at primary level, and to provide reference for further effective development of palliative care. The results showed that the correct rates of pain assessment were generally low, while the rates of dynamic assessment, dose conversion and definition of opioid tolerance were the lowest. The doctors' passing rate of narcotic drug related knowledge test was related to the number of training days in the last year, their professional titles and the districts and counties where the community health service centers are located. The results showed that narcotic drug-related knowledge of doctors provided palliative care at primary level was insufficient. We should strengthen targeted knowledge training, strengthen incentives to enhance doctors' working attitude, and give appropriate preferential policies to suburban community health service centers to attract talented people and allocate medical resources in a balanced manner.
引文
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[2]民政部.2017年社会服务发展统计公报[EB/OL].(2018-08-02)[2018-08-19].http://www.mca.gov.cn/article/sj/tjgb/2017/201708021607.pdf.
[3]《中国卫生和计划生育统计年鉴》编辑委员会.中国卫生和计划生育统计年鉴[M].北京:中国协和医科大学出版社,2017:283.
[4]吴瑾,李先锋,万忠艳,等.妇科癌症晚期15例的临终关怀[J].中国误诊学杂志,2010,10(8):1916-1917.
[5]周宁,姜姗.安宁疗护患者临终前镇痛镇静药物的应用及风险防范[J].医学与哲学,2018,39(4B):18-20.
[6]华桂珍,鲍春燕,杨丽娜,等.肿瘤科护士的疼痛知识、疼痛护理态度及行为倾向调查[J].宁夏医科大学学报,2014,36(12):1356-1359.
[7]贺丽春,陶新陆.实习护生疼痛处理知识、态度和行为倾向的调查[J].中国药物依赖性杂志,2011,20(6):467-473.
[8]贺丽春.护理专业大学生疼痛处理知识、态度和行为倾向的调查研究[D].长沙:中南大学,2009.
[9]冯金娥,袁红娣,吴亚君.护士对用麻醉性镇痛药治疗疼痛发生成瘾的可能性的认识调查分析[J].中国药物依赖性杂志,2005(4):303-305.
[10]童苏琴,应秋平,王玉梅.基层医院护士对麻醉性镇痛药成瘾性的认识现状及对策[J].护理与康复,2012,11(10):920-921.
[11]刘玉平,李瑞,樊桂莲,等.外科护士疼痛知识、态度及疼痛处理现况调查分析[J].全科护理,2018,16(18):2280-2282.
[12]刘晓燕,栾晓嵘,郭锦娜,等.妇科护理人员肿瘤疼痛护理知识与态度调查[J].齐鲁护理杂志,2015,21(7):50-52.
[13]应秋平,冯金娥,童莺歌,等.基层医院临床护士疼痛认知状况调查及对策[J].护理与康复,2011,10(6):477-479.
[14]王明.社区卫生服务中心安宁舒缓疗护服务现况调查[J].中国农村卫生,2017(7):64.
[15]国家卫生与计划生育委员会.国家卫生计生委办公厅关于印发安宁疗护实践指南(试行)的通知[EB/OL].(2017-02-09)[2018-08-19].http://www.moh.gov.cn/yzygj/s3593/201702/83797c0261a94781b158dbd76666b717.shtml.
[16]谭诚炜.三阶梯镇痛简介及其应用现况[J].上海医药,2015,36(2):46-48.
[17]宁艳阳.专家联合倡议“绿色镇痛”[N].健康报,2012-09-24(1).
[18]韩娜,于世英,褚倩.安宁疗护的核心症状和常用药物[J].医学与哲学,2018,39(4B):10-13.