中国临床实践指南制订者对患者指南认知度的调查
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摘要
目的了解我国指南制订相关领域的专家及研究人员对患者指南(patient version of guidelines,PVG)的认知度。方法在"2017中国医师协会循证医学专业年会暨甘肃省医师协会/甘肃省医学会循证医学专业年会"会议期间,对指南制订专场的参会人员发放纸质版问卷调查;同时跟随国家卫生计生委医管中心标准处的指南调研团队进一步调查深圳、广州、西安、北京等地的指南制订者对PVG的认知度。问卷设计了10个问题以了解被调查者对PVG的知晓度及对PVG制订过程的看法与意见。排除无效问卷后采用Excel 2013软件进行数据录入,采用SPSS 19.0软件进行数据分析。结果共发放调查问卷150份,回收问卷107份(71.3%),其中有效问卷90份(60.0%)。关于PVG的知晓度:30.0%的被调查者停留在"仅听说过"的层面,34.4%的被调查者表示"未听说过";且知晓度与学历、部门、专业、地区间均无显著相关性(P>0.05)。关于对PVG本身及其制订过程的看法与意见:86.7%的被调查者认为需要制订PVG;90%的被调查者认为需要参照一定的规范来呈现和报告PVG;45.6%的被调查者认为制订PVG最大的障碍在于认知不足。结论 PVG制订目前在中国正处于起步阶段,国内指南相关专家对其认知度较低,PVG的制订方法也有待进一步探索。未来应积极开展相关研究促进并推广PVG在国内的发展与应用,从而促进临床实践的优化。
Objectives To investigate the awareness and knowledge of Chinese guideline developers on the patient version of guidelines(PVG). Methods A questionnaire was developed and distributed to participants of the guideline development workshop on the "2017 Chinese Medical Doctor Association Annual Conference on Evidence-Based Medicine & Gansu Medical Doctor Association/Gansu Medical Association Annual Conference on Evidence-Based Medicine", and guideline developers in Shenzhen, Guangzhou, Xi'an, Beijing and other places were investigated through field surveys. The questionnaire included ten questions centred on respondents' awareness and their views on the development of PVG. After the invalid questionnaire was excluded, Excel 2013 software was used for data entry,and SPSS 19.0 software was used for data analysis. Results 150 questionnaires were distributed and 107(71.3%) were collected, from which 90(60.0%) questionnaires with complete response were analyzed. For the awareness of PVG:30.0% of respondents chose "just know it without more knowledge", 34.4% chose "never heard of". The awareness was not associated with educational or departmental background, majors and regions(P>0.05). For opinions on PVG and its development process: 86.7% of the respondents thought PVG is necessary, 90% thought the presentation of PVG needs to follow reporting standards, and 45.6% thought the primary barrier of the development of PVG is lack of cognition.Conclusions Research work on PVGs is at an initial stage in China. The awareness among Chinese guideline developers and relevant researchers is lacking and the development methodology requires further exploration. Carrying out research relevant to PVG can promote its development and application in China, so as to improve the clinical practice.
Objectives To investigate the awareness and knowledge of Chinese guideline developers on the patient version of guidelines(PVG). Methods A questionnaire was developed and distributed to participants of the guideline development workshop on the "2017 Chinese Medical Doctor Association Annual Conference on Evidence-Based Medicine & Gansu Medical Doctor Association/Gansu Medical Association Annual Conference on Evidence-Based Medicine", and guideline developers in Shenzhen, Guangzhou, Xi'an, Beijing and other places were investigated through field surveys. The questionnaire included ten questions centred on respondents' awareness and their views on the development of PVG. After the invalid questionnaire was excluded, Excel 2013 software was used for data entry,and SPSS 19.0 software was used for data analysis. Results 150 questionnaires were distributed and 107(71.3%) were collected, from which 90(60.0%) questionnaires with complete response were analyzed. For the awareness of PVG:30.0% of respondents chose "just know it without more knowledge", 34.4% chose "never heard of". The awareness was not associated with educational or departmental background, majors and regions(P>0.05). For opinions on PVG and its development process: 86.7% of the respondents thought PVG is necessary, 90% thought the presentation of PVG needs to follow reporting standards, and 45.6% thought the primary barrier of the development of PVG is lack of cognition.Conclusions Research work on PVGs is at an initial stage in China. The awareness among Chinese guideline developers and relevant researchers is lacking and the development methodology requires further exploration. Carrying out research relevant to PVG can promote its development and application in China, so as to improve the clinical practice.
引文
1胡雁.用循证护理的观念评估“临床实践指南”,护士进修杂志,2005,20(4):309-311.
2赵静.医患关系与病人权益.中医药管理杂志,2007, 15(12):930-931.
3袁一君,颜美琼.患者参与医疗护理决策现状及影响因素研究进展.护理学杂志,2013, 28(5):93-96.
4 Legare F, Boivin A, Weijden TVD, et al. Patient and public involvement in clinical practice guidelines a knowledge synthesis of existing programs. Med Decis Making,2011,31(6):E45-74.
5 Hm VDB, Zuiderent-Jerak T. An empirical study of patient participation in guideline development:exploring the potential for articulating patient knowledge in evidence-based epistemic settings. Health Expect, 2015,18(5):942-945.
6 Kryworuchko J, Stacey D, Bai N, et al. Twelve years of clinical practice guideline development, dissemination and evaluation in Canada(1994 to 2005). Implement Sci,2009,4(1):49.
7肖淑君,高玉婷,王小琴,等.患者指南及其制订方法介绍.药品评价,2017, 14(6):44-48.
8李艳,陈耀龙,陈静,等.心肌梗死二级预防非药物措施患者指南的研制思路.中国循证医学杂志,2016,16(5):617-620.
9张琼文,万晓莉,刘颖,等.病人参与临床决策现状调查与分析.中国循证医学杂志,2010, 10(1):10-13.
10解染,陈耀龙,陈昊,等.循证指南制定中患者价值观和偏好的研究方法.中国循证医学杂志,2015,15(5):586-591.
11 Equator network. Reporting items for public version of guidelines:RIGHT-PVG. Available at:http://www.equator-network.org/library/reporting-guidelines-under-development/#84.
12姜雨婷,田润溪,段思柳,等.对糖尿病高危足患者指南制定的思考.中国护理管理,2016,16(12):1628-1632.
13王小琴,童雅婧,何江华,等.患者指南制订的基本原则和方法(一).中国循证儿科杂志,2017, 12(6):476-478.
14 Wang X, Xiao S, Gao Y, et al. Who is responsible for developing patient guidelines? Available at:https://www.globalevidencesummit.org/abstracts/who-responsible-developing-patient-guidelines.
15 Loudon K, Santesso N, Callaghan M, et al. Patient and public attitudes to and awareness of clinical practice guidelines:a systematic review with thematic and narrative syntheses. BMC Health ServRes, 2014, 14(1):321.
16 Santesso N, Morgano GP, Jack SM, et al. Dissemination of clinical practice guidelines:a content analysis of patient versions. Med Decis Making, 2016, 36(6):692-702.
17 Health NCCFM. Depression:the treatment and management of depression in adults(updated edition). 2010.
18 Brouwers MC, Vukmirovic M, Spithoff K, et al. Understanding optimal approaches to patient and caregiver engagement in the development of cancer practice guidelines:a mixed methods study.BMC Health Serv Res, 2017, 17(1):186.
19 Rgn GMC, Dphil PSB. Patient-controlled analgesia:what information does the patient want? J Adv Nurs,2002, 39(5):459-471.
20陈耀龙,姚亮,王琪,等.甘肃省皋兰县基层医务工作者对临床实践指南的认知、态度与行为调查.中国循证医学杂志,2014,14(6):674-677.
21胡晶,陈茹,谢雁鸣,等.科学和规范的改编临床实践指南.中国循证儿科杂志,2012, 7(3):226-230.
22 Schaefer C. How to develop patient versions of guidelines.Guidelines International Network(GIN). GIN public toolkit:patient and public involvement in guidelines. Berlin:GIN office,2012:52-59.
2赵静.医患关系与病人权益.中医药管理杂志,2007, 15(12):930-931.
3袁一君,颜美琼.患者参与医疗护理决策现状及影响因素研究进展.护理学杂志,2013, 28(5):93-96.
4 Legare F, Boivin A, Weijden TVD, et al. Patient and public involvement in clinical practice guidelines a knowledge synthesis of existing programs. Med Decis Making,2011,31(6):E45-74.
5 Hm VDB, Zuiderent-Jerak T. An empirical study of patient participation in guideline development:exploring the potential for articulating patient knowledge in evidence-based epistemic settings. Health Expect, 2015,18(5):942-945.
6 Kryworuchko J, Stacey D, Bai N, et al. Twelve years of clinical practice guideline development, dissemination and evaluation in Canada(1994 to 2005). Implement Sci,2009,4(1):49.
7肖淑君,高玉婷,王小琴,等.患者指南及其制订方法介绍.药品评价,2017, 14(6):44-48.
8李艳,陈耀龙,陈静,等.心肌梗死二级预防非药物措施患者指南的研制思路.中国循证医学杂志,2016,16(5):617-620.
9张琼文,万晓莉,刘颖,等.病人参与临床决策现状调查与分析.中国循证医学杂志,2010, 10(1):10-13.
10解染,陈耀龙,陈昊,等.循证指南制定中患者价值观和偏好的研究方法.中国循证医学杂志,2015,15(5):586-591.
11 Equator network. Reporting items for public version of guidelines:RIGHT-PVG. Available at:http://www.equator-network.org/library/reporting-guidelines-under-development/#84.
12姜雨婷,田润溪,段思柳,等.对糖尿病高危足患者指南制定的思考.中国护理管理,2016,16(12):1628-1632.
13王小琴,童雅婧,何江华,等.患者指南制订的基本原则和方法(一).中国循证儿科杂志,2017, 12(6):476-478.
14 Wang X, Xiao S, Gao Y, et al. Who is responsible for developing patient guidelines? Available at:https://www.globalevidencesummit.org/abstracts/who-responsible-developing-patient-guidelines.
15 Loudon K, Santesso N, Callaghan M, et al. Patient and public attitudes to and awareness of clinical practice guidelines:a systematic review with thematic and narrative syntheses. BMC Health ServRes, 2014, 14(1):321.
16 Santesso N, Morgano GP, Jack SM, et al. Dissemination of clinical practice guidelines:a content analysis of patient versions. Med Decis Making, 2016, 36(6):692-702.
17 Health NCCFM. Depression:the treatment and management of depression in adults(updated edition). 2010.
18 Brouwers MC, Vukmirovic M, Spithoff K, et al. Understanding optimal approaches to patient and caregiver engagement in the development of cancer practice guidelines:a mixed methods study.BMC Health Serv Res, 2017, 17(1):186.
19 Rgn GMC, Dphil PSB. Patient-controlled analgesia:what information does the patient want? J Adv Nurs,2002, 39(5):459-471.
20陈耀龙,姚亮,王琪,等.甘肃省皋兰县基层医务工作者对临床实践指南的认知、态度与行为调查.中国循证医学杂志,2014,14(6):674-677.
21胡晶,陈茹,谢雁鸣,等.科学和规范的改编临床实践指南.中国循证儿科杂志,2012, 7(3):226-230.
22 Schaefer C. How to develop patient versions of guidelines.Guidelines International Network(GIN). GIN public toolkit:patient and public involvement in guidelines. Berlin:GIN office,2012:52-59.