目的：了解阿尔茨海默病（ AD）早期识别技能强化培训对社区医生的培训效果。方法于2013年6月—2014年4月，在北京市海淀区和朝阳区自愿参加本研究的7家社区卫生服务中心抽取符合本研究纳入及排除标准的社区医生63名。根据培训方法不同，将63名社区医生分为常规培训组（n＝31）和强化培训组（n＝32）。两组均接受集中授课，内容为AD筛查和诊疗技能，授课时长均为1 h。授课结束后，强化培训组进行每月1次的定期督导。比较两组培训前（t0）、培训后即刻（t1）及培训后3个月（t2）的知识得分、态度得分、病例分析正确率及AD筛查率。结果（1）培训前，两组间知识得分比较，差异无统计学意义（ P＞0.05）；培训后即刻、培训后3个月，两组间知识得分比较，差异有统计学意义（ P＜0.05）。培训后即刻，两组知识得分与培训前比较，差异有统计学意义（ P＜0.05）。培训后3个月，强化培训组知识得分与培训前比较，差异有统计学意义（ P＜0.05）；而常规培训组知识得分与培训前比较，差异无统计学意义（P＞0.05）。（2）培训前、培训后即刻、培训后3个月，两组间态度得分比较，差异均无统计学意义（ P＞0.05）；培训后3个月，强化培训组态度得分与培训前比较，差异有统计学意义（ P＜0.05）。（3）两组轻、中、重度病例分析正确率，培训后即刻与培训前比较，培训后3个月与培训前比较，差异均无统计学意义（P＞0.05）；培训后即刻，两组间轻度病例分析正确率比较，差异有统计学意义（P＜0.05）；培训后3个月，两组间重度病例分析正确率比较，差异有统计学意义（ P＜0.05）。（4）两组AD筛查率比较，差异有统计学意义（t＝2.24， P＝0.04）。结论 AD早期识别技能培训可以提高社区医生的AD知识水平，强化培训优于常规培训；强化培训也可以在一定程度上改善社区医生对AD患者的态度，提高AD筛查率，但对医生病例分析能力的提高不明显。%Objective To investigate the effectiveness of the training of community doctors on the skills of early recognition of Alzheimer disease .Methods From June 2013 to April 2014, we enrolled 63 community doctors who accorded with the inclusion and exclusion criteria from 7 community health service centers in Haidian District and Chaoyang District of Beijing that were volunteer to participate in the study .According to the training methods , we divided the enrolled community doctors into two groups: conventional training group ( n =31 ) and intensive training group ( n =32 ) .The two groups both received concentrated training on skills for AD screening , diagnosis and treatment for 1 hour.After training , the intensive training group received supervision once per month .Before training ( t0 ) , immediately after training ( t1 ) and three months after training ( t2 ) , the two groups were compared by the scores of knowledge and attitude , the accuracy rate of case analysis and AD screening rate.Results (1) Before training, the two groups were not significantly different in the score of knowledge (P >0.05);immediately after training and three months after training , the two groups were significantly different in the score of knowledge ( P<0.05) .Immediately after training, the scores of knowledge of the two groups were significantly different from those before training ( P<0.05 ) .Three months after training , the score of knowledge of the intensified training group was significantly different from that before training (P<0.05), while the score of knowledge of conventional group was not significantly different from that before training (P>0.05) .(2) Before training, immediately after training and three months after training , the two groups were not significantly different in the score of attitude ( P>0.05); three months after training , the score of attitude of the intensified training group was significantly different from that before training (P<0.05) .(3) The accuracy rate of analysis of mild, medium and severe cases had no significant change ( P>0.05) immediately after training and three months after training , compared with that before training; immediately after training , the two groups were significantly different ( P<0.05 ) in the accuracy rate of analysis of mild cases; three months after training, the two groups were significantly different (P<0.05) in the accuracy rate of analysis of severe cases .(4) The two groups were significantly different in AD screening rate ( t=2.24, P=0.04) .Gonclusion The training of community doctors on the skills of early recognition of AD can increase the professional knowledge of community doctors , and intensified training is superior to conventional training; intensified training can improve community doctors′attitude towards AD patients and raise AD screening rate , while it can not significantly improve doctors′ability of case analysis.
展开▼
