目的 调查西藏日喀则地区基层医疗机构全科医生培训的需求情况。方法 2022年3至6月,对西藏自治区日喀则市204家基层医疗机构进行网上调研,内容包括基本信息、临床技能培训需求以及社区慢病管理技能培训需求等8个类别。采用χ2检验分析不同特征全科医生的培训需求差异。结果 回收的275份有效问卷中,分别有195人(70.9%)、186人(67.6%)、216人(78.6%)对“清创、缝合、骨折固定等操作”“全科临床诊疗思维”“高血压慢病管理”有较高培训需求。不同工作年限全科医生的“穿刺、导尿、留置胃管等培训需求”差异有统计学意义(小于5年103人,5年及以上62人,P=0.001),不同学历医生的中(藏)医中(藏)药技术培训需求差异有统计学意义(本科以下25人,本科及以上138人,P=0.046),而不同执业类别全科医生的慢性肾脏病管理等需求差异有统计学意义(执业医师108人,执业助理医师31人,P=0.001)。结论 西藏日喀则地区基层全科医生培训需求较大且不同特征医生的需求各异,应结合高原地区特点和医生工作年限、学历、执业类别因素,开展有针对性的培训。
杨森
,
王俊鹏
,
张含之
,
葛许华
,
马乐
,
加参
,
洛桑仁增
,
石建军
,
于德华
. 西藏日喀则地区基层医疗机构全科医生培训需求分析[J]. 中华医学教育杂志, 2023
, 43(5)
: 381
-385
.
DOI: 10.3760/cma.j.cn115259-20220617-00795
Objective To investigate the needs for general practitioner (GP) training in primary care institutions in Shigatse, Tibet. Methods From March to June 2022, an online survey was conducted in 204 primary care institutions in Shigatse, Tibet Autonomous Region, covering eight categories, including basic information, clinical skills training needs, and community chronic disease management skills training needs and so on. The χ2 test was used to analyze the differences in training needs of GPs with different characteristics. Results Among the 275 valid questionnaires collected, 195 (70.9%), 186 (67.6%) and 216 (78.6%) had higher training needs for ″debridement, suturing, fracture fixation, etc.″ , ″clinical thought in general practice″ and ″hypertension management″. There were statistically significant differences in training needs for puncture, catheterization, and indwelling gastric tube among GPs with different working years (103 GPs with less than 5 years, 62 GPs with 5 years and above, P=0.001), and statistically significant differences in training needs for Chinese (Tibetan) medicine (TCM) techniques among GPs with different education levels (25 less than bachelor's degree, 138 bachelor's degree and above, P=0.046).And the difference in needs such as chronic kidney disease management among GPs in different practice categories was statistically significant (108 practicing physicians and 31 practicing assistant physicians, P=0.001). Conclusions In the Shigatse prefecture of Tibet, GPs have extensive and diverse training demands due to a variety of factors. A targeted training program should be implemented in accordance with the features of the plateau region and the GPs' practice categories, working years, and educational background.
[1] 任跃旺. 西藏农村公共服务配置效率研究[D].哈尔滨:东北林业大学,2019.
[2] 谭利霞. 西藏全科医生队伍建设现状及思考[J].中国农村卫生事业管理,2020,40(11):799-801,805. DOI: 10.3969/j.issn.1005-5916.2020.11.010.
[3] 中华人民共和国国家卫生和计划生育委员会. 《国务院办公厅关于改革完善全科医生培养与使用激励机制的意见》政策解读[J].中国实用乡村医生杂志,2018,25(3):2-4. DOI: 10.3969/j.issn.1672-7185.2018.03.002.
[4] 李一萱, 张阳, 于晓松. 中外全科医生岗位胜任力模型分析与借鉴[J].中华全科医师杂志,2021,20(2):248-252. DOI: 10.3760/cma.j.cn114798-20200603-00663.
[5] 关于印发健康中国行动——儿童青少年心理健康行动方案(2019-2022年)的通知[J].中华人民共和国国家卫生健康委员会公报,2019,(12):18-21.
[6] 李颖, 杨慧敏, 尹德卢. 基于基层常见病的全科医生继续医学教育内容需求研究[J].中国全科医学,2018,21(34):4246-4249. DOI: 10.12114/j.issn.1007-9572.2018.34.017.
[7] 徐仲卿, 施丹丹, 雍刚, 等. 社区管理层视角下的全科医生能力现状评价与培养需求调查[J].中华全科医师杂志,2020,19(6):522-527. DOI: 10.3760/cma.j.cn114798-20200916-00698.
[8] 范晓燕. 江苏省全科医师知识技能现况调查与需求分析[J].江苏卫生事业管理,2018,29(1):102-105. DOI: 10.3969/j.issn.1005-7803.2018.01.036.
[9] 李颖, 杨慧敏, 尹德卢. 基于基层常见病的全科医生继续医学教育内容需求研究[J].中国全科医学,2018,21(34):4246-4249. DOI: 10.12114/j.issn.1007-9572.2018.34.017.
[10] 安康,饶昕,苏巧俐,等.西藏自治区全科住院医师规范化培训委托培养的探索[J].中华全科医师杂志,2021,20(7):807-811. DOI: 10.3760/cma.j.cn114798-20201112-01139.
[11] Labasangzhu, Bjertness E, McNeil EB, et al. Progress and challenges in improving maternal health in the Tibet Autonomous Region, China[J]. Risk Manag Healthc Policy, 2018,11:221-231. DOI: 10.2147/RMHP.S170445.
[12] 于跃, 白国霞, 史恒. 2018年西藏自治区居民死因状况分析[J].中国保健营养,2020,30(23):345-346.
[13] 曾雪琴, 于伟, 孙雪, 等. 民族地区农村中医药服务发展研究[J].医学与法学,2022,14(3):67-71. DOI: 10.3969/j.issn.1674-7526.2022.03.013.
[14] 臧克承, 谢金平, 邵蓉. 西藏自治区藏药产业发展现状与对策建议[J].西藏大学学报(社会科学版),2021,36(2):186-193. DOI: 10.16249/j.cnki.1005-5738.2021.02.024.
[15] Zhang L, Wang Z, Chen Y, et al. Prevalence and risk factors associated with chronic kidney disease in adults living in 3 different altitude regions in the Tibetan Plateau[J]. Clin Chim Acta, 2018,481:212-217. DOI: 10.1016/j.cca.2018.03.025.
[16] Haldane V, Zhang Z, Ma Q, et al. A qualitative study of perspectives on access to tuberculosis health services in Xigaze, China[J]. Infect Dis Poverty, 2021,10(1):120. DOI: 10.1186/s40249-021-00906-4.
