目的 分析医务人员注意缺陷多动障碍( attention-deficit /hyperactivity disorder,ADHD)远程系统式执行技能训练的培训效果及其影响因素。方法 采用问卷调查和半结构化访谈方法。选取2020年11至12月参加由北京大学第六医院和重庆医科大学附属儿童医院联合举办的“ADHD远程系统式执行技能训练实操培训”训练班学员共73名为研究对象,在培训后进行课程设置评价问卷调查,培训前后分别进行学员自我效能感问卷调查。培训完成1年后,根据性别、职业、居住地等随机抽取8名学员进行访谈,并分析培训效果的影响因素。结果 学员对课程设置8项内容的满意度为97.3%～100.0%。培训后学员在ADHD诊疗的知识、技能、自信、胜任力知识掌握和胜任力实际操作的得分均高于培训前[7.0(2.0)分比5.0 (4.0)分,7.0(2.0)分比5.0 (4.0)分,7.0(2.0)分比5.0 (4.0)分,6.0(1.0)分比4.0 (2.0)分,5.0(1.0)分比4.0 (3.0)分,均P＜0.001];学员的逻辑动力自评得分低于培训前[10.0(4.0)分比10.0(4.5)分,P=0.020]访谈结果共总结出7个影响因素,其中学员从业经验、课程内容、教师教学水平被8名学员全部提及,此外还包括学员职业耗竭状态、学习动机、课程设置、患儿家长素质。结论 学员对ADHD远程系统式执行技能课程设置的满意度良好,培训后自我效能感明显提升。学员从业经验、课程内容、教师教学水平是ADHD远程系统式执行技能培训效果的重要影响因素。建议在保证课程质量的基础上,根据学员能力进行分班教学,进一步提升教师教学水平。
Objective To analyze the effectiveness and influencing factors of remote systematic execution skill training for attention deficit hyperactivity disorder (ADHD) in medical staffs. Methods questionnaire survey and semi-structured interview methods were used. A total of 73 participants in the ″ADHD systemic execution skills training practical training″ training course jointly organized by Peking University Sixth Hospital and Chongqing Medical University Affiliated Children′s Hospital from November to December 2020 were selected as the research subjects. The course evaluation questionnaire was conducted after the training, and the self-efficacy questionnaire was conducted before and after the training. After one year of training, 8 trainees were randomly selected based on gender, occupation, and place of residence for qualitative interviews, and the influencing factors of training effectiveness were analyzed. Results The satisfaction of trainees with the course design ranges from 97.3% to 100.0%. After training, the trainees′ scores in terms of knowledge, skills, confidence, competence, mastery of ADHD diagnosis and treatment, as well as practical operation of competence, were higher than before training [7.0(2.0) vs.5.0(4.0), 7.0(2.0) vs. 5.0(4.0), 7.0(2.0) vs. 5.0(4.0), 7.0(2.0) vs. 5.0(4.0). 6.0(1.0) vs. 4.0(2.0), 5.0(1.0) vs. 4.0(3.0)] (all P<0.001); The trainees′ self-evaluation score for logical motivation was lower than before the training [10.0(4.0) vs.10.0(4.5)] (P=0.020). The interview results had summarized a total of 7 influencing factors, among which 8 students mentioned their professional experience, course content, and teaching capacities of teachers. in addition, the occupational exhaustion state of the trainees, learning motivation, course setting and parental quality were also included. Conclusions The satisfaction of the trainees with the ADHD remote system execution skills course was good, and their self-efficacy significantly improved after the training. The professional experience of trainees, course content, and teacher influence are important influencing factors for the effectiveness of ADHD remote system execution skill training. It is recommended to ensure the quality of the course and divide teaching according to the existing professional experience of trainees, and further improve the teaching capacities of teachers.
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