目的 调查西藏部分地区基层医生的服务现状和培训需求,提升当地基层医疗服务水平。方法 采用分层随机抽样方法,2023年3至6月对西藏自治区日喀则市、林芝市和阿里三地区基层医生进行调研。采用描述性统计分析,评估基层医生的人口学特征、服务实施情况和培训需求情况。结果 在服务现状方面,高血压、急性感染和关节疼痛为最常见病种。在基本医疗服务方面主要是血压和呼吸脉搏测量、伤口换药和家庭出诊;公共卫生服务则以健康教育、高血压管理和预防接种最为常见。培训需求分析显示,基层医生强烈要求开展实践技能、新技术和急救知识方面的培训,偏好线下培训模式,如实践演示和面授。此外,在院前急救和传染病知识培训方面,急救培训需求位列前3位的是心肺复苏、外伤处理和急性高原反应的救治;传染病知识培训需求方面主要是肺结核、肝炎和包虫病的防治。结论 西藏自治区基层医生在实践技能、医疗知识和急救技能方面存在迫切培训需求,面对面培训和现场操作示范效果最佳。特别需要加强心肺复苏、外伤处理和传染病防治等培训,以提升当地医生的理论与实践能力,进一步提高基层医疗服务水平。

Objective To investigate the service status and training needs of primary care physicians in some areas of Tibet, with the aim of improving the level of local primary medical services. Methods By stratified random sampling, the primary care physicians in Shigatse, Nyingchi and Ngari districts of Tibet were surveyed from March to June 2023. Descriptive statistical analysis was employed to evaluate the demographic characteristics, service implementation and training needs of primary care physicians. Results In terms of service status, hypertension, acute infection and joint pain were the most common diseases. In terms of basic medical services,blood pressure and respiratory rate measurement,wound dressing change and home visits were the main tasks; public health services mainly included health education, hypertension management, and vaccination. The analysis of training needs showed that primary care physicians had a strong demand for training in practical skills, emerging technologies, and first-aid knowledge, and preferred offline training modes, sush as real-operation demonstrations, and face-to-face teaching. In addition, in terms of pre-hospital first-aid and infectious disease knowledge training, the top three first-aid training demands were cardiopulmonary resuscitation,trauma management and acute altitude sickness treatment. In terms of infectious disease training, the primary areas of need included the prevention and control of tuberculosis, hepatitis, and echinococcosis. Conclusions Primary care physicians in Tibet have urgent training needs in practical skills, medical knowledge and first-aid skills, and face-to-face training and on-site operation demonstration have the most favorable effects. In particular, it is necessary to strengthen training in cardiopulmonary resuscitation, trauma management and prevention and treatment of infectious diseases, thereby strengthening the theoretical and practical abilities of primary care physicians and improving the level of primary healthcare.