Abstract: Background　The number of patients with coronary heart disease（CHD）is increasing year by year in China. As an important means of prevention and treatment，cardiac rehabilitation can improve the quality of life，reduce the readmission rate and mortality of CHD patients. However，community-based cardiac rehabilitation is less developed at present，and CHD patients have gained less merits from sleeping guidance，psychological counseling and cardiac risk assessment in exercise. Objective　To explore community general practitioners'（GPs'）perception of community-based cardiac rehabilitation for stable coronary artery disease（SCAD）providing a scientific basis for the development of community-based cardiac rehabilitation. Methods　By use of cluster sampling，we selected frontline general practitioners（GPs）（n=212）from 5 community health centers（Yuetan，Guangwai，Zhanzhan Road，Taoranting，Desheng）in November 2020. Then we conducted a survey on wjx.cn（an online questionnaire survey platform）using a self-administered questionnaire（consisting of basic demographics，attitudes and perceptions regarding community-based cardiac rehabilitation for SCAD，essential knowledge and practice of cardiac rehabilitation）developed by us，and invited the GPs to anonymously complete the survey via scanning the WeChat QR code or printed QR code using a mobile phone or computer between November 26 and December 31，2020. The survey data were collected to input into a database，and analyzed for understanding GPs' perceptions of community-based cardiac rehabilitation for SCAD. Willingness of community GPs' to provide community-based cardiac rehabilitation services for patient swith SCAD and scores of GPs obtained by answering the questions about community-based cardiac rehabilitation for SCAD by demographic factors were compared. Binary Logistic regression was used to identify potential factors associated with community GPs' willingness to provide community-based cardiac rehabilitation services for SCAD patients. Results　A survey response rate of 98.1%（208/212）was obtained. In accordance with the analysis，of the respondents，91.3%（190/208）thought that SCAD patients need community-based cardiac rehabilitation，90.4%（188/208）thought that community-based cardiac rehabilitation could be safely implemented without monitoring，74.0%（154/208）were willing to provide the services. Binary Logistic regression analysis showed that participating in cardiac rehabilitation training for CHD patients 〔OR（95%CI）=6.042（1.935，18.867），P<0.05〕，and perceptions of SCAD patients needing community-based cardiac rehabilitation〔OR（95%CI）=10.792（2.361，49.336），P<0.05〕 were associated with community GPs' willingness to provide community-based cardiac rehabilitation services for SCAD patients. The respondents obtained an average SCAD cardiac rehabilitation knowledge test score of（70.12±9.54），with a pass rate of 86.5%（180/208）.  There is a statistically significant difference in SCAD cardiac rehabilitation knowledge test score among  professional title groups（P<0.001）. The correct rates of the respondents answering "basic concept of cardiac rehabilitation" "selection of target population for intervening" "health education" "follow-up" and "psychological and sleep management" were 94.2%（196/208），90.4%（188/208），98.6%（205/208），92.8%（193/208），and 98.1%（204/208），respectively. But the correct rates of them answering "comprehensive cardiovascular evaluation" "cardiovascular risk control" "risk stratification of coronary heart disease" and "formulation of exercise prescription" were 1.9%（4/208），1.9%（4/208），3.4%（7/208），and 1.4%（3/208），respectively. Only 10.1%（21/208）of the respondents knew the 6-min walk test and often used it. Conclusion　The GPs generally thought that community-based cardiac rehabilitation services for SCAD patients is necessary and feasible，and they were willing to provide such services with high enthusiasm，but their awareness rate of key contents of SCAD cardiac rehabilitation was low. To ensure the successful implementation of community-based cardiac rehabilitation，multi-party collaboration should be strengthened to improve GPs' community cardiac rehabilitation skills.

Key words: Cardiac rehabilitation, Stable coronary artery diseases, General practitioners, Community health services, Beijing

摘要： 背景　在我国冠心病发病率逐年增加的背景下，心脏康复作为心血管事件预防和治疗的重要手段，可以提高冠心病患者生活质量，降低其再住院率及死亡率。目前，社区心脏康复开展较少，且社区全科医生为稳定性冠心病（SCAD）患者提供的睡眠指导、心理疏导、运动风险信息等仍不充分。目的　调查社区全科医生对SCAD社区心脏康复的认知情况，旨在为开展社区心脏康复工作提供科学依据。方法　于2020年11月，采用整群抽样法，抽取北京市西城区5家社区卫生服务中心（月坛、广外、展览路、陶然亭、德胜）从事临床一线工作的全科医生212例进行问卷调查。由课题组自行研制问卷，内容包括社区全科医生基本情况、对SCAD社区心脏康复的看法与态度、SCAD心脏康复基本知识与实践。问卷通过“问卷星”网站发布，于2020-11-26至2020-12-31通过微信或纸质二维码向参与调查的社区全科医生进行推送。调查对象通过手机/电脑“问卷星”在线填写的方式完成调研。完成调研数据收集后，建立数据库，对社区全科医生SCAD社区心脏康复认知情况进行分析。比较不同特征社区全科医生为SCAD患者提供社区心脏康复服务的意愿及对SCAD心脏康复相关知识的掌握情况，采用二元Logistic回归分析探讨影响社区全科医生为SCAD患者提供心脏康复服务意愿的因素。结果　共发放问卷212份，回收有效问卷208份，有效问卷回收率为98.1%。190例（91.3%）社区全科医生认为SCAD患者需要进行社区心脏康复；188例（90.4%）认为SCAD患者进行社区心脏康复是安全的；154例（74.0%）愿意为SCAD患者提供社区心脏康复。参加过冠心病患者心脏康复相关培训、认为SCAD患者需要进行社区心脏康复及认为SCAD患者进行社区心脏康复是安全的社区全科医生更愿意为SCAD患者提供社区心脏康复服务（P<0.05）。二元Logistic回归分析结果显示，是否参加过冠心病心脏康复相关培训〔OR（95%CI）=0.193（0.063，0.591），P<0.05〕和是否认为SCAD患者需要进行社区心脏康复〔OR（95%CI）=0.092（0.021，0.401），P<0.05〕是影响社区全科医生为SCAD患者提供社区心脏康复服务意愿的因素。社区全科医生SCAD心脏康复知识测评平均得分为（70.12±9.54）分，及格率为86.5%（180/208）。不同职称的社区全科医生SCAD心脏康复知识测评得分比较，差异有统计学意义（P<0.001）。社区全科医生对“心脏康复基本概念”“干预对象筛选”“健康教育”“随访”“心理和睡眠管理”5个方面知识点的回答正确率分别为94.2%（196/208）、90.4%（188/208）、98.6%（205/208）、92.8%（193/208）、98.1%（204/208），对“心血管综合评估”“心血管危险因素控制”“冠心病危险分层”“运动处方制定”4个方面知识点的回答正确率分别为1.9%（4/208）、1.9%（4/208）、3.4%（7/208）、1.4%（3/208）。仅有21例（10.1%）社区全科医生对6 min步行试验表示“了解并经常进行试验”。结论　北京市西城区社区全科医生普遍认为为SCAD患者提供社区心脏康复服务是必要、可行的，且对参与SCAD社区心脏康复工作具有较高的积极性，但对SCAD社区心脏康复重点知识的知晓率仍然偏低。今后需多方联动，提升社区全科医生心脏康复认知、技能水平，方能保障SCAD社区心脏康复工作的顺利开展。

关键词: 心脏康复, 稳定性冠心病, 全科医生, 社区卫生服务, 北京