Chinese General Practice ›› 2023, Vol. 26 ›› Issue (07): 869-876.DOI: 10.12114/j.issn.1007-9572.2022.0405
• Original Research·Focus on Clinical Practice and Improvement • Previous Articles Next Articles
Received:
2022-06-09
Revised:
2022-11-05
Published:
2023-03-05
Online:
2023-01-05
Contact:
GU Jie
通讯作者:
顾杰
作者简介:
基金资助:
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URL: https://www.chinagp.net/EN/10.12114/j.issn.1007-9572.2022.0405
类别 | 例数 | 房颤基本知识 | 抗凝治疗知识 | 心律/心率控制知识 | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
不及格 | 及格 | 良好 | 优秀 | 不及格 | 及格 | 良好 | 优秀 | 不及格 | 及格 | 良好 | 优秀 | ||
全科医生 | 506 | 149(29.45) | 172(33.99) | 138(27.27) | 47(9.29) | 483(95.45) | 18(3.56) | 3(0.59) | 2(0.39) | 273(53.95) | 168(33.20) | 54(10.67) | 11(2.17) |
护士 | 441 | 305(69.16) | 95(21.54) | 39(8.84) | 2(0.45) | 435(98.64) | 5(1.13) | 1(0.23) | 0 | 348(78.91) | 75(17.01) | 18(4.08) | 0 |
药剂师 | 117 | 83 (70.94) | 32(27.35) | 2(1.71) | 0 | 114(97.43) | 3(2.56) | 0 | 0 | 75(64.10) | 25(21.37) | 17(14.53) | 0 |
公共卫生医师 | 115 | 85(73.91) | 26(22.61) | 4(3.48) | 0 | 115(100.00) | 0 | 0 | 0 | 108(93.91) | 7(6.09) | 0 | 0 |
其他医务人员 | 204 | 137(67.16) | 48(23.53) | 12(5.88) | 7(3.43) | 204(100.00) | 0 | 0 | 0 | 159(77.94) | 38(18.63) | 7(3.43) | 0 |
H值 | 256.096 | 20.529 | 116.236 | ||||||||||
P值 | <0.001 | <0.001 | <0.001 |
Table 1 Comparison of the scores of atrial fibrillation knowledge,anticoagulation knowledge and heart rhythm/heart rate control knowledge among grassroots medical staff in different positions
类别 | 例数 | 房颤基本知识 | 抗凝治疗知识 | 心律/心率控制知识 | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
不及格 | 及格 | 良好 | 优秀 | 不及格 | 及格 | 良好 | 优秀 | 不及格 | 及格 | 良好 | 优秀 | ||
全科医生 | 506 | 149(29.45) | 172(33.99) | 138(27.27) | 47(9.29) | 483(95.45) | 18(3.56) | 3(0.59) | 2(0.39) | 273(53.95) | 168(33.20) | 54(10.67) | 11(2.17) |
护士 | 441 | 305(69.16) | 95(21.54) | 39(8.84) | 2(0.45) | 435(98.64) | 5(1.13) | 1(0.23) | 0 | 348(78.91) | 75(17.01) | 18(4.08) | 0 |
药剂师 | 117 | 83 (70.94) | 32(27.35) | 2(1.71) | 0 | 114(97.43) | 3(2.56) | 0 | 0 | 75(64.10) | 25(21.37) | 17(14.53) | 0 |
公共卫生医师 | 115 | 85(73.91) | 26(22.61) | 4(3.48) | 0 | 115(100.00) | 0 | 0 | 0 | 108(93.91) | 7(6.09) | 0 | 0 |
其他医务人员 | 204 | 137(67.16) | 48(23.53) | 12(5.88) | 7(3.43) | 204(100.00) | 0 | 0 | 0 | 159(77.94) | 38(18.63) | 7(3.43) | 0 |
H值 | 256.096 | 20.529 | 116.236 | ||||||||||
P值 | <0.001 | <0.001 | <0.001 |
自变量 | 单因素Logistic回归分析 | 有序多分类Logistic回归分析 | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
b | SE | Wald χ2值 | P值 | OR(95%CI) | b | SE | Wald χ2值 | P值 | OR(95%CI) | ||
性别(以女为参照) | |||||||||||
男 | 0.313 | 0.132 | 5.619 | 0.018 | 1.368(1.056,1.772) | 0.124 | 0.140 | 0.786 | 0.375 | 1.132(0.860,1.491) | |
年龄(原值进入) | 0.011 | 0.006 | 3.577 | 0.049 | 1.011(1.001,1.023) | -0.004 | 0.009 | 0.186 | 0.666 | 0.996(0.978,1.014) | |
学历(以硕士研究生及以上为参照) | |||||||||||
初中/中专及以下 | -1.724 | 0.543 | 10.077 | 0.002 | 0.178(0.062,0.517) | -0.428 | 0.588 | 0.531 | 0.466 | 0.652(0.206,2.062) | |
大专 | -1.756 | 0.431 | 16.639 | <0.001 | 0.173(0.074,0.402) | -0.539 | 0.459 | 1.379 | 0.240 | 0.583(0.237,1.434) | |
本科 | -1.200 | 0.419 | 8.205 | 0.004 | 0.301(0.132,0.685) | -0.499 | 0.441 | 1.281 | 0.258 | 0.607(0.256,1.440) | |
工作岗位(以非全科医生为参照) | |||||||||||
全科医生 | 1.786 | 0.114 | 244.835 | <0.001 | 5.963(4.768,7.458) | 1.601 | 0.137 | 137.024 | <0.001 | 4.958(3.792,6.482) | |
职称(以副高级及以上为参照) | |||||||||||
无 | -1.174 | 0.270 | 18.962 | <0.001 | 0.309(0.182,0.524) | -0.636 | 0.345 | 3.408 | 0.065 | 0.529(0.269,1.040) | |
初级 | -1.454 | 0.235 | 38.375 | <0.001 | 0.234(0.148,0.370) | -0.815 | 0.278 | 8.615 | 0.003 | 0.443(0.257,0.763) | |
中级 | -1.010 | 0.232 | 18.899 | <0.001 | 0.364(0.231,0.574) | -0.544 | 0.244 | 4.989 | 0.026 | 0.580(0.360,0.936) | |
有无在上级医院工作的经历(以无为参照) | |||||||||||
有 | 0.304 | 0.115 | 7.033 | 0.008 | 1.355(1.083,1.696) | 0.205 | 0.126 | 2.639 | 0.104 | 1.227(0.959,1.571) | |
是否接受过规范化培训(以否为参照) | |||||||||||
是 | 1.005 | 0.145 | 47.749 | <0.001 | 2.731(2.054,3.632) | 0.216 | 0.191 | 1.287 | 0.257 | 1.242(0.854,1.805) | |
一年内是否阅读过房颤指南(以否为参照) | |||||||||||
是 | 0.330 | 0.120 | 7.596 | 0.006 | 1.391(1.100,1.759) | -0.005 | 0.142 | 0.001 | 0.972 | 0.995(0.753,1.315) | |
一年内是否参加过房颤相关培训(以否为参照) | |||||||||||
是 | 0.322 | 0.125 | 6.609 | 0.010 | 1.380(1.079,1.763) | 0.080 | 0.149 | 0.287 | 0.592 | 1.083(0.809,1.449) |
Table 2 Logistic regression analysis of influencing factors of score in the basic knowledge related to atrial fibrillation among grassroots medical staff
自变量 | 单因素Logistic回归分析 | 有序多分类Logistic回归分析 | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
b | SE | Wald χ2值 | P值 | OR(95%CI) | b | SE | Wald χ2值 | P值 | OR(95%CI) | ||
性别(以女为参照) | |||||||||||
男 | 0.313 | 0.132 | 5.619 | 0.018 | 1.368(1.056,1.772) | 0.124 | 0.140 | 0.786 | 0.375 | 1.132(0.860,1.491) | |
年龄(原值进入) | 0.011 | 0.006 | 3.577 | 0.049 | 1.011(1.001,1.023) | -0.004 | 0.009 | 0.186 | 0.666 | 0.996(0.978,1.014) | |
学历(以硕士研究生及以上为参照) | |||||||||||
初中/中专及以下 | -1.724 | 0.543 | 10.077 | 0.002 | 0.178(0.062,0.517) | -0.428 | 0.588 | 0.531 | 0.466 | 0.652(0.206,2.062) | |
大专 | -1.756 | 0.431 | 16.639 | <0.001 | 0.173(0.074,0.402) | -0.539 | 0.459 | 1.379 | 0.240 | 0.583(0.237,1.434) | |
本科 | -1.200 | 0.419 | 8.205 | 0.004 | 0.301(0.132,0.685) | -0.499 | 0.441 | 1.281 | 0.258 | 0.607(0.256,1.440) | |
工作岗位(以非全科医生为参照) | |||||||||||
全科医生 | 1.786 | 0.114 | 244.835 | <0.001 | 5.963(4.768,7.458) | 1.601 | 0.137 | 137.024 | <0.001 | 4.958(3.792,6.482) | |
职称(以副高级及以上为参照) | |||||||||||
无 | -1.174 | 0.270 | 18.962 | <0.001 | 0.309(0.182,0.524) | -0.636 | 0.345 | 3.408 | 0.065 | 0.529(0.269,1.040) | |
初级 | -1.454 | 0.235 | 38.375 | <0.001 | 0.234(0.148,0.370) | -0.815 | 0.278 | 8.615 | 0.003 | 0.443(0.257,0.763) | |
中级 | -1.010 | 0.232 | 18.899 | <0.001 | 0.364(0.231,0.574) | -0.544 | 0.244 | 4.989 | 0.026 | 0.580(0.360,0.936) | |
有无在上级医院工作的经历(以无为参照) | |||||||||||
有 | 0.304 | 0.115 | 7.033 | 0.008 | 1.355(1.083,1.696) | 0.205 | 0.126 | 2.639 | 0.104 | 1.227(0.959,1.571) | |
是否接受过规范化培训(以否为参照) | |||||||||||
是 | 1.005 | 0.145 | 47.749 | <0.001 | 2.731(2.054,3.632) | 0.216 | 0.191 | 1.287 | 0.257 | 1.242(0.854,1.805) | |
一年内是否阅读过房颤指南(以否为参照) | |||||||||||
是 | 0.330 | 0.120 | 7.596 | 0.006 | 1.391(1.100,1.759) | -0.005 | 0.142 | 0.001 | 0.972 | 0.995(0.753,1.315) | |
一年内是否参加过房颤相关培训(以否为参照) | |||||||||||
是 | 0.322 | 0.125 | 6.609 | 0.010 | 1.380(1.079,1.763) | 0.080 | 0.149 | 0.287 | 0.592 | 1.083(0.809,1.449) |
自变量 | 单因素Logistic回归分析 | 二元Logistic回归分析 | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
b | SE | Wald χ2值 | P值 | OR(95%CI) | b | SE | Wald χ2值 | P值 | OR(95%CI) | ||
性别(以女为参照) | |||||||||||
男 | -0.434 | 0.539 | 0.647 | 0.421 | 0.648(0.225,1.865) | — | — | — | — | — | |
年龄(原值进入) | -0.042 | 0.022 | 3.740 | 0.043 | 0.959(0.919,0.988) | -0.061 | 0.030 | 4.134 | 0.042 | 0.940(0.886,0.998) | |
学历(以硕士研究生及以上为参照) | |||||||||||
中专/初中及以下 | -19.063 | 6 893.038 | 8.000×10-6 | 0.998 | 5.262×10-9 a | -16.571 | 6 578.526 | 6.000×10-6 | 0.998 | 6.360×10-8 a | |
大专 | -2.028 | 0.873 | 5.399 | 0.020 | 0.132(0.024,0.728) | -0.528 | 0.957 | 0.304 | 0.582 | 0.590(0.090,3.853) | |
本科 | -1.526 | 0.774 | 3.880 | 0.049 | 0.218(0.048,0.992) | -0.536 | 0.845 | 0.402 | 0.526 | 0.585(0.112,3.069) | |
工作岗位(以非全科医生为参照) | |||||||||||
全科医生 | -1.524 | 0.397 | 14.726 | <0.001 | 4.593(2.108,10.005) | 1.657 | 0.520 | 10.143 | <0.001 | 5.243(1.891,14.537) | |
职称(以副高级及以上为参照) | |||||||||||
无 | -0.809 | 0.723 | 1.254 | 0.263 | 0.445(0.108,1.835) | — | — | — | — | — | |
初级 | -0.993 | 0.587 | 2.864 | 0.091 | 0.371(0.117,1.170) | — | — | — | — | — | |
中级 | -1.160 | 0.598 | 3.756 | 0.053 | 0.314(0.097,1.013) | — | — | — | — | — | |
有无在上级医院工作的经历(以无为参照) | |||||||||||
有 | 0.880 | 0.360 | 5.989 | 0.014 | 2.411(1.192,4.877) | 0.548 | 0.390 | 1.975 | 0.160 | 1.729(0.806,3.713) | |
是否接受过规范化培训(以否为参照) | |||||||||||
是 | 1.097 | 0.390 | 7.922 | 0.005 | 2.995(1.395,6.430) | -0.480 | 0.576 | 0.695 | 0.404 | 0.619(0.200,1.913) | |
一年内是否阅读过房颤指南(以否为参照) | |||||||||||
是 | 1.207 | 0.359 | 11.281 | 0.001 | 3.344(1.653,6.764) | 0.563 | 0.415 | 1.840 | 0.175 | 1.755(0.779,3.956) | |
一年内是否参加过房颤相关培训(以否为参照) | |||||||||||
是 | 1.253 | 0.361 | 12.065 | 0.001 | 3.500(1.726,7.098) | 0.759 | 0.414 | 3.356 | 0.067 | 2.136(0.948,4.814) |
Table 3 Logistic regression analysis of influencing factors of whether the score in knowledge related to anticoagulation therapy reaches the pass level or above among grassroots medical staff
自变量 | 单因素Logistic回归分析 | 二元Logistic回归分析 | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
b | SE | Wald χ2值 | P值 | OR(95%CI) | b | SE | Wald χ2值 | P值 | OR(95%CI) | ||
性别(以女为参照) | |||||||||||
男 | -0.434 | 0.539 | 0.647 | 0.421 | 0.648(0.225,1.865) | — | — | — | — | — | |
年龄(原值进入) | -0.042 | 0.022 | 3.740 | 0.043 | 0.959(0.919,0.988) | -0.061 | 0.030 | 4.134 | 0.042 | 0.940(0.886,0.998) | |
学历(以硕士研究生及以上为参照) | |||||||||||
中专/初中及以下 | -19.063 | 6 893.038 | 8.000×10-6 | 0.998 | 5.262×10-9 a | -16.571 | 6 578.526 | 6.000×10-6 | 0.998 | 6.360×10-8 a | |
大专 | -2.028 | 0.873 | 5.399 | 0.020 | 0.132(0.024,0.728) | -0.528 | 0.957 | 0.304 | 0.582 | 0.590(0.090,3.853) | |
本科 | -1.526 | 0.774 | 3.880 | 0.049 | 0.218(0.048,0.992) | -0.536 | 0.845 | 0.402 | 0.526 | 0.585(0.112,3.069) | |
工作岗位(以非全科医生为参照) | |||||||||||
全科医生 | -1.524 | 0.397 | 14.726 | <0.001 | 4.593(2.108,10.005) | 1.657 | 0.520 | 10.143 | <0.001 | 5.243(1.891,14.537) | |
职称(以副高级及以上为参照) | |||||||||||
无 | -0.809 | 0.723 | 1.254 | 0.263 | 0.445(0.108,1.835) | — | — | — | — | — | |
初级 | -0.993 | 0.587 | 2.864 | 0.091 | 0.371(0.117,1.170) | — | — | — | — | — | |
中级 | -1.160 | 0.598 | 3.756 | 0.053 | 0.314(0.097,1.013) | — | — | — | — | — | |
有无在上级医院工作的经历(以无为参照) | |||||||||||
有 | 0.880 | 0.360 | 5.989 | 0.014 | 2.411(1.192,4.877) | 0.548 | 0.390 | 1.975 | 0.160 | 1.729(0.806,3.713) | |
是否接受过规范化培训(以否为参照) | |||||||||||
是 | 1.097 | 0.390 | 7.922 | 0.005 | 2.995(1.395,6.430) | -0.480 | 0.576 | 0.695 | 0.404 | 0.619(0.200,1.913) | |
一年内是否阅读过房颤指南(以否为参照) | |||||||||||
是 | 1.207 | 0.359 | 11.281 | 0.001 | 3.344(1.653,6.764) | 0.563 | 0.415 | 1.840 | 0.175 | 1.755(0.779,3.956) | |
一年内是否参加过房颤相关培训(以否为参照) | |||||||||||
是 | 1.253 | 0.361 | 12.065 | 0.001 | 3.500(1.726,7.098) | 0.759 | 0.414 | 3.356 | 0.067 | 2.136(0.948,4.814) |
自变量 | 单因素Logistic回归分析 | 有序多分类Logistic回归分析 | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
b | SE | Wald χ2值 | P值 | OR(95%CI) | b | SE | Wald χ2值 | P值 | OR(95%CI) | ||
性别(以女为参照) | |||||||||||
男 | 0.088 | 0.148 | 0.355 | 0.551 | 1.092(0.817,1.460) | — | — | — | — | — | |
年龄(原值进入) | 0.003 | 0.007 | 0.175 | 0.675 | 1.003(0.990,1.016) | — | — | — | — | — | |
学历(以硕士研究生及以上为参照) | |||||||||||
中专/初中及以下 | -0.495 | 0.604 | 0.672 | 0.413 | 0.610(0.187,1.992) | — | — | — | — | — | |
大专 | -0.672 | 0.484 | 1.927 | 0.165 | 0.511(0.198,1.319) | — | — | — | — | — | |
本科 | -0.183 | 0.470 | 0.151 | 0.687 | 0.833(0.331,2.094) | — | — | — | — | — | |
工作岗位(以非全科医生为参照) | |||||||||||
全科医生 | 1.131 | 0.119 | 89.774 | <0.001 | 3.098(2.452,3.915) | 0.946 | 0.130 | 52.956 | <0.001 | 2.575(1.996,3.322) | |
职称(以副高级及以上为参照) | |||||||||||
无 | -0.331 | 0.305 | 1.178 | 0.278 | 0.718(0.395,1.305) | — | — | — | — | — | |
初级 | -0.502 | 0.264 | 3.606 | 0.058 | 0.606(0.361,1.016) | — | — | — | — | — | |
中级 | -0.172 | 0.262 | 0.432 | 0.511 | 0.842(0.504,1.407) | — | — | — | — | — | |
有无在上级医院工作的经历(以无为参照) | |||||||||||
有 | 0.410 | 0.125 | 10.732 | 0.001 | 1.507(1.179,1.926) | 0.235 | 0.135 | 3.028 | 0.082 | 1.265(0.971,1.648) | |
是否接受过规范化培训(以否为参照) | |||||||||||
是 | 0.866 | 0.155 | 31.367 | <0.001 | 2.377(1.755,3.218) | 0.299 | 0.175 | 2.925 | 0.047 | 1.349(1.030,1.898) | |
一年内是否阅读过房颤指南(以否为参照) | |||||||||||
是 | 0.988 | 0.128 | 59.843 | <0.001 | 2.687(2.091,3.451) | 0.740 | 0.148 | 25.013 | <0.001 | 2.096(1.568,2.801) | |
一年内是否参加过房颤相关培训(以否为参照) | |||||||||||
是 | 0.693 | 0.134 | 26.964 | <0.001 | 2.000(1.540,2.598) | 0.208 | 0.156 | 1.795 | 0.181 | 1.232(0.908,1.671) |
Table 4 Logistic regression analysis of influencing factors of the score in knowledge related to heart rhythm/heart rate control among grassroots medical staff
自变量 | 单因素Logistic回归分析 | 有序多分类Logistic回归分析 | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
b | SE | Wald χ2值 | P值 | OR(95%CI) | b | SE | Wald χ2值 | P值 | OR(95%CI) | ||
性别(以女为参照) | |||||||||||
男 | 0.088 | 0.148 | 0.355 | 0.551 | 1.092(0.817,1.460) | — | — | — | — | — | |
年龄(原值进入) | 0.003 | 0.007 | 0.175 | 0.675 | 1.003(0.990,1.016) | — | — | — | — | — | |
学历(以硕士研究生及以上为参照) | |||||||||||
中专/初中及以下 | -0.495 | 0.604 | 0.672 | 0.413 | 0.610(0.187,1.992) | — | — | — | — | — | |
大专 | -0.672 | 0.484 | 1.927 | 0.165 | 0.511(0.198,1.319) | — | — | — | — | — | |
本科 | -0.183 | 0.470 | 0.151 | 0.687 | 0.833(0.331,2.094) | — | — | — | — | — | |
工作岗位(以非全科医生为参照) | |||||||||||
全科医生 | 1.131 | 0.119 | 89.774 | <0.001 | 3.098(2.452,3.915) | 0.946 | 0.130 | 52.956 | <0.001 | 2.575(1.996,3.322) | |
职称(以副高级及以上为参照) | |||||||||||
无 | -0.331 | 0.305 | 1.178 | 0.278 | 0.718(0.395,1.305) | — | — | — | — | — | |
初级 | -0.502 | 0.264 | 3.606 | 0.058 | 0.606(0.361,1.016) | — | — | — | — | — | |
中级 | -0.172 | 0.262 | 0.432 | 0.511 | 0.842(0.504,1.407) | — | — | — | — | — | |
有无在上级医院工作的经历(以无为参照) | |||||||||||
有 | 0.410 | 0.125 | 10.732 | 0.001 | 1.507(1.179,1.926) | 0.235 | 0.135 | 3.028 | 0.082 | 1.265(0.971,1.648) | |
是否接受过规范化培训(以否为参照) | |||||||||||
是 | 0.866 | 0.155 | 31.367 | <0.001 | 2.377(1.755,3.218) | 0.299 | 0.175 | 2.925 | 0.047 | 1.349(1.030,1.898) | |
一年内是否阅读过房颤指南(以否为参照) | |||||||||||
是 | 0.988 | 0.128 | 59.843 | <0.001 | 2.687(2.091,3.451) | 0.740 | 0.148 | 25.013 | <0.001 | 2.096(1.568,2.801) | |
一年内是否参加过房颤相关培训(以否为参照) | |||||||||||
是 | 0.693 | 0.134 | 26.964 | <0.001 | 2.000(1.540,2.598) | 0.208 | 0.156 | 1.795 | 0.181 | 1.232(0.908,1.671) |
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