Abstract: Objective　To systematically evaluate attitudes of general practitioners（GPs） toward application of point-of-care tests（POCTs） in communities.Methods　In January 2016,literature relevant to GPs’ attitudes toward application of POCTs in communities was searched systematically in PubMed（1978—2016）,EMbase（1978—2016）,CNKI（1980—2016） and Wanfang Database（1980—2016）,and references included in the literature were searched manually.EPPI-Reviewer 3.0 was used and statistical analysis was conducted for qualitative data through thematic synthesis.Results　Finally,six qualified studies were included,all being qualitative studies;they covered 204 interviewees in total,all being GPs.Three analytic themes were generated,each including both their positive and negative attitudes:（1）Influence of POCTs on shared decision making,diagnosis,and treatment between doctors and patients,positive aspects including helping clarifying diagnostic results and making effective schemes,and negative ones including doubt in precision,less help for individual diagnosis and treatment,over-reliance on test results;（2）Influence of POCTs on other aspects of diagnosis and treatment,positive aspects including reducing times of visiting and telephone counseling,prevention of information disclosure,optimization of chronic disease management,and enhancement of GPs’ working satisfaction,and negative ones including rise of medical examination,cost rise brought by equipment maintenance and increasing items for examination,narrow usage,and imperfect quality control;（3）Influence of POCTs on doctor-patient relationship,and patients’ satisfaction,positive aspects including promotion of communication between doctors and patients,establishment of patients’ confidence,improvement of patients’ compliance in treatment,enhancement of patients’ self-management of chronic diseases,optimization of shared decision making pattern by doctors and patients,and increase of patients’ satisfaction,and negative ones including increase of patients’ nervousness,and possible increase of patients’ resistance toward examination.Conclusion　Application of POCTs has become increasingly popular in communities,promoting shared decision making and communication between doctors and patients;but various evidences proving the accuracy of POCTs should be further provided to evaluate practical and economic effectiveness of applying POCTs in primary health care.

Key words: Point-of-care testing, Community health services, General practitioners, Attitude, Systematic evaluation

摘要： 目的　系统评价全科医生对社区应用即时检验（POCTs）的态度。方法　于2016年1月，系统检索PubMed（1978—2016年）、EMbase（1978—2016年）、中国知网（1980—2016年）及万方数据知识服务平台（1980—2016年）中与全科医生对社区应用POCTs态度有关的文献，同时根据纳入文献进行人工检索。采用EPPI-Reviewer 3.0软件，通过主题合成的方法进行定性资料的统计分析。结果　最终纳入合格文献6篇，均为定性研究，共有受访者204例，均为全科医生。生成分析性主题3项，均包括全科医生的积极态度和消极态度两方面：（1）POCTs对医患共同决策、诊断及治疗的影响，积极态度包括可帮助明确诊断结果、制定有效治疗方案，消极态度包括准确性存在质疑、对个别诊疗帮助不大、过于依赖检查结果；（2）POCTs对诊疗其他方面的影响，积极态度包括可减少针对同一健康问题的就诊次数和电话咨询次数、防止信息遗漏、优化慢性病管理、增强全科医生工作满意度，消极态度包括医疗检查费用上涨、仪器维护和检查项目增加带来的成本增加、使用面窄、质量控制不完善；（3）POCTs对医患关系、患者满意度的影响，积极态度包括促进医患沟通、树立患者信心并提高其治疗依从性、加强患者慢性病自我管理能力、优化医患共同决策模式、增加患者满意度，消极态度包括增加患者紧张焦虑情绪、可能增加患者的检查抵触情绪。结论　即时检验在社区中的应用正逐年普及，有助于医患共同决策，促进医患沟通；但应进一步提供各类相关即时检验准确性的证据，评价即时检验在基层医疗中的应用效果和经济效益。

关键词: 即时检验, 社区卫生服务, 全科医生, 态度, 系统评价