北京市全科医生骨性关节炎社区康复治疗现状及影响因素分析

曹雨; 马丽; 何续芳; 赵亚利; 王佳欣

doi:10.16766/j.cnki.issn.1674-4152.003511

北京市全科医生骨性关节炎社区康复治疗现状及影响因素分析

doi: 10.16766/j.cnki.issn.1674-4152.003511

曹雨^{1, 2},
马丽^1, ,,
何续芳³,
赵亚利²,
王佳欣²

1.
北京市通州区永乐店社区卫生服务中心，北京 101105
2.
首都医科大学全科医学与继续教育学院，北京 100069
3.
首都医科大学附属复兴医院全科，北京 100038

基金项目:

首都全科医学研究专项 22QK11

详细信息

通讯作者:
马丽，E-mail: maliwangzijia@163.com

中图分类号: R684.3 R493
计量
- 文章访问数: 145
- HTML全文浏览量: 84
- PDF下载量: 3
- 被引次数: 0
出版历程
- 收稿日期: 2023-11-15
- 网络出版日期: 2024-07-20

The status and its influencing factors of community rehabilitation treatment for osteoarthritis among general practitioners in Beijing

CAO Yu^{1, 2},
MA Li^{1
, ,},
HE Xufang³,
ZHAO Yali²,
WANG Jiaxin²

1.
Tongzhou District Yongledian Community Health Service Center, Beijing 101105, China

摘要

摘要: 目的了解全科医生骨性关节炎(OA)社区康复知识知晓情况，参与社区康复治疗现状及影响因素，为促进全面开展社区康复提供对策。方法采取分层整群抽样方法，选取北京市城六区及郊区社区卫生服务中心全科门诊的全科医生作为研究对象，于2022年10—12月进行问卷调查。采用χ²检验和logistic回归分析对全科医生参与OA社区康复治疗影响因素进行分析。结果 200名全科医生中，男性占29.5%(59/200)，女性占70.5%(141/200)，年龄为(38.10±9.11)岁。对OA临床症状知晓的全科医生占99.5%(199/200)，社区康复设备知晓者占48.5%(97/200)。参与OA社区康复治疗的全科医生占22.5%(45/200)。性别、年龄、日门诊量、工作年限、参加康复培训、知晓康复评估、知晓康复设备均是全科医生参与OA社区康复治疗的影响因素(P＜0.05)。女性、工作年限30年及以上、年龄40岁及以上、知晓康复疗效评估方法、知晓康复设备和参加过康复培训是全科医生参与OA社区康复治疗的有利因素。根据OR值，是否参加康复培训是影响作用最大的因素。结论全科医生对OA社区康复知识知晓率较低, 社区康复培训率低，应加强相关培训及宣传，增强全科医生康复服务意识及能力，利于全科医生开展OA社区康复治疗。
- 骨性关节炎 /
- 全科医生 /
- 社区康复 /
- 参与 /
- 影响因素
Abstract: Objective To understand the knowledge and awareness of community rehabilitation for osteoarthritis (OA) among general practitioners, the current situation and influencing factors of their participation in community rehabilitation treatment, and to provide strategies for promoting comprehensive community rehabilitation. Methods A stratified cluster sampling method was used to select general practitioners from the general clinics of community health service centers in the six districts and suburbs of Beijing as the research subjects. A questionnaire survey was conducted from October to December 2022. Chi square test and logistic regression were used to analyze the influencing factors of general practitioners participating in OA community rehabilitation treatment. Results Among the 200 general practitioners, males accounted for 29.5% (59/200) and females accounted for 70.5% (141/200). The average age was (38.10±9.11) years old. 99.5% (199/200) of general practitioners were aware of the clinical symptoms of OA, 48.5% (97/200) were aware of community rehabilitation equipment, and 22.5% (45/200) of general practitioners participated in OA community rehabilitation treatment. Gender, age, daily outpatient volume, years of work, participation in rehabilitation training, awareness of rehabilitation assessment, and awareness of rehabilitation equipment were the influencing factors for general practitioners to participate in OA community rehabilitation treatment (P < 0.05). Women, working experience of 30 years or more, age of 40 years or more, knowledge of rehabilitation efficacy evaluation methods, knowledge of rehabilitation equipment, and participation in rehabilitation training were favorable factors for general practitioners to participate in OA community rehabilitation treatment. According to the OR value, whether to participate in rehabilitation training was the most influential factor. Conclusion General practitioners have a low awareness rate of OA community rehabilitation knowledge and a low rate of community rehabilitation training. Relevant training and promotion should be strengthened to improve the awareness and ability of general practitioners in rehabilitation services, which is beneficial for them to carry out OA community rehabilitation treatment.
- Osteoarthritis /
- General practitioner /
- Community rehabilitation /
- Participation /
- Influencing factor

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表 1 200名全科医生基本信息

Table 1. Basic information of 200 general practitioners

项目	类别	人(%)
性别	女性	141(70.5)
	男性	59(29.5)
年龄(岁)	＜30	37(18.5)
	30~＜40	87(43.5)
	40~＜50	49(24.5)
	≥50	27(13.5)
职称	医师及以下	56(28.0)
	主治医师	85(42.5)
	副主任医师及以上	59(29.5)
文化程度	大专及以下	18(9.0)
	本科	135(67.5)
	硕士	46(23.0)
	博士	1(0.5)
工作年限(年)	＜10	86(43.0)
	10~＜20	64(32.0)
	20~＜30	34(17.0)
	≥30	16(8.0)
日门诊量(人)	＜20	8(4.0)
	20~＜40	67(33.5)
	40~＜60	53(26.5)
	60~＜80	34(17.0)
	80~＜100	24(12.0)
	≥100	14(7.0)

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表 2 全科医生是否参与OA社区康复治疗的单因素分析[人(%)]

Table 2. Unifactorial analysis of general practitioners' involvement in OA community rehabilitation therapy [persons(%)]

项目	类别	不参与(n=155)	参与(n=45)	χ²值	P值
性别	男性	38(19.0)	21(10.5)	8.228	0.004
	女性	117(58.5)	24(12.0)
知晓社区康复治疗	知晓	88(44.0)	38(19.0)	11.455	0.001
	不知晓	67(33.5)	7(3.5)
知晓社区康复标准	知晓	67(33.5)	37(18.5)	21.248	＜0.001
	不知晓	88(44.0)	8(4.0)
知晓社区康复转诊指征	知晓	73(36.5)	38(19.0)	19.696	＜0.001
	不知晓	82(41.0)	7(3.5)
知晓康复评估	知晓	116(58.0)	42(21.0)	7.190	0.007
	不知晓	39(19.5)	3(1.5)
知晓康复评估方法	知晓	52(26.0)	40(20.0)	42.998	＜0.001
	不知晓	103(51.5)	5(2.5)
知晓康复设备	知晓	59(29.5)	38(19.0)	30.035	＜0.001
	不知晓	96(48.0)	7(3.5)
知晓传统康复方法	知晓	85(42.5)	36(18.0)	9.239	0.002
	不知晓	70(35.0)	9(4.5)
是否健康教育	是	103(51.5)	41(20.5)	10.519	0.001
	否	52(26.0)	4(2.0)
是否介绍辅具	是	68(34.0)	35(17.5)	16.052	＜0.001
	否	87(43.5)	10(5.0)
是否参加培训	是	44(22.0)	32(16.0)	27.020	＜0.001
	否	111(55.5)	13(6.5)
注：由于篇幅限制，该表仅列出差异有统计学意义(P＜0.05)的自变量。

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表 3 多因素分析中自变量名称及赋值

Table 3. Independent variable names and assignments in multivariate analysis

自变量	赋值
性别	女性=0，男性=1
年龄(岁)	＜30=0，30~＜40=1，40~＜50=2，≥50=3
日门诊量(人)	＜20=0，20~＜40=1，40~＜60=2，60~＜80=3，80~＜100=4，≥100=5
工作年限(年)	＜10=0，10~＜20=1，20~＜30=2，≥30=3
知晓社区康复治疗	不知晓=0，知晓=1
知晓社区康复标准	不知晓=0，知晓=1
知晓社区康复转诊指征	不知晓=0，知晓=1
知晓康复评估	不知晓=0，知晓=1
知晓康复评估方法	不知晓=0，知晓=1
知晓康复设备	不知晓=0，知晓=1
知晓传统方法	不知晓=0，知晓=1
是否健康教育	否=0，是=1
是否介绍辅具	否=0，是=1
是否康复培训	否=0，是=1

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表 4 全科医生OA社区康复治疗参与的多因素logistic回归分析

Table 4. Multifactor logistic regression analysis on general practitioners ' involvement in community rehabilitation therapy

自变量	B	SE	Waldχ²	P值	OR(95% CI)
年龄(岁)
30~＜40	1.720	1.508	1.301	0.163	5.584(0.916~7.391)
40~＜50	1.859	1.332	1.948	0.047	6.417(2.023~8.217)
≥50	2.528	1.166	4.710	0.030	4.609(1.689~6.852)
男性	-1.048	0.554	3.573	0.045	0.351(0.118~0.639)
日门诊量(人)
20~＜40	-2.629	1.650	1.145	0.254	0.072(0.021~1.012)
40~＜60	-2.613	1.077	4.241	0.032	0.073(0.024~0.137)
60~＜80	-2.265	1.074	3.013	0.134	0.104(0.034~1.216)
80~＜100	-1.670	1.058	1.651	0.239	0.188(0.064~2.067)
≥100	-1.941	1.167	2.021	0.526	0.143(0.040~1.040)
工作年限(年)
10~＜20	1.702	1.055	1.246	0.702	5.485(0.722~9.983)
20~＜30	1.238	1.990	1.534	0.137	3.449(0.401~5.008)
≥30	1.226	1.871	4.104	0.033	3.407(1.750~5.572)
知晓康复疗效评估方法	1.728	0.734	12.545	0.006	5.629(3.194~10.767)
知晓康复设备	1.735	0.725	5.723	0.017	5.669(2.368~13.502)
参加康复培训	1.507	0.573	12.867	0.005	12.268(3.194~22.930)
注：该表仅列出除年龄、性别、日门诊量、工作年限外，差异有统计学意义(P＜0.05)的自变量。自变量中年龄，以＜30岁为参照；性别，以女性为参照；日门诊量，以＜20人为参照；工作年限，以＜10年为参照；知晓康复疗效评估方法和知晓康复设备，均以不知晓为参照；是否康复培训，以否为参照。

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