| Objective:To analyze the knowledge and the influential factors of gastroenterologists in Yunnan Province about management of inflamatory bowel disease(IBD),and to understand the difference regarding IBD which between the clinical practice in Yunnan Province and the evidence-based consensus,so that to improve the quality of care about IBD in Yunnan Province.Methods:We adopted the method of sampling survey with self-designed questionnaire to survey the gastroenterologists about the management of IBD in dimethyl hospitals and above hospitals in Yunnan Province.The questionnaire includes the basic data of the subjects,the etiology?diagnosis?treatment and the prognosis of IBD.SPSS 18.0 statistical package was used in the data processing,statistical analyses were described by percentages and the rates were analyzed by the x 2 test.A P-value less than 0.05 was considered statistically significant differences.Multivariate logistic regression analysis was applied to identify the influential factors on the knowledge of gastroenterologists about management of IBD in Yunnan Province.Results:1.In total,200 questionnaires were distributed,and 177 effective questionnaires were taken back.Respondents come from different hoatipals,including grade A tertiary hospitals?grade B tertiary hospitals and dimethyl hospitals,the number of which was 66(33.9%)?51(28.8%)?60(37.3%),respectively.The gastroenterologists consist of 9 chief physicians(5.1%)?28 associate chief physicians(15.8%)?50 attending doctors(28.2%)?44 resident doctors(24.9%)?46 intems(26.0%).Among them,100 people had participated in our IBD trainings(56.5%),77 people had not participated(43.5%);and 98 people(55.4%)had read the clinical guidelines of IBD,of which 69 people(70.4%)had just read the Chinese guidelines.2.The general knowledge about the etiology of IBD in 177 gastroenterologists was poorer,among which there were 105 people(59.3%)with the total accuracy rate below 60%.3.The general knowledge about the diagnosis of IBD in 177 gastroenterologists was relatively higher,among which there were 24 people(13.6%)with the total accuracy rate below 60%.4.The general knowledge about the treatment of IBD in 177 gastroenterologists was weaker,among which there were 119 people(67.2%)with the total accuracy rate below 60%.Which were mainly the time of glucocorticoids and immunosuppressants therapy was inappropriate,and the congnition of the drug dosage was poorer.5.The awareness about colorectal cancer screening in patients with UC was higher(92.1%)in 177 gastroenterologists,and they had mainly followed up the IBD patients through telephone(46.9%)or outpatient(33.9%),while simultaneously 16.9%of physicians had not followed up the prognosis of IBD.6.The results showed that there were significant gaps in the IBD clinical care actually practiced and the care recommended in evidence-based guidelines,especially on the diagnosis and the treatment of IBD.in Yunnan Province,including the diagnostic procedure was not normal,the medication was inappropriate and the drug dosage was not standard.7.The higher the level of hospital(?2=16.536,P<0.05),the higher the doctor's title(? 2=16.264,P<0.05),the better general knowledge of gastroenterologists in Yunnan Province about the management of IBD.Morever,the gastroenterologists who had participated in our IBD trainings was more knowledgeable about the management of IBD than the ones who had not participated(x2 =16.241,P<0.05).8.Logistic regression analysis showed that,the grades of hospitals and whether the gastroenterologists had participated in our IBD trainings had an influence on the general knowledge about the management of IBD in Yunnan Province,and the difference was statistically significance(P<0.05).Participating the IBD trainings could improve the awareness on the management of IBD(OR=3.787,95%CI:1.777-8.069).Conclutions:1.The general knowledge of gastroenterologists about the management of IBD was poorer in Yunnan Province.This survey showed that there were significant gaps in the IBD clinical care actually practiced and the care recommended in evidence-based guidelines,so it's important to improve the quality of care in IBD in Yunnan Province.2.The higher the level of hospital,the higher the doctor's title,the better general knowledge of gastroenterologists about the management of IBD in Yunnan Province.3.Participating the IBD trainings could improve the awareness of gastroenterologists about the management of IBD.4.The grades of hospitals and whether the gastroenterologists had participated in our IBD trainings were the two factors influencing the general knowledge about the management of IBD in Yunnan Province.5.The gastroenterologists need to strengthen the professtional knowledge update and the specialized trainings of IBD in Yunnan Province.Shared Decision Making can be applied to the management of IBD. |
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