Chikaodinaka Ayuk Adaeze, Ubesie Agozie, Laura Odimegwu Chioma, Iloh Kenechukwu
Department of Paediatrics, University of Nigeria Teaching Hospital, Enugu, Nigeria.
College of Medicine, University of Nigeria Enugu Campus, Nigeria.
Pan Afr Med J. 2017 Jun 15;27:120. doi: 10.11604/pamj.2017.27.120.9260. eCollection 2017.
Clinical practice guidelines are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances. Despite abundance of asthma guidelines, prevalence has continued to increase globally. There is need to assess how the contents of asthma guidelines are put to clinical use by doctors in the management of children with asthma. This study aims at evaluating the clinical practice of paediatric residents in applying GINA guidelines.
Cross-sectional descriptive study of paediatric residents from 23 university teaching hospitals in Nigeria using structured questionnaire. Data analyses were with Statistical Package for Social Sciences (SPSS) version 19 (Chicago IL). Chi square was used to assess for any significant associations between categorical variables. A p < 0.05 was regarded to be statistically significant.
Sixty-six paediatric residents aged 27- 40 years were enrolled into the study (37 females and 29 males). One-third had spent more than three years in residency training. Fifty-eight residents (87.9%) were aware of the GINA guidelines while 46 (69.7%) were familiar with its contents. Only 39 (59.1%) residents adhered to the GINA guidelines. Twenty of the 35 junior residents (57.1%) compared to 26 of 31 (83.9%) senior residents were familiar with the GINA guidelines (p=0.031) while 15 of 35 junior residents (42.9%) compared to 24 of 31 senior residents (77.4%) consistently follow the GINA guidelines (p=0.006). Adherence to GINA guidelines was not influenced significantly by years of graduation or training (p>0.05).
The use of the GINA guidelines was poor among paediatric residents. Application of contents rather than just availability of asthma guidelines may partly account for increasing asthma prevalence globally.
临床实践指南是系统制定的声明,旨在帮助从业者和患者针对特定临床情况做出关于适当医疗保健的决策。尽管有大量哮喘指南,但全球哮喘患病率仍在持续上升。有必要评估哮喘指南的内容在医生管理儿童哮喘时是如何应用于临床的。本研究旨在评估儿科住院医师应用全球哮喘防治创议(GINA)指南的临床实践情况。
采用结构化问卷对尼日利亚23所大学教学医院的儿科住院医师进行横断面描述性研究。数据分析使用社会科学统计软件包(SPSS)第19版(伊利诺伊州芝加哥)。卡方检验用于评估分类变量之间的任何显著关联。p<0.05被视为具有统计学意义。
66名年龄在27至40岁之间的儿科住院医师纳入研究(37名女性和29名男性)。三分之一的人接受住院医师培训超过三年。58名住院医师(87.9%)知晓GINA指南,46名(69.7%)熟悉其内容。只有39名(59.1%)住院医师遵循GINA指南。35名初级住院医师中有20名(57.1%)熟悉GINA指南,而31名高级住院医师中有26名(83.9%)熟悉(p=0.031);35名初级住院医师中有15名(42.9%)始终遵循GINA指南,31名高级住院医师中有24名(77.4%)遵循(p=0.006)。遵循GINA指南不受毕业年限或培训年限的显著影响(p>0.05)。
儿科住院医师对GINA指南的使用情况不佳。哮喘患病率在全球范围内上升,部分原因可能是指南内容的应用情况,而非仅仅是指南的可得性。