在初级保健中探索COPD误诊的原因:一项混合方法研究
Ketan Patel1, Daniel J Smith2, Christopher C Huntley1
1University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom.
PloS one
|March 6, 2024
概括
误解螺旋计结果经常导致慢性阻塞性肺病 (COPD) 在初级保健中被误诊. 应对诊断方面的挑战和确保螺旋计检查的准入,是减少错误诊断的COPD患者的关键.
科学领域:
- 呼吸系统医学 呼吸系统医学
- 主要护理诊断 诊断 初级护理诊断
- 医疗保健服务研究 医疗服务研究
背景情况:
- 在初级保健中,大量患者被误诊为慢性阻塞性肺病 (COPD).
- 错误诊断COPD会对患者健康和医疗保健经济产生负面影响.
- 了解COPD误诊的根本原因对于未来的预防策略至关重要.
研究的目的:
- 探索慢性阻塞性肺病在初级保健机构内误诊的感知原因.
- 确定导致COPD在初级保健群体中的错误诊断的因素.
主要方法:
- 采用了一种连续的混合方法方法,从206名错误诊断的COPD患者的定量数据开始 (INTEGR COPD研究,NCT03482700).
- 通过采访21名医疗保健专业人员和通过最大变异有目的抽样选择的8名错误诊断的患者,收集了定性数据.
主要成果:
- 错误解释螺旋计结果是主要原因,影响了59%的错误诊断患者.
- 在接受进一步调查的患者中,41%的螺旋测量正常,40%患有喘.
- 定性调查结果显示,不愿意挑战现有诊断和差异诊断中的困难是关键的根本问题.
结论:
- 被诊断为COPD的患者没有螺旋测量确认风险继续错误标记,使错误诊断的COPD在初级保健中延续.
- 由于COVID-19大流行加剧了有限的螺旋测量准入,可能会增加被误诊的COPD患者的数量.
- 呼吸系统专家的加强支持可以显著降低COPD误诊在初级保健中的患病率.
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