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在初级保健中识别,诊断和治疗 vulval lichen sclerosus 的障碍:一种混合方法调查研究
Louise Clarke1, Rosalind Simpson1, Arabella Crew1
1University of Nottingham.
初级保健临床医生面临的挑战是诊断状样硬化症 (VLS). 需要改善教育和明确的诊断标准,以解决知识差距,并提高临床医生对管理这种疾病的信心.
科学领域:
- 皮肤病学 皮肤病学
- 主要护理医学 医疗保健
- 医学教育 医学教育
背景情况:
- Vulval lichen sclerosus (VLS) 是一种与疼痛,解剖学变化和大量增加 vulval 癌症风险相关的重大疾病.
- 尽管可以用局部类固醇治疗,但VLS诊断在初级保健机构中经常被推迟或错过.
- 以前的研究表明,患者报告的临床医生的知识和相互作用问题有助于诊断延迟.
研究的目的:
- 探索初级保健医生对识别和管理VLS和其他皮肤疾病的信心.
- 确定VLS诊断的障碍,并评估目前对皮肤疾病的教育规定.
- 测量VLS标准化诊断标准的感知实用性.
主要方法:
- 通过专业活动和网络传播了一项混合方法调查,以收集初级保健临床医生的数据.
- 用NVivo.的诱导主题分析分析了定性数据.
- 斯皮尔曼的等级相关性被用来检查参与者的特征和信心水平之间的关系.
主要成果:
- 收到了122个回复,主要来自全科医生实习生 (48%) 和全科医生 (43%).
- 对VLS诊断和管理的更高信心与女性性别相关,实践时间更长,检查频率增加.
- 关键主题包括患者对正常解剖学的不熟悉,男性临床医生的犹,一般知识缺陷以及诊断/治疗的不确定性. 值得注意的是,38%的人没有先前接受过皮肤疾病的培训,98%的人希望达到诊断标准.
结论:
- 在初级保健中存在对VLS诊断和治疗的重大障碍,反映了患者对临床医生的知识不足的担忧.
- 这项研究强调了为VLS制定明确诊断标准的必要性.
- 结果将为有针对性的教育干预提供信息,以提高临床医生的信心和管理VLS的能力.
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