同職業不同地域之行為差異的研究分析－以醫療人員使用電子醫學資料庫為例

Preliminary Exploration of Electronic Databases Using on the Implementation of Evidence Based Medicine among the Physicians and Paramedics

陳聲平(Chen Sheng-Pyng)

《中華職業醫學雜誌》 26卷4期 (2019/10) Pp. 247-254

摘要

背景：為瞭解在大陸三級醫院的醫療人員間的對網路電子資料庫的使用情形，以作為醫院與同級機構未來推行實證教學時的參考。研究方法：以具內容效度與信度的封閉結構式問卷，對67位醫院醫療人員進行調查，並進行基本資料及調查結果之頻率、次數、百分比與相關變項間的統計分析與差異比較。結果：資職淺、非主管與年資淺者需要相關醫學資訊時會向有經驗者請教（p＜0.05），資職淺的醫療人員，在使用考科藍資料庫與維普中文科技期刊的熟悉度與次數均較資職深者為高（p＜0.05），同時碩博士在使用電子資料庫與熟悉度及次數方面，均優於本科生（p＜0.05）。結論：因實證醫學教學應用模式在國內大部份醫療機構尚屬萌芽階段，故醫療人員在查詢醫學相關資訊時，會使用網路電子資料庫的醫療人員比例遠落後於預期，甚至20%以上甚少使用相關全文與循證電子資料庫。同時學歷是醫療人員間使用電子資料庫的熟悉度與使用次數的重要影響因數。未來如何讓醫療專業人員及早接觸EBM相關專業知識與如何系統化整合於醫療的臨床作業中，以全面提升對病患的優質醫療服務，是我們努力的方向。

關鍵字

實證醫學 ； 教學方案 ； 問卷調查

並列摘要

Background: The purpose of this study is to understand how the internet database are perceived and applied among the physicians and paramedics in hospital , so the results can be used by the hospital or peer institutions as the reference for policy promotion and formulation. Methods: A questionnaire with reliability and validity was developed and a total of 67 (physicians and paramedics)were selected as the samples for a cross-section questionnaire survey. Subsequently, relevant variables and basic data were compiled, analyzed and compared. Results: Non-managerial and junior doctors and paramedics would ask those with experience for help when they encountered problem when using the electronic database, while the managerial and senior people will not (P ＜0.05). Junior doctors and paramedics are more familiar with the relevant electronic database resources than senior (P ＜0.05), the educational level is the only one significant confounder when make comparison between those questions (P ＜0.05) Conclusion: Overall, the EBM teaching and clinical practice model are still rudement in China. May be this is why the different results are found when compare with the previous studies. Even the ability of searching in internet medical information database which were lag behind than our prediction. And the education level was the only important confounding factor of our study. We have to strengthen the teaching contents in the professional competency and design the EBM curriculums for the student earilier. Moreover, we need to try to overcome the problems of not being able to integrate effectively in the clinical practice for the purpose of improving the medical care quality for the patient. Sharing the experience on how to integrate the EBM courses and clinical practice and on how to implement EBM with peer institutions should be a workable solution to promote the EBM feasibility.

並列關鍵字

evidence-based-medicine ； medical education ； questionnaire