广州市番禺区不同等级医疗机构对慢性阻塞性肺疾病肺康复认知的横断面调查

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Abstract Objective To understand the pulmonary rehabilitation awareness of chronic obstructive pulmonary disease（COPD）in various medical institutions in Panyu District of Guangzhou City.Methods From March to October in 2017，a questionnaire survey was conducted among 339 medical staff from respiratory specialists and community at all levels of medical institutions in the district.Data were input and statistical analysis was performed.Results The level of awareness of the severity of COPD airflow limitation was the highest in the tertiary hospitals （50.0%），and the lowest in the community （20.2%）.On the familiarity of the GOLD guidelines，the highest was in tertiary hospitals （22.7%）and the lowest in the community （1.6%）.The standard terminology used was up to 90.9%of tertiary hospitals.The highest awareness rate for the definite diagnosis of COPD was in tertiary hospitals （86.4%），and the lowest（58.7%）in the firstgrade hospital.The acknowledgement of lung function knowledge was most in tertiary hospitals （70.5%），and the lowest in the first-grade hospitals （30.4%）.The use of β-agonists to relieve shortness of breath was lowest in tertiary hospitals（34.1%）and highest in secondary hospitals （60.8%）.Inhaled drug varieties and usage understood in most in tertiary hospitals （52.3%），and lowest in primary hospitals （8.7%）.All medical institutions have the highest awareness of pursed lips breathing and abdominal breathing in various rehabilitation exercises.For upper and lower limb exercises，cycle ergometer，and treadmill exercise，the awareness rate of tertiary hospitals was higher than those of other medical institutions.Awareness of respiratory muscles was most in tertiary hospitals （72.8% ），and 19.5%of primary hospitals.Awareness of airway clearance technology was most in tertiary hospitals （77.3%），and lowest at primary hospi-tals （15.2%）.The return visits of various medical institutions mainly include re-visit to hospital （37.1%-84.1%）and telephone follow-up （26.1%-56.8%），and community visit was more than other medical institutions.Drug cost and absence of acknowledgement of treatment benefits were the main factors affecting the compliance of patients with COPD.72.7%～82.4%of all medical institutions would advise patients to quit smoking during each visit.Insufficient drugs，personnel，poor patient compliance，inadequate medical care，inadequate equipment，and backward information systems were the main reasons for community management of COPD.Conclusion Different levels of medical institutions in the Panyu District have different understanding of COPD pulmonary rehabilitation.Strenthening training for primary hospitals and communities should depend on the specific conditions，and give full play to the role of different medical institutions to jointly manage COPD.

Key words： Chronic obstructive pulmonary disease Medical institutions Pulmonary rehabilitation Awareness Crosssectional survey

Fund:广东省广州市卫生计生科技一般引导项目（2018 1A010088）

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