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标题：Physicians’ attitudes toward, use of, and perceived barriers to clinical guidelines: a survey among Swiss physicians
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作者：Tanja Birrenbach ; Simone Kraehenmann ; Martin Perrig 等
期刊名称：Advances in Medical Education and Practice
电子版ISSN：1179-7258
出版年度：2016
卷号：7
页码：673-680
DOI：https://doi.org/10.2147/AMEP.S115149
出版社：Dove Medical Press Ltd
摘要：Background: Little is known about the attitudes toward, use of, and perceived barriers to clinical guidelines in Switzerland, a country with no national guideline agency. Moreover, there is no available data on the objective assessment of guideline knowledge in Switzerland. Therefore, we conducted a study at a large university’s Department of General Internal Medicine in Switzerland to assess physicians’ attitudes toward, use of, perceived barriers to, and knowledge of clinical guidelines. Participants and methods: Ninety-six physicians (residents, n=78, and attendings, n=18) were invited to take part in a survey. Attitudes toward, self-reported use of, and barriers hindering adherence to the clinical guidelines were assessed using established scales and frameworks. Knowledge of the guidelines was objectively tested in a written assessment comprising of 14 multiple-choice and 3 short answer case-based questions. Results: Fifty-five participants completed the survey (residents, n=42, and attendings, n=13; overall response rate 57%). Of these, 50 took part in the knowledge assessment (residents, n=37, and attendings, n=13; overall response rate 52%). Attitudes toward guidelines were favorable. They were considered to be a convenient source of advice (94% agreement), good educational tools (89% agreement), and likely to improve patient quality of care (91% agreement). Self-reported use of guidelines was limited, with only one-third reporting using guidelines often or very often. The main barriers to guideline adherence were identified as lack of guideline awareness and familiarity, applicability of existing guidelines to multimorbid patients, unfavorable guideline factors, and lack of time as well as inertia toward changing previous practice. In the assessment of guideline knowledge, the scores were rather modest (mean ± standard deviation: 60.5%±12.7% correct answers). Conclusion: In general, this study found favorable physician attitudes toward clinical guidelines. However, several barriers hindering guideline implementation were identified. The importance of improving guideline implementation was supported by modest results in a guideline knowledge test.
关键词：clinical guidelines; attitudes; barriers; knowledge; survey; physicians