2014年3月7日 星期五

[論文發表] Using A Questionnaire among Patient, Resident Doctor and Senior Supervisor: Are their Answers the Same? 研究在患者、住院醫師、資深主治醫師使用同一問卷之一致性:三者的答案否相同?

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 2014 Apr;22(2):296-303. doi: 10.1016/j.ctim.2014.02.006. Epub 2014 Mar 4.

Using a questionnaire among patientresident doctor and senior supervisor: Are their answers the same

研究在患者、住院醫師、資深主治醫師使用同一問卷之一致性:三者的答案否相同?

Abstract

OBJECTIVES:

This study aims to contribute to the development of objective diagnostic standards in Traditional Chinese Medicine (TCM), in order to improve the training of physicians.

METHODS:

We devised a questionnaire study to evaluate the accuracy of resident doctors' diagnostic skills by comparing their assessment of patients with those of their senior supervising physician and the patients themselves. We selected 39 patients with systemic lupus erythematosus (SLE) at Chang Gung Memorial Hospital, Taiwan, between November 1, 2008 and June 30, 2012, and had the resident doctors (R), their senior supervisor (S) and their patients (P) fill out questionnaires before treatment (V1), immediately after treatment (V5) and two months after treatment (V6), in order to record their assessments on the patients' condition. The R and S questionnaires covered subjective symptoms, tongue, and pulse, while the P questionnaires only included general symptoms. We then compared the assessment records to determine the level of agreement between them.

RESULTS:

The agreements of inquiry during the study for P and S were 0.78 (V1) to 0.84 (V6) and 0.87 (V1) to 0.94 (V6) for R and S, respectively, the agreements between R and S for tongue diagnosis and pulse diagnosis were 0.87 (V1) to 0.90 (V6) and 0.91 (V1) to 0.95 (V6), respectively. All the above agreements improved with time from V1 to V6.

CONCLUSIONS:

The results show that the patient input was feasible and effective and that the questionnaire method provided an objective assessment standard to determine how successfully the resident doctor was trained. Furthermore, it facilitated a training process that could help resident doctors improve their skills.

KEYWORDS:

Agreement; Chinese Medicine diagnosis; Objective and standard assessments; Quality of medical practice; Questionnaire; Systemic lupus erythematosus; Training