Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-02T21:38:46.987Z Has data issue: false hasContentIssue false

Doctor’s Knowledge and Practices of Traumatic Brain Injury Management in Chinese Prehospital Settings

Published online by Cambridge University Press:  22 October 2015

Kou Kou
Affiliation:
School of Public Health and Social Work & Institute Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
Xiang-Yu Hou*
Affiliation:
School of Public Health and Social Work & Institute Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
Jian-Dong Sun
Affiliation:
School of Public Health and Social Work & Institute Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
Kevin Chu
Affiliation:
Royal Brisbane and Women’s Hospital Metro North Hospital and Health Service, Butterfield Street Herston, Queensland, Australia
*
Correspondence: Xiang-Yu Hou, MD, PhD School of Public Health and Social Work Institute Health and Biomedical Innovation Queensland University of Technology Victoria Park Road, Kelvin Grove Brisbane, Queensland 4059, Australia E-mail: [email protected]

Abstract

Objectives

The incidence and mortality of traumatic brain injury (TBI) has increased rapidly in the last decade in China. Appropriate ambulance service can reduce case-fatality rates of TBI significantly. This study aimed to explore the factors (age, gender, education level, clinical experience, professional title, organization, specialty before prehospital care, and training frequency) that could influence prehospital doctors’ knowledge level and practices in TBI management in China, Hubei Province.

Methods

A cross-sectional questionnaire survey was conducted in two cities in Hubei Province. The self-administered questionnaire consisted of demographic information and questions about prehospital TBI management. Independent samples t-test and one-way ANOVA were used to analyze group differences in the average scores in terms of demographic character. General linear regression was used to explore associated factors in prehospital TBI management.

Results

A total of 56 questionnaires were handed out and 52 (93%) were returned. Participants received the lowest scores in TBI treatment (0.64; SD=0.08) and the highest scores in TBI assessment (0.80; SD=0.14). According to the regression model, the education level was associated positively with the score of TBI identification (P=.019); participants who worked in the emergency department (ED; P=.011) or formerly practiced internal medicine (P=.009) tended to get lower scores in TBI assessment; participants’ scores in TBI treatment were associated positively with the training frequency (P=.011); and no statistically significant associated factor was found in the overall TBI management.

Conclusion

This study described the current situation of prehospital TBI management. The prehospital doctors’ knowledge level and practices in TBI management were quantified and the influential factors hidden underneath were explored. The results indicated that an appropriate continuing medical education (CME) program enables improvement of the quality of ambulance service in China.

KouK , HouXY , SunJD , ChuK . Doctor’s Knowledge and Practices of Traumatic Brain Injury Management in Chinese Prehospital Settings. Prehosp Disaster Med. 2015;30(6):560–568.

Type
Original Research
Copyright
© World Association for Disaster and Emergency Medicine 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Maas, AI, Stocchetti, N, Bullock, R. Moderate and severe traumatic brain injury in adults. Lancet Neurol. 2008;7(8):728-741.Google Scholar
2. Ghajar, J. Traumatic brain injury. Lancet. 2000;356(9233):923-929.CrossRefGoogle ScholarPubMed
3. Wu, X, Hu, J, Zhuo, L, et al. Epidemiology of traumatic brain injury in eastern China, 2004: a prospective large case study. J Trauma. 2008;64(5):1313-1319.Google ScholarPubMed
4. Marshall, LF, Gautille, T, Klauber, MR, et al. The outcome of severe closed head injury. Special Supplements. 1991;75(1):S28-S36.Google Scholar
5. Li, D, Zhang, J, Tan, F. Some problems and strategies in Chinese emergency medical systems. Clinical Education of General Practice. 2008;6:353-354.Google Scholar
6. Hou, XY, Lu, C. The current workforce status of prehospital care in China. Journal of Emergency Primary Health Care. 2005;3(3).Google Scholar
7. Hubei Province Bureau of Statistics. Statistical Report of Hubei Province 2015. http://www.stats-hb.gov.cn/info/iIndex.jsp?cat_id=10007. Accessed June 16, 2015.Google Scholar
8. People’s Republic of China National Bureau of Statistics. National Data 2015. http://data.stats.gov.cn/workspace/index?m=fsnd. Accessed June 16, 2015.Google Scholar
9. Sun, B. The discussion of work division in ambulance services in our city. Chinese Journal of Critical Care Medicine. 2009;29:373.Google Scholar
10. Li, J, Pei, Y. The problem and solution in the development of Chinese prehospital medicine [in Chinese]. China Journal of Emergency Resuscitation and Disaster Medicine. 2006;1:246-248.Google Scholar
11. Zhou, H, Huang, P, Xu, X, Zhao, S. The discussion of the management style for Chinese prehospital medicine [in Chinese]. Chinese General Practice. 2005;8:822-823.Google Scholar
12. Zhou, Y, Jiang, W. Analysis of the cooperation between Emergency Medical Centers and hospital EDs [in Chinese]. Modern Hospital Management. 2014;12:51-53.Google Scholar
13. Wuhan Medical Emergency Center. Introduction to Wuhan Medical Emergency Center 2012. http://wuhan.emss.cn/intro.asp. Accessed July 05, 2014.Google Scholar
14. Chilton, M. A brief analysis of trends in prehospital care services and a vision for the future. Australasian Journal of Paramedicine. 2012;2(1):1-7.Google Scholar
15. Queensland Government. Clinical Practice Manual – Trauma. Queensland Ambulance Service, 2011. https://ambulance.qld.gov.au/docs/09_cpp_trauma_030912.pdf. Accessed October 30, 2014.Google Scholar
16. Gu, X. Strengthening the first-aid human resources building. Chinese Hospitals. 2011;15:45-47.Google Scholar
17. Paramedic Australasia. What is a Paramedic. https://www.paramedics.org/paramedics/what-is-a-paramedic/paramedic/. Accessed October 30, 2014.Google Scholar
18. Paramedic Australasia. Paramedics in the 2011 Census. https://www.paramedics.org/featured/home-featured/paramedics-in-the-2011-census/. Published 2012. Accessed October 30, 2014.Google Scholar
19. Yang, Y, Chao, J. A survey of doctors’ degrees of satisfaction in Nanjing Hospital [in Chinese]. Chinese Hospital Management. 2008: 31-33.Google Scholar
20. Ren, X, Sun, H, Yang, F. Investigation and analysis of doctors’ lassitude in class 3-A hospitals in Beijing [in Chinese]. Chinese Hospital Management. 2007;27:15-17.Google Scholar
21. Liang, Q, Li, S. Safety risk and prevention methods for prehospital management [in Chinese]. Journal of Youjiang Medical College For Nationalities. 2008;30:990-991.Google Scholar
22. Lam, Tp, Wan, Xh, Ip, MSm. Current perspectives on medical education in China. Med Edu. 2006;40(1):940-949.Google Scholar
23. Fernandez, AR, Studnek, JR, Margolis, GS. Estimating the probability of passing the national paramedic certification examination. Acad Emerg Med. 2008;15(3):258-264.CrossRefGoogle ScholarPubMed
24. Allery, LA, Owen, PA, Robling, MR. Why general practitioners and consultants change their clinical practice: a critical incident study. BMJ. 1997;314(7084):870-874.Google Scholar
25. Lu, F, Li, M. Practice and discussion of the pre-job training for prehospital doctors [in Chinese]. Chinese Hospitals. 2011: 55-57.Google Scholar
26. Bloom, BS. Effects of continuing medical education on improving physician clinical care and patient health: a review of systematic reviews. Int J Technol Assess Health Care. 2005;21(3):380-385.Google Scholar
27. Davis, D, O’Brien, MAT, Freemantle, N, Wolf, FM, Mazmanian, P, Taylor-Vaisey, A. Impact of formal continuing medical education: do conferences, workshops, rounds, and other traditional continuing education activities change physician behavior or health care outcomes? JAMA. 1999;282(9):867-874.CrossRefGoogle ScholarPubMed