Chronic disease management professionals‘ COPD Knowledge: A survey in China's rural health centres^☆

Abstract

Background:Health professionals in rural primary care settings who engaged in non-communicable disease (NCD) management play a critical role in prevention and treatment of chronic obstructive pulmonary disease (COPD). Understanding their COPD relevant knowledge can provide evidence for informing COPD prevention and management enhancement strategies in primary care.
Objective:To understand the knowledge of COPD among health professionals who engaged in NCD management in rural health centres.
Methods:In June 2021, 20 township hospitals in Zigong, Sichuan Province were randomly selected. A self-developed survey questionnaire was administrated to all health professionals who engaged in NCD management, including general practitioners(GPs), public health professionals, and rural doctors. The participants were asked to choose correct answers on a number of questions regarding knowledge of NCD management.
Results:All participants (n=474) completed the survey questionnaires. The respondents consisted of 68 GPs (14.4 %), 177 public health professionals (37.3 %), and 229 rural doctors (48.3 %). Regarding comprehensive COPD knowledge, GPs had a statistically significant higher percentage of correctness than rural doctors (35.3% vs 7.4 %, P < 0.017), and public health workers also outperformed rural doctors (31.6% vs 7.4 %, P < 0.017). In identifying risk factors for COPD, GPs achieved a significantly higher percentage of correctness than rural doctors(73.5% vs 46.3 %, P < 0.017), as did public health workers (66.7% vs 46.3 %, P < 0.017). In the assessment of diagnosis and evaluation of COPD, GPs' percentage of correctness was significantly higher (38.2 %) compared to public health workers (20.3 %) and rural doctors (3.9 %, P < 0.017), with public health workers also exceeding rural doctors (P < 0.017). In terms of treatment strategies for COPD, both GPs (30.9 %) and public health workers (19.2 %) showed significantly higher percentage of correctness than rural doctors (6.6 %, P < 0.017). Regarding follow-up management for COPD, public health workers exhibited a significantly higher percentage of correctness than both GPs (46.9% vs 29.4 % ) and rural doctors (46.9% vs 14.4 %, P < 0.017), with GPs higher than rural doctors(P < 0.017).
Conclusion:The health professionals who engaged in NCD management in primary care settings in rural areas of Zigong city in Sichuan Province demonstrate inadequate knowledge of COPD, especially in terms of diagnosis, evaluation, treatment strategies, and follow-up management. Levels of COPD understanding varies between different types of health professionals who engaged in NCD management, with rural doctors displaying lower awareness. Based on the findings, the authors suggest improving the knowledge of rural health professionals on prevention and management of COPD.

Keywords

Pulmonary disease / Chronic obstructive / Chronic disease management / Primary health care / Rural / Knowledge / Questionnaire survey

Declarations

Not applicable.

Authors' contributions

Conceptualization, L.J., Z.Y. and L.C.; Methodology, L.J., Z.Y., P.H. and Y.L.; Data curation, Z.Y., P.H. and Y.L.; Formal analysis, L.J.; Funding acquisition, not applicable; Project administration, not applicable; Resources, not applicable; Supervision, L.J. and L.C.; Validation, L.J. and L.C.; Writing—original draft, L.J.; Writing—review and editing, L.J. and L.C. All authors have read and agreed to the published version of the manuscript.

Ethics approval and consent to participate

The study received approval from Zigong Hospital of TCM Ethics Review Committee (IRB-2021-2-23).

Consent for publication

Not applicable.

Availability of data and materials

Not applicable.

Authors' other information

Not applicable.

Declaration of competing interest

The authors declare that they have no competing interests.

Funding

This research was supported by grants from the Sichuan Provincial Administration of Traditional Chinese Medicine (2021MS562) and Zigong First People Hospital.

Acknowledgements

Not applicable.

References

[1] Rong J, Ge YH, Chen GM, et al. Meta-analysis of prevalence of COPD among Chinese aged 40 years old and above, 2010-2019. (Chinese). Mod Prev Med. 2020;47(13):2305-2309 2336.

[2] Zhang J. Genetic variants in FAM13A and IREB2 are associated with the susceptibility to COPD in a Chinese rural population: a case-control study. Acute Chronic Dis Rep. 2021; 13:1735-1745. doi: 10.2147/COPD.S162241.

[3] Zhang J, Li DS, Xu YY. Prevalence and influencing factors of chronic obstructive pulmonary disease among residents over 18 years old in Changsha City of Hunan Province. (Chinese). Occup and Health. 2019; 35(6):806-809.

[4] Ding Y, Yang D, Ping H, et al. Prevalence and risk factors of chronic obstructive pulmonary diseases in a Hlai c4o mmunity in Hainan Island of China. Clin Respir J. 2018; 12(1):126-133. doi: 10.1111/crj.12497.

[5] Li X, Cai L, Wang XM, et al. The prevalence of five common chronic diseases and multi-morbidity and its relationship with socioeconomic position among rural older adults in Yunnan Province. (Chinese). Chin J Dis Control Prev. 2019; 23(6):630-634. doi: 10.16462/j.cnki.zhjbkz.2019.06.003.

[6] Xu L, Xu DQ, Mu HD, et al. Clinical characteristics and current situation of diagnosis and treatment of chronic obstructive pulmonary disease in community population of Jinshan District in Shanghai. (Chinese). Shanghai Med J. 2020; 43(8):454-458. doi: 10.19842/j.cnki.issn.0253-9934.2020.08.002.

[7] Tang YM, Li Q, Zhang L, et al. An epidemiological survey and risk factors analysis of chronic obstructive pulmonary disease in Hubei Province. (Chinese). Chin J Disease Control Prev. 2018; 22(7):721-725. doi: 10.16462/j.cnki.zhjbkz.2018.07.016.

[8] Li L, Zhong X, Zheng A, et al. Prevalence and risk factors of chronic obstructive pulmonary disease in Kashi region, northwestern China. Int J Chron Obstruct Pulmon Dis. 2021; 16:655-663. doi: 10.2147/COPD.S289620.

[9] Chen JY, Zhong WL, Lin XQ, et al. Prevalence and influencing factors of chronic obstructive pulmonary disease among middle-aged and elderly population in Fujian province. (Chinese). Chin J Public Health. 2020; 36(2):170-173. doi: 10.11847/zgggws1122525.

[10] Cao XX, Xu CJ, Hou YB, et al.The epidemic trend and prediction of chronic diseases with high incidence in China from 1990 to 2025. (Chinese). Chin J Prev Contr Chron Dis. 2020; 28(1):14-19. doi: 10.16386/j.cjpccd.issn.1004-6194.2020.01.004.

[11] Zhang Y, Liu QM, Fu W, et al. Trend of the mortality rate of chronic obstructive pulmonary disease in residents in Hangzhou, 2006-2018. (Chinese). Disease Surveillance. 2020; 35(5):446-450. doi: 10.3784/j.issn.1003-9961.2020.05.017.

[12] Tian PR, Zhang SM, Ni P, et al. Analysis and prediction research of death and premature death by chronic obstructive pulmonary disease in rural areas of Liaoning Province from 2009 to 2016. (Chinese). Chin Gen Pract. 2019; 22(24):2985-2990. doi: 10.12114/j.issn.1007-9572.2018.00.330.

[13] Meng J, Mao W, Huang JM, et al. Mortality and trend prediction of chronic obstructive pulmonary disease in six counties (districts) of Guangxi, 2008-2016. (Chinese). Applied Prev Med. 2018; 24(3):181-184.

[14] Lin ZZ. Progress in epidemiological research on chronic obstructive pulmonary disease in China. (Chinese). J Hebei Univ (Natural Science Edition). 2020; 36(8):49-51 56. doi: 10.3969/j.issn.1673-1492.2020.08.018.

[15] Wang DZ, Zhang H, Xu ZL, et al. Analysis of the trend of mortality from chronic obstructive pulmonary disease in Tianjin from 2000 to 2016. (Chinese). Chin J Disease Cont and Prev. 2018; 52(7):709-714. doi: 10.3760/cma.j.issn.0253-9624.2018.07.006.

[16] Liu RX, Jia CB, Zhang CY, et al. Investigation and Analysis of the Allocation of Medical Resources Related to Chronic Obstructive Pulmonary Disease in Primary Medical Institutions. (Chinese). Chin Hosp Manag. 2021; 41(7):43-46.

[17] Zhu ZQ, Zheng WG, Tang YH, et al. Current awareness of chronic obstructive pulmonary disease among rural residents in some areas of Shandong Province. (Chinese). Chin J Prev Contr Chron Dis. 2017; 25(2):108-110. doi: 10.16386/j.cjpccd.issn.1004-6194.2017.02.008.

[18] Chen R, Li NX, Yang Z, et al. Analysis of the current situation of chronic disease management service and utilization of patients with chronic diseases in a ruralpgbrkf area of Sichuan Province. (Chinese). Modern Prev Med. 2017; 44(12):2179-2182.

[19] Sun YC. Challenges and countermeasures for chronic obstructive pulmonary disease in Chinese primary health care institutions. (Chinese). Chin J Tubercul Respiratory Diseases. 2020; 43(1):14-16. doi: 10.3760/cma.j.issn.1001-0939.2020.01.005.

[20] Liu Q, Chen YH, Wang Z, et al. Analysis of the status quo and influencing factors of community general practitioners in Beijing on chronic obstructive pulmonary disease. (Chinese). Chin Gen Pract J. 2021; 24(8):982-988. doi: 10.12114/j.issn.1007-9572.2021.00.401.

[21] Zou Q, Cai M, Zhang CY, et al. Survey on the allocation of chronic disease management service resources in a county of Shanxi Province. (Chinese). Chin Hosp Manag. 2021; 37(2):139-143. doi: 10.3760/cma.j.cn111325-20201211-02210.

[22] Li F, Sheng CF, Wang HY. Improving the role of general practitioners in the early diagnosis and management of chronic diseases: a case analysis of chronic obstructive pulmonary disease. (Chinese). Chin Gen Pract. 2021; 24(9):1044-1050. doi: 10.12114/j.issn.1007-9572.2020.00.607.

[23] Liu JC, Zheng HY, Li CF. Management models and development trends of chronic obstructive pulmonary disease. (Chinese). Chin J Prev Contr Chron Dis. 2022; 30(7):541-544. doi: 10.16386/j.cjpccd.issn.1004-6194.2022.07.014.

[24] Zhu XL, Zhang XC, Si X, et al. Capability in noncommunicable diseases management among village doctors in China. (Chinese). Chin J Public Health. 2019; 35(5):622-625. doi: 10.11847/zgggws1122693.

[25] Zhu XL, Zhang XC, Wushouer P, et al. Analysis of non-communicable diseases management by medical staff of primary institutions in eight provinces in 2012 and 2015 of China. (Chinese). Chin J Prev Contr Chron Dis. 2019; 27(3):161-165. doi: 10.16386/j.cjpccd.issn.1004-6194.2019.03.001.

[26] Huang LM, Zhu SZ, Li JL, et al. Training status and needs of primary care personnel for chronic disease health management in Hubei Province. (Chinese). J Pub Health and Prev Med. 2018; 29(6):119-122. doi: 10.3969/j.issn.1006-2483.2018.06.030.

[27] Peng B, Zhang XJ, Jiang XT, et al. The availability of essential medicines and diagnostic devices for chronic obstructive pulmonary disease in primary care. (Chinese). Chin Gen Pract. 2022; 25(7):771-781. doi: 10.12114/j.issn.1007-9572.2022.00.001.

[28] Yin FX, Yi M, Liu X, et al. Study on the effect of standardized training for primary physicians on chronic obstructive pulmonary disease. (Chinese). Chin J Med. 2020; 55(7):809-812. doi: 10.3969/j.issn.1008-1070.2020.07.036.

[29] Li L, Yao AJ, Chen YS, et al. Analyse on the mode and effectiveness of standardized training for the grassroots general practitioners in the diagnosis and treatment of chronic diseases. (Chinese). Chin. J of PHM. 2019; 35(5):621-624 628. doi: 10.19568/j.cnki.23-1318.2019.05.012.

[30] Sun XR, Wan HP. Study on the current status and suggestions for continuing education training of general practitioners based on online training of common diseases diagnosis and treatment knowledge. (Chinese). Chin Gen Pract. 2021; 24(7):875-880 885. doi: 10.12114/j.issn.1007-9572.2021.00.023.

[31] Huang JJ, Zhang XY. Influencing factors of satisfaction about promotion of appropriate technology of chronic respiratory diseases, Guizhou. (Chinese). Mod Prevent Med. 2020; 47(17):3184-3188.

[32] Liu LL, Zhang SQ, Gong F. Current status of general practitioner training in Chongqing and corresponding policy recommendations. (Chinese). Chin Gen Pract. 2017; 20(1):89-94. doi: 10.3969/j.issn.1007-9572.2017.01.019.

[33] Wang YL, Tu CL, Wan XF, et al. Investigation of awareness level of general doctors about chronic obstructive pulmonary disease in Jiading District, Shanghai. (Chinese). J Clin Pulm Med. 2019; 24(10):1775-1780. doi: 10.3969/j.issn.1009-6663.2019.10.008.

[34] Ye XL, Yang J, Li M, et al. Awareness and short-term training effectiveness of basic knowledge about chronic obstructive pulmonary disease among rural primary medical workers in Yunnan and the effect of short-term training. (Chinese). J Kunming Med Univ. 2020; 41(2):43-48.

[35] Wang M. Investigation and Research On the Awareness Anddemands of Elderly With COPD Under Different Elderlycare Models in Urumqi. (Chinese). Urumqi: Xinjiang Medical University; 2021.

[36] Lei YQ, Wu GX, Zhu SQ, et al. Investigation and analysis of doctors’ cognition of chronic obstructive pulmonary disease in medical institutions at all levels in Wuzhou City. (Chinese). Guangxi Med J. 2021; 43(10):1222-1227. doi: 10.11675/j.issn.0253-4304.2021.10.13.

[37] Jia CB, Huang K, Zhang CY, et al. Status survey of the diagnosis and management ability of chronic obstructive pulmonary disease in eighty cities in China. (Chinese). Chin J Clin. 2021; 49(6):669-671. doi: 10.3969/j.issn.2095-8552.2021.06.012.

[38] You S. Construction of Health Education Path For COPD Patients Basedon clinical Decision Support system. (Chinese). Huzhou: Huzhou Teachers College; 2022.

[39] Yuan F, Wu GX, Wu R, et al. Investigation of cognition and diagnosis and treatment on chronic obstructive pulmonary disease of physicians in Yanqing District primary hospital of Beijing. (Chinese). J Tuberc Lung Dis. 2021; 2(3):228-233. doi: 10.3969/j.issn.2096-8493.20210053.

[40] Liu L. Study On the Situation of Health Management of Non-communicable Chronic Diseases(HM-NCDs), the Capacity of Healthcare workers to Delivery HM-NCDs and Measures to Improve It in Primary Healthcare Sections in Chongqing. (Chinese). Chongqing: Army Medical University; 2020.

[41] Mao H, Liang JM, Sang ZX, et al. Analysis of the current situation of occupational burnout among public health personnel in primary medical and health institutions. (Chinese). Applied Prev Med. 2019; 25(5):367-370.