臺灣博碩士論文加值系統

本研究之主要目的在於瞭解南台灣地區急診專科醫師對實證醫學的認知、態度與應用的情形，希望能作為台灣急診醫界推動實證醫學之參考。本研究為橫斷性研究，以嘉義縣市以南之地區醫院層級以上的急診專科醫師為研究對象，研究內容主要為量性研究，以結構式問卷進行調查，以了解急診醫師對實證醫學之認知、態度與應用的看法，問卷共發出214份，回收之有效問卷為189份，回收率為88.32%。本研究之主要結果如下：一、急診醫師對實證醫學之認知方面：1、急診醫師對實證醫學名詞的了解程度方面，對各項實證醫學相關名詞的了解程度平均分數介於1.88至2.79分之間（以非常了解為1分，完全不了解為4分）。二、急診醫師對實證醫學之態度方面：1、醫師參與實證醫學相關活動情形，有57.7%急診醫師在職期間曾經參與實證醫學相關訓練課程，但有93.1%表示未來願意參與實證醫學相關活動。2、大部分的急診醫師（86.7％）認為實證醫學研究方法的應用會對臨床工作有所幫助。3、急診醫師在應用實證醫學所遭遇到的障礙主要依序為缺乏時間（57.1％）、對實證醫學知識不足（50.3％）、研究方法學知識不足（45.5％）與評判文獻證據有困難（40.7％）。4、急診醫師對各項實證醫學敘述的贊同程度平均分數介於1.79至3.09分之間（以非常同意為1分，完全不同意為5分）。三、急診醫師對實證醫學之應用方面：1、急診醫師自評診療中符合實證醫學的百分比平均為32.4%。2、急診醫師對實證醫學臨床問題之應用方面，結果發現急診醫師在治療病患的選擇上會有很大的差異性存在，只有在少數的臨床情況下會有一定程度的共識。根據研究結果，本研究建議後續研究者可以針對全國的急診專科醫師作全面性的調查或抽樣調查，另外嘗試加入某些部分的開放式問題，或許可以更清楚的全面性的了解急診醫師對實證醫學的認知、態度與應用的實際情況。

The purposes of this study were to understand emergency physicians’ perception, attitude and application of evidence-based medicine(EBM). This cross-sectional study employed quantitative methods. Regarding the quantitative method, the study population included emergency physicians in southern Taiwan of 32 participating hospitals. Structured questionnaires were sent to emergency physicians, a total of 214 questionnaires were distributed with 189 questionnaires being returned. The response rate was 88.32%. Descriptive statistics was used in data analysis. The major findings were: 1. Emergency physician’s perception of EBM: The average score in Physicians’ understanding EBM terminologies were from 1.88 to 2.79(score ranged from 1 to 4, 1 represented fully understand). 2. Emergency physician’s attitude of EBM: a. There were over a half (57.7%) emergency physicians had taken EBM training courses, while 93.1% expressed their willingness to attend EBM activities in the future. b. Most emergency physicians(86.7%) agreed that application of EBM was useful in clinical practice. c. The major barriers of emergency physicians to apply EBM were lack of time(57.1%), lack of EBM knowledge(50.3%), lack of research methodology knowledge(45.5%) and hardness of critical appraisal(40.7%). d. In general, emergency physicians hold positive attitudes toward EBM, the average score was from 1.79 to 3.09 (score ranged from 1 to 5, 1 represented the most agree). 3. Emergency physician’s application of EBM: a. The average proportion of EBM application in emergency physicians’ clinical practice was 54.42% . b. Emergency physician’s choice of clinical problem-treating was diverse, only little clinical problem may have uniform opinions.

第一章 緒論 -- 1
第二章 文獻探討 -- 4
第三章 研究方法 -- 17
第四章 研究結果 -- 31
第五章 討論 -- 56
第六章 結論與建議 -- 65
參考文獻 ---------------- 68
附錄一 本研究問卷 -- 72

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