Analysis On The Standardized Training Of Anti-Coagulation Of Atrial Fibrillation In The Suburbs Of Changsha And Its Influencing Factors

Objective:Through standardized training of primary doctors on anti-coagu lation knowledge of atrial fibrillation,the primary doctors's anti-coagulation knowledge and the prescription rate of anti-coagulation drugs for atrial fibrillation were improved.Meanwhile,the influencing factors of training effect were analyzed.This research provide reference for health management departments to formulate training programs to promote anti-coagulation of atrial fibrillation in basic-level hospitals.Methods:140 medical staffs were selected for investigation and interve ntion,who come from three hospitals:the First People's Hospital of Changsha County,Yongan Health Center of Liuyang City,Beishan Town Health Center of Changsha County.Two questionnaire surveys were conducted among doctors in three hospitals.Main training content of standardized training of anti-coagulation knowledge of atrial fibrillation:?1?:AF anti-coagulation prevention knowledge 4 lessons,?2?:Attitude to AF anti-coagulation 4 lessons,?3?:How to take AF anti-coagulation 2lessons;?4?:Case analysis and lesson of atrial fibrillation in primary hospitals.Collectting pre-and post-training data and then analyzing data.Counting on the prevalence of anti-coagulation drugs in atrial fibrillation in three primary hospitals from January 2017 to December2017?before training?and from January 2018 to December 2018?after training?.Result:1.Average score of prevention and treatment of anti-coagulation therapy before training is?3.28±1.02?.The awareness rate of risk factor of CHADS₂ score,CHA₂DS₂-VASc score,HAS-BLED score is 35.29%,25.21%and 24.37%,respectively.The average score of prevention attitude of anti-coagulation therapy is?10.56±1.32?.The doctors who want to receive AF anti-coagulation related knowledge training is 67.22%,who will to carry out AF anti-coagulation related health education for AF patients is 83.19%,who hope patients know about the necessity and risk of anti-coagulation treatment is 76.47%.2.After AF anti-coagulation knowledge training,the average score of anti-coagulation prevention and treatment knowledge is?8.01±1.75?.The awareness rate of risk factor of CHADS₂ score,CHA₂DS₂-VASc score,HAS-BLED score is 51.26%,41.18%and35.29%respectively.The doctors who want to receive AF anti-coagulation related knowledge training is 94.96%.The remaining four items are between 80%and 91%,both of which have increased.3.In primary doctors who using the CHADS₂ score and the CHA₂DS₂-VASc score to evaluate stroke risk of AF anti-coagulation prevention and treatment is 80.67%and 52.10%respectively,using HAS-BLED to assess bleeding risk accounted for 52.10%,adjusting the amount of warfarin according to the INR by 73.95%,informing patients about dietary precautions and follow up by 43.70%before training.4.After the training,using the CHADS₂ score and the CHA₂DS₂-VASc score to assess stroke risk is 95.80%and 94.12%respectively,which significantly higher than the previous,using HAS-BLED to assess bleeding risk accounted for 89.08%,adjusting the amount of warfarin according to the INR by 90%,informing patients about dietary precautions and follow up by 73.41%.5.Through statistical analysis,primary doctors of different ages,working years,educational background,professional titles,unit levels,and departments will affect the effect of standardized training on anti-coagulation knowledge of atrial fibrillation.6.Through training,the prescription rate of anti-coagulation drugs in the primary doctors was significantly increased,and the difference was statistically significant?P<0.05?.Conclusion:1.Standardized training on anti-coagulation knowledge of atrial fibrillation can improve the prevention knowledge,prevention attitude,prevention behavior level and prescription rate of anti-coagulation drugs of primary doctors.2.Age,working years,educational background,professional title,unit level,and department can all affect the effect of atrial fibrillation training.The age of 31⁴0 years old,the working years are 6¹0years,bachelor,attending physician,county hospital,physician will get the best training results.