Doctor's Knowledge and Practices of Traumatic Brain Injury Management in Chinese Prehospital Settings.
OBJECTIVE
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.


CONCLUSIONS
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.
1School of Public Health and Social Work & Institute Health and Biomedical Innovation,Queensland University of Technology,Brisbane,Queensland,Australia.
Kou
K
Kou
1School of Public Health and Social Work & Institute Health and Biomedical Innovation,Queensland University of Technology,Brisbane,Queensland,Australia.
Xiang-Yu
XY
Hou
1School of Public Health and Social Work & Institute Health and Biomedical Innovation,Queensland University of Technology,Brisbane,Queensland,Australia.
Jian-Dong
JD
Sun
2Royal Brisbane and Women's Hospital Metro North Hospital and Health Service,Butterfield Street Herston,Queensland,Australia.
Kevin
K
Chu
D000328:Adult; D000070642:Brain Injuries, Traumatic / Q000628:therapy*; D002681:China; D002983:Clinical Competence / Q000592:standards*; D003430:Cross-Sectional Studies; D004632:Emergency Medical Services / Q000379:methods*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010820:Physicians; D011795:Surveys and Questionnaires
CME continuing medical education; China; ED emergency department; TBI traumatic brain injury; emergency medicine; prehospital; traumatic brain injury