新型冠状病毒肺炎疫情下基层医生自我角色定位与专家建议一致性及影响因素研究

Background: Primary doctors have participated in containing the COVID-19 pandemic outbroken in December 2019 at the primary level. Investigating their perception of their own roles in the pandemic containment and influencing factors is necessary, since their perceived roles have impact on their recognition of obligations. Objective: To investigate the consistency of primary doctors and experts' perceptions of roles of primary doctors in COVID-19 containment, providing evidence for the development of targeted trainings for primary doctors and the determination of the roles of them in major public health events. Methods: A questionnaire survey was conducted among 1 758 primary care doctors from Zhejiang Province from February 21 to 27, 2020 for investigating their perceptions of roles of primary care doctors in COVID-19 containment, including whether health education of infectious diseases should be conducted, the classification of COVID-19 and classification, reporting and referral of suspected cases, treatment of suspected or confirmed cases, follow-up of patients after treatment. The role positioning of primary care doctors was compared the consensus rate with expert recommendations, and the consistency rate was high when it was more than 90%. Multivariate Logistic regression was used to analyze the factors that the self-role orientation of primary care doctors was inconsistent with the expert's suggestion. Results: Among 1 758 participants, 1 513(86.1%) participated in the frontline containment of COVID-19 pandemic. Respondents and experts had highly identical perceptions on primary care doctors' roles in carrying out health education on infectious diseases〔99.6%(1 751/1 758)〕, reporting or referring suspected cases〔96.8%(1 702/1 758)〕 and following-up of the treaded patients〔91.3%(1 605/1 758)〕, while they were at variance over diagnosing and classifying COVID-19〔49.5%(871/1 758)〕 as well as treating suspected cases〔61.4%(1 080 /1 758)〕. Logistic regression analysis indicated that working at a clinic or health station, and intermediate or senior professional title were facilitators for respondents having similar perceptions on primary care doctors' roles in diagnosing and classifying COVID-19(P<0.05);working at a clinic or health station, intermediate or senior professional title, and participating in COVID-19 containment were facilitators for respondents having similar perceptions on treating suspected cases to those of experts(P<0.05). Conclusion: Most primary care doctors have participated in frontline COVID-19 containment. Their perceptions of their roles over diagnosing and classifying COVID-19, and treating suspected cases are low consistent with those of experts. In view of this, functional support for diagnosing and treating COVID-19 and guidance on how to appropriately understand primary doctors' roles in COVID-19 containment should be given to primary doctors with junior professional title, less years of working as a doctor, working at the community(township) health center, or without an experience of containing COVID-19 at the frontline.