衛生福利部所屬醫院醫事人員實證醫學的能力與態度調查

Survey of the Ability and Attitudes towards Evidence-Based Medicine among the Employees of the Hospitals Affiliated with the Ministry of Health and Welfare

目的：台灣於2000年代起將實證醫學（Evidence-based medicine; EBM）歸納為醫學教育的必要研習項目及能力之一，以提升照護病人的品質，但台灣某些醫療院所缺乏EBM的資源可供應用，故如何提供EBM資源及教育訓練成為成功關鍵。本研究之目的在於探討衛生福利部所屬醫院同仁之EBM能力與態度，以供未來改善參考。方法：本研究與台北醫學大學EBM中心共同完成EBM認知、態度和能力評值工具的建置、完成評值問卷工具，並以衛生福利部所屬醫院醫師、護理及其它醫事人員為研究對象，採網路公告及電子郵件調查。結果：計有421位部屬醫院同仁回覆本調查。結果顯示；各級醫事人員EBM能力以實證照護態度最佳，最差的為文獻評讀能力。受訪者有主管職者、有教學職務者、學歷較高者其EBM五大能力均較高。專業別、是否用過資料庫及是否知道Cochrane Library中有中文資料庫這三項乃為EBM五項個別能力最佳預測因子。專業別（p<0.001）、年資（p<0.005）、是否用過資料庫（p<0.005）及是否知道Cochrane Library中有中文資料庫（p<0.001）這四項為EBM總體能力之最佳預測因子。結論：本研究顯示如何提升實證資料庫，尤其是中文資料庫的利用度為提高部屬醫院同仁EBM能力之最可行策略，進而可提升照護病人的能力與品質。

Objectives. Evidence-Based Medicine (EBM) has been included into all levels of medical education since the 2000s in Taiwan. However, there is still a lack of EBM resources in some hospitals in Taiwan, especially public hospitals and community hospitals. The purpose of this study was to assess the ability and attitudes towards EBM among the employees of hospitals affiliated with Ministry of Health and Welfare, and to be a reference for further improvement. Methods. From August through December, 2013, all employees of hospitals affiliated with the Ministry of Health and Welfare were invited by e-mail to participate in the selfadministered structured questionnaire survey on the ability and attitudes towards EBM. Results. A total of 421 hospital workers completed the questionnaire. The results showed that their score on attitude towards evidence-based care was the best, followed by the ability to form an answerable question and the ability to apply evidences for patient care, while the worse was with regard to the ability to critically appraise evidence . Administrators, faculty, and people who received higher education were found to have higher scores on each of the five EBM competencies . Expertise (p<0.001), years of working experience (p<0.005), whether database was used or not (p<0.005), and whether or not one knows there is a Chinese database in the Cochrane Library were the four significant predictive factors of the overall EBM ability. Conclusion. Promoting the utilization of EBM database, especially the Chinese database may increase health care workers’ ability to utilize data and findings reported by EBM which will also lead to improvements in the quality of patient care.