台灣臨床醫師輸血醫學認知情形

Physicians’Transfusion Medicine Knowledge in Taiwan

"背景：台灣用血量高於許多先進國家，且人口快速老化，有血液捐供不平衡的風險，因此需要實施有效的病人血液管理(patient blood management, PBM)，減少非必要的血液使用。為此，須確保臨床醫師對輸血醫學有足夠的認知。材料與方法：本研究為橫斷式研究，於2019年11至12月間，邀請台灣北部一家醫學中心的醫師參與輸血醫學認知調查，並探討可能影響其認知程度的因素。本研究採用自填式匿名問卷，內容包括參與者特性及20題輸血醫學認知題目。我們也取得該醫院各科別於2019年的輸血量，以評估各科別醫師的輸血醫學認知程度與血液輸用量之相關性。結果：總計236位醫師完成問卷並納入分析，整體平均答對題數為10.9±3.4，相當於總題數的54.5%。血液腫瘤科(16.0±3.3, 80.0%)、麻醉科(13.8±3.0, 69.1%)及急診科(12.7±2.3, 63.5%)醫師的輸血醫學認知表現顯著較佳。然而，血液輸用量越大的科別，未觀察到顯著較佳的認知表現。值得注意的是，醫師若曾閱讀或擁有輸血醫學教科書，其輸血醫學認知表現顯著較佳(â = 1.10, p = 0.0091)。結論及建議：本研究發現整體醫師的輸血醫學認知表現不如預期，若欲在台灣實施有效的PBM計畫，首先應加強臨床醫師的輸血醫學教育訓練，特別是在輸血量較大的科別，因此台灣血液基金會出版了「精實輸血手冊」，期能協助增加醫師對輸血醫學的認知，同時提升對PBM的意識。"

"Background: An imbalance between the supply of and demand for blood products in Taiwan is anticipated in the near future. This is because more blood is used clinically in Taiwan than in developed countries, and Taiwan’s population is aging rapidly. An effective patient blood management (PBM) program is therefore urgently required, and ensuring that physicians have sufficient knowledge of transfusion medicine (TM) is critical.Materials and Methods: A cross-sectional survey was conducted in November and December 2019 at a tertiary medical center in northern Taiwan to determine physicians’TM knowledge and explore related factors. An anonymous and self-administered questionnaire with two sections was adopted; the first related to the characteristics of the participants, and the second consisted of 20 multiple choice questions assessing TM knowledge. The numbers of units transfused in 2019 by specialty were also obtained to evaluate the correlation between physicians’TM knowledge and amount of blood used in their specialty.Results: A total of 236 physicians completed the questionnaire. The overall mean number of correct answers on the TM knowledge assessment was 10.9±3.4 (54.5%). Hematologist/ oncologists (16.0±3.3, 80.0%), anesthesiologists (13.8±3.0, 69.1%), and emergency physicians (12.7±2.3, 63.5%) achieved significantly higher scores than other physicians did. For physicians in the specialties with the most transfused units, the level of TM knowledge was not significantly higher. Physicians who read or owned TM textbooks demonstrated significantly greater TM knowledge (β= 1.10, p = 0.0091); however, those who had higher seniority, prescribed transfusion of more blood units, or had a history of PBM training did not have significantly greater knowledge than those who did not.Conclusion: The physicians’TM knowledge was lower than expected. To implement an effective PBM program, additional TM training for physicians in Taiwan is required, especially for those in the specialties prescribing the most blood transfusions. The Taiwan Blood Services Foundation published the Handbook of Precise and Practical Blood Transfusion to improve physicians’TM knowledge and increase their awareness of PBM."