台灣家庭醫學專科醫師參與性病防治計畫的門診成效評估與滿意度調查

The Effectiveness of Family Physicians Participating Sexually Transmitted Diseases Clinic Project and Their Satisfaction in Taiwan

目的：本研究目的調查台灣家庭醫學專科醫師參與性病防治計畫，855位醫師的認知、觀感與執行情形，以瞭解門診成效與滿意度。
方法：針對2010-2014參與計畫的醫師，自2014年1月1日至9月30日期間以記名的書面郵件、傳真、電子郵件及線上問卷的方式，調查門診成效與醫師滿意度。門診成效的評估共有4項成效指標，分別為衛教諮詢(25%)、疾病防治(40%)、服務滿意(10%)及行政管理(25%)。
結果：共發出855份問卷。門診成效調查回收191份(22.3%)，醫師滿意度調查回收174份(20.4%)，回收樣本經檢定與母群體無差異。研究結果顯示醫師加入計畫的時間越久，計畫成效越顯著，佐證計畫持續執行的重要性；當醫師對計畫內容的瞭解程度愈高，成效分數越高，證明了持續輔導醫師有助於達成各項指標和業務目標。要加強醫師執行的意願，首先必須簡化行政流程；其次為加強本身性病治療服務的能力，更能增加面對各項疾病治療的自信度。而增加經費的誘因對於醫師在執行業務上也會更有動力。98.8%醫師認為學會應該繼續爭取計畫；89.5%醫師願意繼續參加計畫；59.4%醫師認為加入計畫對診所有正面加值的效果。
結論：透過專科醫學會推動社區疾病管理的概念，在家庭醫學會得到了良好的成效。醫師的持續教育，可以提升知能與自信、增加服務成效、並提升民眾健康。性伴侶追蹤、檢體運送、陽性轉介與追蹤、申報與行政繁瑣，是需要解決的困難，也將影響計畫的成效。本計畫的成效評估與回饋機制，將可提供性病防治工作的政策與績效之依據。

Purpose: Prevention and control of sexually transmitted diseases (STDs), has been a major issue in both medical care and public health. The purpose of the study was to evaluate the knowledge, attitudes and practice of family physicians who had participated in the project for STD prevention and control (STDs Clinic Project) from 2010 to 2014.
Methods: During the period from January 1 to September 30, 2014, a total of 855 family physicians were interviewed with structured questionnaires about their perceptions on the effectiveness of and their satisfaction with the STDs Clinic Project. Data were analyzed by SPSS statistical package, and p<0.05 was set as the level of statistical significance.
Results: A total of 191 (22.3%) and 174 (20.4%) physicians completed respectively the effectiveness and the satisfaction questionnaires. No significant difference in personal profiles between respondents and non-respondents was observed. Results showed that the longer the physicians stayed with the project or the more knowledge about STDs they had, the greater the effectiveness of the STDs Clinic Project appeared to be. Keys for promoting physicians willingness to participate in the project included simplification of bureaucratic procedures, assistance in enhancing physicians STD treatment competency, and payment expansion. Totally, 89.5% of the respondents expressed willingness to stay with the project, and 59.4% found the STDs Clinic Project contributive to their medical business.
Conclusion:The community-based project on STD prevention and control initiated by the Taiwan Association of Family Medicine and funded by Centers for Disease Control proves to be effective in helping people in needs. Continuing medical education on STDs is needed to keep updating the knowledge and upgrading the competence of participating physicians. In the future, more efforts should be invested to implement effective follow-up of STD patients partners, referral, and reduction of bureaucratic procedures on payment claim. It is hoped that the results of the study can provide reference for drafting policies and establishing effective strategies for STD prevention and control.