| Summary: | 碩士 === 中山醫學大學 === 醫學研究所 === 90 === The purpose of this study was to investigate whether menopause women received proper supplement through the cognition of hormone replacement therapy by gynecologist-obstetrician.
According to the medical reports that estrogen content reducing plays the major role of climacteric symptoms which happening to menopause female’s body. Nevertheless, the outcome through supplement of estrogen to solve the climacteric symptoms seems not as it expected. It revival the concern about the side effects and outcomes of hormone replacement therapy, and how to take hormone treatment’s medicine become an attractive strategy.
In this study of conducting survey by open-ended describe questionnaire is investigated. Two of the major questionnaires: the first subject of the question is “Menopause women received proper supplement through the cognition of hormone replacement therapy by gynecologist-obstetrician” The second subject of the question is ”Process and experience of clinical supplement through the cognition of hormone replacement therapy.” Twelve sub-questions come to those two major subjects. Surveys were distributed to two thousand and six hundred forty six members of Taiwan Association of Obstetrics and Gynecology through the attachment mail of Taiwanese Journal of Obstetrics and Gynecology. Analysis is fundamental based on the idea of specific information topics as listed below:
1. Total rate of right answer.
2. Right answer rate for each question.
3. Right answer rate comes with specific service units.
4. Right answer rate comes with age of physician.
Total four hundred and seventy completed surveys were returned, resulting in a 16.68% response rate which eighteen surveys are coming from medical centers, total one hundred and forty three surveys are coming from regional and district hospitals (hospitals otherwise medical center) and total two hundred and eighty five number of doctors’ survey are coming from basic level clinics. The age distribution described as following: the age from seventy to eighty total number is twenty people; the age from sixty to sixty nine total number total number is forty seven people; the age from fifty to fifty nine total number is one hundred and fifty one people; the age from forty to forty nine total number is one hundred and sixty four people and the age from thirty to thirty nine total number is sixty four people. As we expect from the result from the implement of the survey that average rate of 8 right answers out of 8.33 comes from the average right answer of twelve resident doctors in Chung Shan Medical University Hospital as the reasonable basic cognition.
The majority of the doctors achieve seven right answers (equal to 23.54% of doctors) or eight right answers (equal to 29.37% of doctors) is mostly match the result of survey under the condition of no matter where they are working or how old they are. The number of doctor who achieves seven right answers is two hundred forty four people (equal to 54.71% of doctors) and the number of doctor who achieves nine right answers is one hundred and thirty three people (equal to 25.37% of doctors). About 90.13% of doctors understand that to collect the detail information and medical history of patients before implement HRT to patients, however only one of third of doctors ever request the patient to take entire physical examination before to take HRT. According to the ratiocinations from scholar and specialist that influences of taking HRT to composition of blood lipid may prevent cardiovascular disease. The influences of composition of blood lipid that taking HRT as a basic cognition index of HRT for doctor. Beyond understanding of us that only 32.74% of doctors achieve right answer of the questions. The further analysis on the reply that the doctors who are working for the clinic only achieve 25.96% compare to the right answer. Either the doctors who are working for the hospitals otherwise medical center receive only 42.1% of right answer rate; besides, the most right answer rate is coming from the age of thirty to thirty nine doctors.
Does it supposed to present the shortage of cognition of HRT in older age doctor? Doubtfully to receive right consult for climacteric women as they request the proper advice from doctors. Reeducation of climacteric for obstetrics and gynecology should supervise under the official medical department. According to the methods of medical system in United States of America and through collecting update reports from foreign countries to revise the suitable medical environment for Taiwan government in each year. Not only by built up hygiene education and follow up system for patients to achieve the best benefit from the implement of HRT through educated gynecologist-obstetrician treatment, but also reduce the happening of medical treatment disputation caused by imperfect treatment or different physician.
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