Participant characteristics (n = 232).

Objectives To evaluate the practice of TB care among physicians at private facilities. Methods A cross-sectional study was conducted using questionnaires on knowledge, attitude, and practice related to TB care. The responses to these scales were used to explore latent constructs and calculate the standardized continuous scores for these domains. We described the percentages of participant’s responses and explored their associated factors using multiple linear regression. Results A total of 232 physicians were recruited. The most important gaps in practice included requesting chest imaging to confirm TB diagnosis (~80%), not testing HIV for confirmed active TB cases (~50%), only requesting sputum testing for MDR-TB cases (65%), only requesting follow-up examination at the end of the treatment course (64%), and not requesting sputum testing at follow-up (54%). Surgical mask was preferred to N95 respirator when examining TB patients. Prior TB training was associated with better knowledge and less stigmatizing attitude, which were associated with better practice in both TB management and precautions. Conclusion There were important gaps in knowledge, attitude, and practice of TB care among private providers. Better knowledge was associated with positive attitude towards TB and better practice. Tailored training may help to address these gaps and improve the quality of TB care in the private sector.研究目的 评估民营医疗机构中医师的结核病（Tuberculosis, TB）护理实践情况。 研究方法 采用针对结核病护理相关知识、态度与行为的调查问卷开展一项横断面研究。利用该量表的应答数据探索潜在构念，并计算各维度的标准化连续得分。本研究描述了受试者应答的百分比分布，并通过多重线性回归分析其相关影响因素。 研究结果 共纳入232名医师。临床实践中存在的主要短板包括：约80%的医师需借助胸部影像学检查确认结核病诊断；约50%的确诊活动性结核病患者未接受HIV检测；仅65%的耐多药结核病（Multidrug-Resistant Tuberculosis, MDR-TB）患者需开展痰检；仅64%的患者在治疗疗程结束时接受随访检查；54%的随访环节未安排痰检。接诊结核病患者时，医师更倾向于佩戴外科口罩而非N95防护口罩。既往接受过结核病相关培训的医师，其结核病相关知识水平更高、污名化态度更弱，而这两者均与更规范的结核病管理及防护实践相关。 研究结论 民营医疗从业者在结核病护理的知识、态度与行为层面均存在显著不足。更扎实的结核病相关知识与积极的结核病防治态度正相关，且二者均与更规范的临床实践相关。定制化培训或可弥补上述不足，进而提升民营医疗机构的结核病护理质量。