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纪律严明的医疗保健专业人员:关于荷兰纪律处分程序及实施措施影响的定性访谈研究

The disciplined healthcare professional: a qualitative interview study on the impact of the disciplinary process and imposed measures in the Netherlands.

作者信息

Verhoef Lise M, Weenink Jan-Willem, Winters Sjenny, Robben Paul B M, Westert Gert P, Kool Rudolf B

机构信息

Scientific Institute for Quality of Health Care, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands.

Institute of Health Policy & Management, Erasmus University, Rotterdam, The Netherlands Department of Research and Innovation, Health Care Inspectorate, Utrecht, The Netherlands.

出版信息

BMJ Open. 2015 Nov 25;5(11):e009275. doi: 10.1136/bmjopen-2015-009275.

Abstract

OBJECTIVE

It is known that doctors who receive complaints may have feelings of anger, guilt, shame and depression, both in the short and in the long term. This might lead to functional impairment. Less is known about the impact of the disciplinary process and imposed measures. Previous studies of disciplinary proceedings have mainly focused on identifying characteristics of disciplined doctors and on sentencing policies. Therefore, the aim of this study is to explore what impact the disciplinary process and imposed measures have on healthcare professionals.

DESIGN

Semistructured interview study, with purposive sampling and inductive qualitative content analysis.

PARTICIPANTS

16 healthcare professionals (9 medical specialists, 3 general practitioners, 2 physiotherapists and 2 psychologists) that were sanctioned by the disciplinary tribunal.

SETTING

The Netherlands.

RESULTS

Professionals described feelings of misery and insecurity both during the process as in its aftermath. Furthermore, they reported to fear receiving new complaints and provide care more cautiously after the imposed measure. Factors that may enhance psychological and professional impact are the publication of measures online and in newspapers, media coverage, the feeling of treated as guilty before any verdict has been reached, and the long duration of the process.

CONCLUSIONS

This study shows that the disciplinary process and imposed measures can have a profound psychological and professional impact on healthcare professionals. Although a disciplinary measure is meant to have a corrective effect, our results suggest that the impact that is experienced by professionals might hamper optimal rehabilitation afterwards. Therefore, organising emotional support should be considered during the disciplinary process and in the period after the verdict.

摘要

目的

众所周知,收到投诉的医生在短期和长期内可能会产生愤怒、内疚、羞耻和抑郁情绪。这可能会导致功能受损。关于纪律处分程序和所实施措施的影响,人们了解得较少。以往对纪律处分程序的研究主要集中在确定受处分医生的特征和量刑政策上。因此,本研究的目的是探讨纪律处分程序和所实施的措施对医疗保健专业人员有何影响。

设计

半结构化访谈研究,采用目的抽样和归纳定性内容分析。

参与者

16名医疗保健专业人员(9名医学专家、3名全科医生、2名物理治疗师和2名心理学家),他们受到了纪律法庭的制裁。

地点

荷兰。

结果

专业人员描述了在这个过程中以及之后的痛苦和不安全感。此外,他们报告说担心收到新的投诉,并在实施措施后更加谨慎地提供护理。可能增强心理和职业影响的因素包括措施在网上和报纸上的公布、媒体报道、在任何判决达成之前就被视为有罪的感觉以及过程的持续时间。

结论

本研究表明,纪律处分程序和所实施的措施可能会对医疗保健专业人员产生深远的心理和职业影响。虽然纪律处分措施旨在起到纠正作用,但我们的结果表明,专业人员所经历的影响可能会妨碍之后的最佳康复。因此,在纪律处分过程中以及判决后的时期应考虑提供情感支持。

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