Hs Arvinder-Singh, Rashid Abdul
Masters in Health Research (RCSI, Hons), Penang Medical College, Georgetown, Pulau Pinang, Malaysia.
Clinical Research Centre (Perak), 4th Floor Ambulatory Care Centre (ACC), Raja Permaisuri Bainun Hospital, Jalan Raja Ashman Shah, Ipoh, 30450, Perak, Malaysia.
BMC Med Ethics. 2017 Jan 23;18(1):3. doi: 10.1186/s12910-016-0161-x.
In this study, medical errors are defined as unintentional patient harm caused by a doctor's mistake. This topic, due to limited research, is poorly understood in Malaysia. The objective of this study was to determine the proportion of doctors intending to disclose medical errors, and their attitudes/perception pertaining to medical errors.
This cross-sectional study was conducted at a tertiary public hospital from July- December 2015 among 276 randomly selected doctors. Data was collected using a standardized and validated self-administered questionnaire intending to measure disclosure and attitudes/perceptions. The scale had four vignettes in total two medical and two surgical. Each vignette consisted of five questions and each question measured the disclosure. Disclosure was categorised as "No Disclosure", "Partial Disclosure" or "Full Disclosure". Data was keyed in and analysed using STATA v 13.0.
Only 10.1% (n = 28) intended to disclose medical errors. Most respondents felt that they possessed an attitude/perception of adequately disclosing errors to patients. There was a statistically significant difference (p < 0.001) when comparing the intention of disclosure with perceived disclosures. Most respondents were in common agreement that disclosing an error would make them less likely to get sued, that minor errors should be reported and that they experienced relief from disclosing errors.
Most doctors in this study would not disclose medical errors although they perceived that the errors were serious and felt responsible for it. Poor disclosure could be due the fear of litigations and improper mechanisms/procedures available for disclosure.
在本研究中，医疗差错被定义为由医生失误导致的无意的患者伤害。由于研究有限，该主题在马来西亚的了解程度较低。本研究的目的是确定打算披露医疗差错的医生比例，以及他们对医疗差错的态度/认知。
这项横断面研究于2015年7月至12月在一家三级公立医院对276名随机选择的医生进行。使用标准化且经过验证的自填式问卷收集数据，旨在衡量披露情况以及态度/认知。该量表共有四个案例，两个医疗案例和两个外科案例。每个案例由五个问题组成，每个问题衡量披露情况。披露被分类为“不披露”、“部分披露”或“完全披露”。数据录入并使用STATA v 13.0进行分析。
只有10.1%（n = 28）的医生打算披露医疗差错。大多数受访者认为他们对向患者充分披露差错持有某种态度/认知。在比较披露意图与感知到的披露情况时，存在统计学上的显著差异（p < 0.001）。大多数受访者普遍认为披露差错会降低他们被起诉的可能性，小差错应该报告，并且他们在披露差错后会感到宽慰。
本研究中的大多数医生不会披露医疗差错，尽管他们认为这些差错很严重并对此负有责任。披露不足可能是由于担心诉讼以及缺乏适当的披露机制/程序。
