van Pelt Maria, Smeltzer Suzanne C, van Pelt Frederick, Gazoni Farnaz M, Durieux Marcel E, Polomano Rosemary C
is dean, School of Nursing, and associate dean, Bouvé College of Health Sciences. She is also associate clinical professor at Northeastern University in Boston, Massachusetts.
is director of the Office of Nursing Research and Evaluation, the Richard and Marianne Kreider Endowed Professor in Nursing for Vulnerable Populations, Villanova University, M. Louise Fitzpatrick College of Nursing, Villanova, Pennsylvania.
AANA J. 2019 Dec;87(6):441-450.
The National Academy of Medicine recognizes medical errors as a leading cause of death in the United States. Hospitals nationwide have acted to improve patient safety, quality of care, and system processes; however, no standards mandate assessment of the emotional impact of perioperative catastrophes on healthcare professionals. A cross-sectional descriptive study using a sample of 196 Certified Registered Nurse Anesthetists (CRNAs) tested the psychometric properties of an adapted version of the Perioperative Catastrophes Survey and administered this survey along with the Ways of Coping Questionnaire to measure CRNAs' perceptions, experiences, and responses associated with perioperative catastrophes. The adapted survey demonstrated acceptable internal consistency reliability (α = .893) and construct validity (factor analysis), with 4 subscales explaining 68.1% of the variance in the measure. The CRNAs scored similarly to anesthesiologists in a prior study conducted by Gazoni and colleagues, showing that memorable perioperative catastrophes have a negative emotional, cognitive, and functional impact. On the 8 Ways of Coping Questionnaire subscales, CRNAs with less than 10 years of experience reported significantly higher Escape-Avoidance behaviors compared with more experienced CRNAs (P = .016). Future research must examine perceptions of perioperative catastrophic events and coping mechanisms to identify providers at risk of negative consequences.
美国国家医学院认为医疗失误是美国主要的死亡原因之一。全国的医院都采取行动来提高患者安全、护理质量和系统流程；然而，没有标准要求评估围手术期灾难对医护人员的情感影响。一项横断面描述性研究以196名注册护士麻醉师（CRNA）为样本，测试了改编版围手术期灾难调查问卷的心理测量特性，并同时发放该问卷和应对方式问卷，以测量CRNA对围手术期灾难的认知、经历和反应。改编后的调查问卷显示出可接受的内部一致性信度（α = 0.893）和结构效度（因子分析），4个分量表解释了该测量中68.1%的方差。在Gazoni及其同事之前进行的一项研究中，CRNA的得分与麻醉医生相似，表明难忘的围手术期灾难会产生负面的情感、认知和功能影响。在应对方式问卷的8个分量表上，经验少于10年的CRNA与经验更丰富的CRNA相比，报告的逃避行为显著更多（P = 0.016）。未来的研究必须考察对围手术期灾难性事件的认知和应对机制，以识别有产生负面后果风险的医护人员。
