Nanjing Medical University, School of Nursing, 101 Longmian Avenue, Jiangning District, Nanjing, Jiangsu, China; University of Utah, College of Nursing, 10 2000 E, Salt Lake City, UT, United States.
University of Utah, College of Nursing, 10 2000 E, Salt Lake City, UT, United States.
Int J Nurs Stud. 2020 May;105:103494. doi: 10.1016/j.ijnurstu.2019.103494. Epub 2019 Dec 2.
The fear of social and professional consequences is a significant barrier to medication error reporting among nurses. Although some studies have identified cultural factors as playing a significant role in medication error reporting, little is known about the mechanisms by which these cultural characteristics influence the relationship between patient safety emphasis and the fear of medication error reporting.
(1) Identify nurses' perceptions of patient safety emphasis, face-saving, power distance, and fear of medication error reporting; and (2) explore face-saving and power distance as the underlying mechanisms for cultural factors in the relationship between nurses' perceptions of safety emphasis and the fear of medication error reporting.
A cross-sectional, descriptive, and correlational design.
Three tertiary teaching hospitals located in China, including one children's hospital and two adult hospitals.
We recruited a total of 569 female registered nurses with at least one year of work experience. Most of the participants (73.8%) were junior nurses with mid-associate or associate degrees (55.4%).
Participants completed four questionnaires, including Safety Emphasis subscales from the Safety Climate Scale, Face-Saving Scale, the Index of Hierarchy of Authority, and the Nurses' Fear of Medication Error Reporting.
The average scores of safety emphasis, face-saving, power distance, and the fear of medication error reporting were 20.27 (SD=2.36), 14.63 (SD=3.57), 17.36 (SD=3.49), and 18.92 (SD=4.20), respectively. There were no demographic characteristics associated with these variables, except education (B=-0.16, p = 0.013) and work experience (B=-0.14, p = 0.019), which were related to power distance. Face-saving and power distance were significant mediators that explained the effect of safety emphasis on nurses' fear of medication error reporting. The overall indirect effect for both mediators was statistically significant (β=-0.27, p<0.05). When we compared the specific mediators' indirect effects, face-saving was a more powerful mediator than power distance (β=-0.24 vs. β=-0.04). These mediation effects remained after we adjusted for the effects of education and work experience on power distance.
When nurses have a common cultural background, they tend to perceive similar barriers to medication error reporting. For this study, face-saving and power distance are the two most important cultural factors because they significantly influence the relationship between safety emphasis and the fear of medication error reporting among Chinese nurses. It may not be possible to develop a work culture that minimizes fears of medication error reporting without first addressing face-saving needs and power differences.
对社交和职业后果的恐惧是护士报告用药错误的一个重大障碍。尽管一些研究已经确定文化因素在用药错误报告中起着重要作用，但对于这些文化特征如何影响患者安全重视与对用药错误报告的恐惧之间的关系，知之甚少。
（1）确定护士对患者安全重视、面子观念、权力距离和对用药错误报告的恐惧的看法；（2）探讨面子观念和权力距离作为文化因素在护士对安全重视与对用药错误报告的恐惧之间的关系中的潜在机制。
横断面、描述性和相关性设计。
中国的三家三级教学医院，包括一家儿童医院和两家成人医院。
我们共招募了 569 名具有至少一年工作经验的女性注册护士。大多数参与者（73.8%）是初级护士，拥有中级或大专学历（55.4%）。
参与者完成了四个问卷，包括安全重点分量表，从安全气候量表、面子量表、等级制度的索引和护士对用药错误报告的恐惧。
安全重点、面子观念、权力距离和对用药错误报告的恐惧的平均得分分别为 20.27（SD=2.36）、14.63（SD=3.57）、17.36（SD=3.49）和 18.92（SD=4.20）。除了教育（B=-0.16，p=0.013）和工作经验（B=-0.14，p=0.019）与权力距离相关外，这些变量与人口统计学特征无关。面子观念和权力距离是安全重点对护士对用药错误报告的恐惧的显著中介因素。两个中介因素的总间接效应具有统计学意义（β=-0.27，p<0.05）。当我们比较特定中介因素的间接效应时，面子观念是比权力距离更强大的中介因素（β=-0.24 与β=-0.04）。这些中介效应在调整教育和工作经验对权力距离的影响后仍然存在。
当护士具有共同的文化背景时，他们往往会对用药错误报告存在类似的障碍。对于这项研究，面子观念和权力距离是最重要的两个文化因素，因为它们显著影响了中国护士对安全重视与对用药错误报告的恐惧之间的关系。如果不首先满足面子需求和权力差异，就不可能建立一种最大限度地减少对用药错误报告的恐惧的工作文化。
