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香港医疗专业人员临床事件经历:一项定性研究

Healthcare Professional Experiences of Clinical Incident in Hong Kong: A Qualitative Study.

作者信息

Luk Leung Andrew, Lee Fung Kam Iris, Lam Chi Shan, So Hing Yu, Wong Yuk Yi Michelle, Lui Wai Sze Wacy

机构信息

Nethersole Institute of Continuing Holistic Health Education (NICHE), Alice Ho Miu Ling Nethersole Charity Foundation, Hong Kong.

Department of Anesthesiology & Operating Services, AHNH &NDH, Hong Kong.

出版信息

Risk Manag Healthc Policy. 2021 Mar 8;14:947-957. doi: 10.2147/RMHP.S292875. eCollection 2021.

Abstract

BACKGROUND

Studies showed that adverse events within health care settings can lead to two victims. The first victim is the patient and family and the second victim is the involved healthcare professionals. However, there is a lack of research studying the experiences of healthcare professionals encountering clinical incidents in Hong Kong. This paper reports a qualitative study in exploring the healthcare professional experiences of clinical incident, their impacts and needs.

METHODS

This study is the second part of the mixed research method with two studies conducted in a cluster of hospitals in Hong Kong. Study 1 was a quantitative questionnaire survey and Study 2 was a qualitative In-Depth Interview. In study 2, a semi-interview guide was used.

RESULTS

Results showed that symptoms experienced after the clinical incident were mostly from psychological, physical, then social and lastly spiritual aspects which were consistent with those found in study 1 and other studies. Using content analysis for analyzing the impacts, four themes were identified. Concerning the impacts immediately from the clinical incident, two themes emerged were 1) facing emotion distress and 2) maintaining rationality. Regarding the impacts after the clinical incident, another two themes were 3) managing further emotional distress 4) restoring personal wellness. With regard to the needs after clinical incidents, three themes emerged were 1) self-recovery; 2) senior good mentoring and 3) positive organization climate with emphasis on enhancement of training and development of a positive practice culture.

CONCLUSION

Great impacts are found with healthcare professionals encountering clinical incidents from a holistic perspective. They need time for self-recovery with support from good supervisors, peers and a caring environment. Some recommendations based on the findings of the study are made.

摘要

背景

研究表明,医疗环境中的不良事件会导致两个受害者。第一个受害者是患者及其家属,第二个受害者是涉事的医护人员。然而,在香港,缺乏对医护人员遭遇临床事件经历的研究。本文报告了一项定性研究,旨在探索医护人员对临床事件的经历、其影响和需求。

方法

本研究是混合研究方法的第二部分,在香港的一组医院中进行了两项研究。研究1是定量问卷调查,研究2是定性深入访谈。在研究2中,使用了半访谈指南。

结果

结果表明,临床事件后经历的症状大多来自心理、身体、社会,最后是精神方面,这与研究1和其他研究的结果一致。通过内容分析来分析影响,确定了四个主题。关于临床事件立即产生的影响,出现的两个主题是1)面临情绪困扰和2)保持理性。关于临床事件后的影响,另外两个主题是3)管理进一步的情绪困扰和4)恢复个人健康。关于临床事件后的需求,出现的三个主题是1)自我恢复;2)上级良好的指导和3)积极的组织氛围,强调加强培训和培养积极的实践文化。

结论

从整体角度来看,医护人员遭遇临床事件会产生重大影响。他们需要时间进行自我恢复,需要优秀的上级、同事的支持以及关怀的环境。基于研究结果提出了一些建议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a2c/7953886/ce082d961961/RMHP-14-947-g0001.jpg

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