Xu Meixia, Wang Yifan, Yao Shuxin, Shi Rongju, Sun Long
Department of Current Situation and Policy, School of Marxism, Shandong Women's University, Jinan 250300, China.
Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Jinan 250012, China.
Int J Environ Res Public Health. 2022 Mar 10;19(6):3286. doi: 10.3390/ijerph19063286.
Objective: Medical errors or near misses (MENM) may cause serious negative outcomes for the patients. However, medical professionals with MENM may also be secondary victims. Although the association between MENM and depression among medical professionals has been explored in several previous studies, the possible causal relationship has been explored less, especially in China. In this study, our first aim was to determine the prevalence of MENM among Chinese medical professionals. We also wanted to explore the causal effect of MENM on depressive symptoms based on a propensity-score matching analysis. Methods: A cross-sectional study was conducted among medical professionals in Chinese public general hospitals, and 3426 medical professionals were analyzed in this study. The Center for Epidemiologic Studies Depression (CES-D) scale was used to assess depressive symptoms. Social support was measured by the Multidimensional Scale of Perceived Social Support (MSPSS). MENM, social-demographic variables, occupational characteristics, and physical disease were also evaluated in this study. Results: The one-year prevalence of perceived MENM was 2.9% among medical professionals in Chinese public general hospitals. The results of logistic regressions showed that working hours/week (OR = 1.02, p < 0.05) and depressive symptoms (OR = 1.05, p < 0.001) were associated with MENM. After propensity score matching, depressive symptoms were associated with MENM (OR = 1.05, p < 0.001) among medical professionals. The associations between occupational characteristics, physical disease, social support, and MENM were not supported by this study. Conclusions: The one-year prevalence of MENM was low in Chinese public general hospitals, and based on our propensity score matching analyses, the occurrence of MENM may cause depressive symptoms in medical professionals. A bigger effort by health systems and organizations may be helpful for reducing MENM.
医疗差错或险些发生的差错（MENM）可能给患者带来严重的负面后果。然而，经历过MENM的医疗专业人员也可能成为次生受害者。尽管之前已有多项研究探讨了医疗专业人员中MENM与抑郁之间的关联，但对可能的因果关系的探讨较少，尤其是在中国。在本研究中，我们的首要目标是确定中国医疗专业人员中MENM的患病率。我们还希望基于倾向得分匹配分析来探究MENM对抑郁症状的因果效应。方法：对中国公立综合医院的医疗专业人员开展了一项横断面研究，本研究共分析了3426名医疗专业人员。采用流行病学研究中心抑郁量表（CES-D）评估抑郁症状。通过领悟社会支持量表（MSPSS）测量社会支持。本研究还评估了MENM、社会人口学变量、职业特征和躯体疾病。结果：中国公立综合医院医疗专业人员中，感知到的MENM的一年患病率为2.9%。逻辑回归结果显示，每周工作时长（OR = 1.02，p < 0.05）和抑郁症状（OR = 1.05，p < 0.001）与MENM相关。倾向得分匹配后，医疗专业人员中抑郁症状与MENM相关（OR = 1.05，p < 0.001）。本研究未证实职业特征、躯体疾病、社会支持与MENM之间存在关联。结论：中国公立综合医院中MENM的一年患病率较低，基于我们的倾向得分匹配分析，MENM的发生可能导致医疗专业人员出现抑郁症状。卫生系统和组织加大努力可能有助于减少MENM。
