University of Sousse, Faculty of Medicine of Sousse, 4000, Sousse, Tunisia.
Farhat Hached University Hospital, Medical Intensive Care Unit, Research Laboratory "Heart Failure", LR12SP09, 4000, Sousse, Tunisia.
BMC Psychiatry. 2022 Jun 20;22(1):411. doi: 10.1186/s12888-022-04049-0.
Physicians involved in medical errors (MEs) can experience loss of self-esteem and negative psychological experiences. They are called "second victims" of the ME.
To i) describe the profile, the types and the severity of MEs, and ii) explore the psychological impact on "second victims" to better understand how they cope.
It was a cross sectional retrospective study conducted from March to August 2018. All physicians working at Farhat Hached and Sahloul University hospitals were asked to complete a questionnaire about their possible MEs. The impact of MEs was evaluated using the Impact of Event Scale-Revised (IES-R) (scoring, 0-88) (subscales ranges; intrusion, (0-32); avoidance, (0-32); hyperarousal, (0-24)). The diagnosis of post-traumatic stress disorder (PTSD) was made when the total IES-R score exceeded 33. The coping strategies were evaluated using Ways of Coping Checklist Revised (WCC-R) scale (scoring, problem-focused, (10-40); emotion focused, (9-36); seeking social support, (8-32)).
Among 393 responders, 268(68.2%) reported MEs. Wrong diagnosis (40.5%), faulty treatment (34.6%), preventive errors (13.5%) and faulty communication (6.4%) were the main frequent types of MEs. The most common related causes of MEs were inexperience (47.3%) and job overload (40.2%). The physicians' median (range) score of the IES-R was 19(0-69). According to the IES-R score, the most frequent psychological impacts were median (range): intrusion, 7(0-28) and avoidance symptoms, 7(0-24). PTSD symptoms affected 23.5% of physicians. Female sex and serious MEs were identified as predictors of PTSD. On the WCC-R check list, coping was balanced between the three coping strategies median (range), problem focused, 28.5(10-40); emotion-focused, 24(9-36) and seeking social support 21(8-32).
There is a relatively high impact of ME within these North-African university hospital physicians. Coping was balanced within different three strategies as reported worldwide. Physicians adopted more likely constructive changes than defensive ones.
涉及医疗失误（ME）的医生可能会自尊心受损并产生负面心理体验。他们被称为 ME 的“第二受害者”。
i）描述 ME 的类型、严重程度和类型，ii）探讨对“第二受害者”的心理影响，以更好地了解他们的应对方式。
这是一项横断面回顾性研究，于 2018 年 3 月至 8 月进行。要求 Farhat Hached 和 Sahloul 大学医院的所有医生填写一份关于他们可能发生的 ME 的问卷。使用修订后的事件影响量表（IES-R）（评分，0-88）（子量表范围；侵入，（0-32）；回避，（0-32）；高度警觉，（0-24））评估 ME 的心理影响。当总 IES-R 评分超过 33 时，诊断为创伤后应激障碍（PTSD）。使用修订后的应对方式检查表（WCC-R）量表（评分，问题导向，（10-40）；情绪导向，（9-36）；寻求社会支持，（8-32））评估应对策略。
在 393 名应答者中，268 名（68.2%）报告发生 ME。错误诊断（40.5%）、治疗失误（34.6%）、预防失误（13.5%）和沟通失误（6.4%）是最常见的 ME 类型。ME 最常见的相关原因是经验不足（47.3%）和工作负荷过重（40.2%）。医生的 IES-R 中位数（范围）评分为 19（0-69）。根据 IES-R 评分，最常见的心理影响为中值（范围）：侵入性症状，7（0-28）和回避症状，7（0-24）。23.5%的医生出现 PTSD 症状。女性性别和严重 ME 被确定为 PTSD 的预测因素。在 WCC-R 检查表上，三种应对策略的应对方式平衡，问题导向的中位数（范围）为 28.5（10-40）；情绪导向的中位数（范围）为 24（9-36）；寻求社会支持的中位数（范围）为 21（8-32）。
在这些北非大学医院的医生中，ME 的影响相对较高。应对方式在三种不同策略之间平衡，与全球报道的情况一致。医生采用了更多建设性的改变，而不是防御性的改变。
