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人非圣贤,孰能无过,但是当外科医生犯错时会发生什么呢?

To Err is human, but what happens when surgeons Err?

机构信息

The Ohio State University College of Medicine, Columbus, OH, United States of America.

The Ohio State University College of Medicine, Columbus, OH, United States of America; Nationwide Children's Hospital, Columbus, OH, United States of America.

出版信息

J Pediatr Surg. 2023 Mar;58(3):496-502. doi: 10.1016/j.jpedsurg.2022.06.019. Epub 2022 Jul 6.

Abstract

BACKGROUND

Physicians involved in adverse events may suffer from second victim syndrome and can experience emotional and physical distress long after the complication occurred. We sought determine the prevalence of second victim syndrome among surgeons at our children's hospital and evaluate any differences in how surgeons respond to adverse events based on their age, position, and gender.

METHODS

An anonymous 19-question questionnaire distributed via institutional emails linking to an anonymous Research Electronic Data Capture (REDCap) survey. Eligible participants included all surgeons and rotating surgical trainees at our hospital.

RESULTS

Of 64 faculty surgeons eligible to participate, 63 surveys were returned for a 98% completion rate. Ten additional surveys from surgical trainees were completed for a total of 73 participants. Eighty-four percent reported having had difficulty dealing with a poor outcome or unhappy patient/family. Speaking with a colleague was the most common coping strategy, reported by 82%. Fifty-six percent indicated they believed reporting a poor outcome would have negative ramifications for them. Younger surgeons were more likely to suppress their feelings following an adverse event, and trainees were less likely to advise their peers to speak to a superior about the event (p < 0.05).

CONCLUSION

There is a high prevalence of second victim syndrome among surgeons at our children's hospital. There exist differences in ways that surgeons respond to adverse events based on age and position. Healthcare institutions should establish formal mechanisms of support to shift the culture towards one where help is actively sought and offered.

LEVEL OF EVIDENCE

IV.

摘要

背景

涉及不良事件的医生可能患有第二受害者综合征,并在并发症发生后很长时间内经历情绪和身体上的困扰。我们旨在确定我院外科医生中第二受害者综合征的患病率,并评估外科医生根据其年龄、职位和性别对不良事件的反应是否存在差异。

方法

通过机构电子邮件分发了一份包含 19 个问题的匿名问卷,链接到一个匿名的研究电子数据捕获(REDCap)调查。符合条件的参与者包括我院所有外科医生和轮转外科受训者。

结果

在 64 名有资格参与的外科医生中,有 63 份调查回复,完成率为 98%。另外还有 10 份来自外科受训者的调查,共有 73 名参与者。84%的人报告说在处理不良结果或不开心的患者/家属方面有困难。与同事交谈是最常见的应对策略,有 82%的人报告了这种情况。56%的人表示他们认为报告不良结果会对他们产生负面影响。年轻的外科医生在发生不良事件后更倾向于压抑自己的情绪,而受训者更不愿意建议他们的同事向上级报告事件(p<0.05)。

结论

我院外科医生中第二受害者综合征的患病率很高。外科医生对不良事件的反应方式因年龄和职位而异。医疗机构应建立正式的支持机制,将文化转变为积极寻求和提供帮助的文化。

证据水平

IV。

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