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并发症不可避免,但痛苦是可以选择的——应对手术并发症的心理方面。

Complication Is Inevitable, but Suffering is Optional-Psychological Aspects of Dealing with Complications in Surgery.

机构信息

Division of Pediatric Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States.

Division of Pediatric Surgery, Department of Surgery, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Canada.

出版信息

Eur J Pediatr Surg. 2023 Jun;33(3):181-190. doi: 10.1055/s-0043-1767830. Epub 2023 Mar 22.

Abstract

Surgical complications remain common in health care and constitute a significant challenge for hospitals, surgeons, and patients. While they cause significant physical, financial, and psychological harm to patients and their families, they also heavily burden the involved physicians. This phenomenon, known as the "second victim," results in negative short and long-term physical, cognitive, and psychological consequences on the surgeon. In this review, we explored the intricate connections between the surgeons' emotional response to adverse events concerning the patient outcome, perceived peer reaction, and existing social and institutional support systems. Using a selective literature review coupled with personal experiences, we propose a model of this complex interaction and suggest specific interventions to ameliorate the severity of response within this framework. The institution of the proposed interventions may improve the psychological well-being of surgeons facing complications and promote a cultural shift to better support physicians when they occur.

摘要

手术并发症在医疗保健中仍然很常见,对医院、外科医生和患者构成了重大挑战。虽然它们给患者及其家属带来了巨大的身体、经济和心理伤害,但也给相关医生带来了沉重的负担。这种现象被称为“第二受害者”,会给外科医生带来短期和长期的身体、认知和心理负面影响。在这篇综述中,我们探讨了外科医生对与患者预后相关的不良事件的情绪反应、感知到的同行反应以及现有的社会和机构支持系统之间的复杂联系。我们使用选择性文献回顾和个人经验,提出了一个复杂相互作用的模型,并在该框架内提出了具体的干预措施来减轻反应的严重程度。拟议干预措施的实施可以改善面临并发症的外科医生的心理健康,并促进文化转变,以便在发生并发症时更好地支持医生。

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本文引用的文献

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