CEReSS-Health Service Research and Quality of Life Center, UR3279, Aix-Marseille University, Marseille, France.
Department of Public Health, Assistance Publique-Hôpitaux de Marseille, Marseille, France.
Front Public Health. 2024 Jun 26;12:1423905. doi: 10.3389/fpubh.2024.1423905. eCollection 2024.
The fear of clinical errors among healthcare workers (HCW) is an understudied aspect of patient safety. This study aims to describe this phenomenon among HCW and identify associated socio-demographic, professional, burnout and mental health factors.
We conducted a nationwide, online, cross-sectional study targeting HCW in France from May to June 2021. Recruitment was through social networks, professional networks, and email invitations. To assess the fear of making clinical errors, HCW were asked: "During your daily activities, how often are you afraid of making a professional error that could jeopardize patient safety?" Responses were collected on a 7-point Likert-type scale. HCW were categorized into "High Fear" for those who reported experiencing fear frequently ("once a week," "a few times a week," or "every day"), vs. "Low Fear" for less often. We used multivariate logistic regression to analyze associations between fear of clinical errors and various factors, including sociodemographic, professional, burnout, and mental health. Structural equation modeling was used to explore how this fear fits into a comprehensive theoretical framework.
We recruited a total of 10,325 HCW, of whom 25.9% reported "High Fear" (95% CI: 25.0-26.7%). Multivariate analysis revealed higher odds of "High Fear" among males, younger individuals, and those with less professional experience. High fear was more notable among physicians and nurses, and those working in critical care and surgery, on night shifts or with irregular schedules. Significant associations were found between "High Fear" and burnout, low professional support, major depressive disorder, and sleep disorders.
Fear of clinical errors is associated with factors that also influence patient safety, highlighting the importance of this experience. Incorporating this dimension into patient safety culture assessment could provide valuable insights and could inform ways to proactively enhance patient safety.
医护人员（HCW）对临床失误的恐惧是患者安全研究中一个未被充分研究的方面。本研究旨在描述 HCW 中的这一现象，并确定相关的社会人口学、职业、倦怠和心理健康因素。
我们在 2021 年 5 月至 6 月期间在法国进行了一项针对 HCW 的全国性在线横断面研究。通过社交网络、专业网络和电子邮件邀请招募 HCW。为了评估对临床失误的恐惧，HCW 被问到：“在您的日常活动中，您经常担心犯可能危及患者安全的专业错误吗？”他们的回答是在 7 点 Likert 量表上进行的。将报告经常感到恐惧（“每周一次”、“每周几次”或“每天”）的 HCW 归类为“高恐惧”，而将较少感到恐惧的 HCW 归类为“低恐惧”。我们使用多变量逻辑回归分析恐惧与各种因素之间的关联，包括社会人口学、职业、倦怠和心理健康。结构方程模型用于探索这种恐惧如何适应综合理论框架。
我们共招募了 10325 名 HCW，其中 25.9%（95%CI：25.0-26.7%）报告“高恐惧”。多变量分析显示，男性、年轻个体和职业经验较少的个体发生“高恐惧”的可能性更高。在医生和护士、在重症监护和外科、上夜班或工作时间不规律的个体中，高恐惧更为明显。“高恐惧”与倦怠、专业支持不足、重度抑郁症和睡眠障碍之间存在显著关联。
对临床失误的恐惧与影响患者安全的因素有关，这突出了这种体验的重要性。将这一维度纳入患者安全文化评估中，可以提供有价值的见解，并为主动增强患者安全提供信息。
