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运用扎根理论与网络民族志自然语言处理相结合的方法理解兽医从业者对不良事件的反应。

Understanding veterinary practitioners' responses to adverse events using a combined grounded theory and netnographic natural language processing approach.

作者信息

Gibson Julie, Oxtoby Catherine, Brennan Marnie L, White Kate

机构信息

School of Veterinary Medicine and Science, University of Nottingham, Nottingham, United Kingdom.

Centre for Evidence-based Veterinary Medicine, University of Nottingham, Nottingham, United Kingdom.

出版信息

PLoS One. 2024 Dec 5;19(12):e0314081. doi: 10.1371/journal.pone.0314081. eCollection 2024.

Abstract

Support that mitigates the detrimental impact of adverse events on human healthcare practitioners is underpinned by an understanding of their experiences. This study used a mixed methods approach to understand veterinary practitioners' responses to adverse events. 12 focus groups and 20 interviews with veterinary practitioners were conducted and analysed using grounded theory principles. Experiencing stress, externalising facts and feelings, morally contextualising events and catalysing personal and professional improvements were identified as components of practitioners' response. Natural language processing content analysis of posts regarding involvement in adverse events (n = 572) written by members of a veterinary member-only Facebook group was also performed, to categorise and count words within texts based on underlying meaning. Percentile scores of four summary variables along with relative frequency of function, psychological process and time orientation words used were recorded and compared with content analysis of posts where members discussed euthanasia (n = 471) and animal health certification (n = 419). Lower authenticity scores (reflecting lower honesty), differences in clout scores (reflecting dominance) and higher frequencies of moralisation, future focus, prosocial behaviour and interpersonal conflict were observed in the adverse event group compared to either comparison group. Analytical thinking scores (reflecting logical thinking) and frequencies of total, positive and negative emotion, anxiety, anger and cognitive processing words (reflecting debate) were not significantly different between the adverse events and euthanasia groups. Integration of findings confirmed and expanded inferences made in both studies regarding the emotionally detrimental impact of adverse events and the role that peer-to-peer mediated reflection and learning plays in mitigating pathologisation of responses in the aftermath of adverse events. Discordance in findings related to practitioners' intentions and expressions of honesty suggest that work is needed to normalise open discussion about adverse events. Findings may be used to lever, and to inform, peer-to-peer support for practitioners in relation to veterinary adverse events.

摘要

减轻不良事件对人类医疗从业者不利影响的支持措施,是以对他们经历的理解为基础的。本研究采用混合方法来了解兽医从业者对不良事件的反应。对12个焦点小组和20名兽医从业者进行了访谈,并运用扎根理论原则进行分析。经历压力、外化事实和感受、从道德角度对事件进行情境化以及促成个人和职业改进,被确定为从业者反应的组成部分。还对一个仅限兽医成员的Facebook群组中成员撰写的关于参与不良事件的帖子(n = 572)进行了自然语言处理内容分析,以便根据潜在含义对文本中的单词进行分类和计数。记录了四个汇总变量的百分位数得分以及功能、心理过程和时间取向词的使用相对频率,并与成员讨论安乐死(n = 471)和动物健康认证(n = 419)的帖子内容分析进行比较。与两个对照组相比,不良事件组的真实性得分较低(反映较低的诚实度)、影响力得分存在差异(反映主导性),且道德化、未来关注、亲社会行为和人际冲突的频率较高。不良事件组和安乐死组之间的分析性思维得分(反映逻辑思维)以及总情绪、积极和消极情绪、焦虑、愤怒和认知处理词的频率(反映辩论情况)没有显著差异。研究结果的整合证实并扩展了两项研究中关于不良事件对情绪的有害影响以及同伴介导的反思和学习在减轻不良事件后反应病理化方面所起作用的推论。关于从业者意图和诚实表达的研究结果不一致,这表明需要开展工作使关于不良事件的公开讨论常态化。研究结果可用于推动并为兽医不良事件中从业者的同伴支持提供信息。

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