中国医生和护士自我报告的医疗差错的发生率及相关因素：一项横断面调查。
Occurrence and associated factors of self-reported medical errors among Chinese physicians and nurses: a cross-sectional survey.
作者信息
Li Zejun, Liu Liyan, Zhang Xiaoyu, Yan Kewen, Wang Xin, Wu Min, Xu Huixue, Liu Yueheng, Wang Qianjin, Li Manyun, Hao Yuzhu, He Li, Wang Yunfei, Deng Qijian, Liu Tieqiao, Peng Pu, Wu Qiuxia
机构信息
Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, the Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
Trauma Center, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
出版信息
Ann Med. 2025 Dec;57(1):2445187. doi: 10.1080/07853890.2024.2445187. Epub 2024 Dec 26.
BACKGROUND
Medical errors (MEs) significantly threaten patient safety globally. This study aimed to explore multidimensional factors associated with self-reported MEs among Chinese physicians and nurses.
METHODS
A cross-sectional online survey using snowball sampling collected 7197 valid responses from Chinese physicians and nurses between October 2020 and April 2022. A self-reported question assessed MEs within the past three months. Sociodemographic characteristics, work-related factors, and mental distress were collected. Data were analyzed using stepwise logistic regression.
RESULTS
1285 (17.9%) physicians and nurses self-reported MEs during the previous 3 months. Factors associated with higher odds of self-reported MEs included male sex (OR: 1.44, 95% CI: 1.23-1.69), physician status (OR: 1.48, 95% CI: 1.26-1.73), history of mental illness (OR: 1.49, 95% CI: 1.16-1.91), longer weekly working hours (OR: 1.20-1.23, 95% CI: 1.03-1.47), workplace violence experience (OR: 1.54-1.75, 95% CI: 1.30-2.17), and dissatisfaction with the medical practice environment (OR: 1.20, 95% CI: 1.05-1.37). Conversely, being married (OR: 0.74, 95% CI: 0.62-0.89), holding a bachelor's degree or higher (OR: 0.82, 95% CI: 0.70-0.97), and having more years of professional practice (OR: 0.96, 95% CI: 0.95-0.97) were associated with lower odds of self-reported MEs. Self-reported MEs were significantly and positively correlated with burnout (OR: 1.40, 95% CI: 1.20-1.62), depressive symptoms (OR: 1.38-1.45, 95% CI: 1.04-1.84), perceived stress (OR: 1.28-1.62, 95% CI: 1.06-2.02), and excessive daytime sleepiness (OR: 1.27-1.46, 95% CI: 1.10-1.79).
CONCLUSIONS
Self-reported MEs are relatively common among Chinese physicians and nurses, and are associated with various factors. Poor workplace conditions and mental distress are linked to an increased risk of MEs. Implementing effective interventions to improve workplace conditions and mental health is crucial for reducing MEs.
背景
医疗差错在全球范围内严重威胁患者安全。本研究旨在探讨中国医生和护士自我报告的医疗差错相关的多维度因素。
方法
采用滚雪球抽样的横断面在线调查，于2020年10月至2022年4月期间收集了7197名中国医生和护士的有效回复。一个自我报告问题评估了过去三个月内的医疗差错情况。收集了社会人口学特征、工作相关因素和心理困扰情况。数据采用逐步逻辑回归分析。
结果
1285名（17.9%）医生和护士在之前3个月内自我报告了医疗差错。与自我报告医疗差错几率较高相关的因素包括男性（比值比：1.44，95%置信区间：1.23 - 1.69）、医生身份（比值比：1.48，95%置信区间：1.26 - 1.73）、精神疾病史（比值比：1.49，9%置信区间：1.16 - 1.91）、每周工作时间较长（比值比：1.20 - 1.23，95%置信区间：1.03 - 1.47）、工作场所暴力经历（比值比：1.54 - 1.75，95%置信区间：1.30 - 2.17）以及对医疗执业环境不满意（比值比：1.20，95%置信区间：1.05 - 1.37）。相反，已婚（比值比：0.74，95%置信区间：0.62 - 0.89）、拥有学士学位或更高学历（比值比：0.82，95%置信区间：0.70 - 0.97）以及专业执业年限较长（比值比：0.96，95%置信区间：0.95 - 0.97）与自我报告医疗差错的几率较低相关。自我报告的医疗差错与职业倦怠（比值比：1.40，95%置信区间：1.20 - 1.62）、抑郁症状（比值比：1.38 - 1.45，95%置信区间：1.04 - 1.84）、感知压力（比值比：1.28 - 1.62，95%置信区间：1.06 - 2.02）和日间过度嗜睡（比值比：1.27 - 1.46，95%置信区间：1.10 - 1.79）显著正相关。
结论
自我报告的医疗差错在中国医生和护士中相对普遍，且与多种因素相关。恶劣的工作场所条件和心理困扰与医疗差错风险增加有关。实施有效的干预措施以改善工作场所条件和心理健康对于减少医疗差错至关重要。
Zotero 插件