Newman M C
Department of Family Medicine, Medical College of Pennsylvania and Hahneman University, Philadelphia, USA.
Arch Fam Med. 1996 Feb;5(2):71-5. doi: 10.1001/archfami.5.2.71.
To explore the emotional impact of the most memorable mistake on family physicians, the support they needed and received, and their response to a hypothetical scenario in which a colleague's decision was associated with a fatal outcome.
Randomly selected members of a county chapter of a midwestern state academy of family physicians.
Qualitative cross-sectional survey using in-depth interviews subject to content analysis.
I audiotaped interviews with each of the physicians in their offices. Two medical sociologists and I first independently, and then consensually, categorized the data based on the frequency with which a word or idea appeared in the text.
Thirty (75 %) of the 40 physicians originally contacted participated in the study. Twenty-three (77%) of the 30 physicians admitted to making a mistake. The physicians experienced emotional adversity. Of 27 physicians, 17 (63%) needed someone to talk to, 13 (48 %) needed to review their case management, 16 (59%) needed professional reaffirmation, and eight (30%) needed personal reassurance. Having someone to talk to was the support that 12 (44%) of the 27 physicians valued most. Eighteen (67%) of 27 received this support from someone other than their peers. Although all subjects recognized their colleague's pain and need for support in the hypothetical scenario, only nine (32%) of 28 physicians would have unconditionally offered support.
Making mistakes unfavorably affects family physicians and creates a strong need for support. Family physicians may benefit from sharing experiences that diminish perfectionism and recognize mistakes as a natural part of practicing medicine. Further research needs to address how physicians can be encouraged toward therapeutic self-disclosure and peer support.
探讨最难忘的失误对家庭医生的情感影响、他们所需及获得的支持，以及他们对一种假设情景的反应，在该情景中同事的决策导致了致命后果。
随机选取中西部某州家庭医生学会一个县分会的成员。
采用深入访谈并进行内容分析的定性横断面调查。
我在医生办公室对每位医生的访谈进行了录音。两位医学社会学家和我首先各自独立，然后通过协商，根据某个词或想法在文本中出现的频率对数据进行分类。
最初联系的40位医生中有30位（75%）参与了研究。30位医生中有23位（77%）承认犯过错误。这些医生经历了情感困境。在27位医生中，17位（63%）需要找人倾诉，13位（48%）需要回顾他们的病例管理，16位（59%）需要专业上的肯定，8位（30%）需要个人安慰。找人倾诉是27位医生中12位（44%）最看重的支持。27位医生中有18位（67%）从同行以外的人那里获得了这种支持。尽管所有受试者在假设情景中都认识到同事的痛苦和对支持的需求，但28位医生中只有9位（32%）会无条件地提供支持。
犯错对家庭医生产生不利影响，并产生对支持的强烈需求。家庭医生可能会从分享经验中受益，这些经验可以减少完美主义，并认识到错误是行医过程中自然的一部分。需要进一步研究如何鼓励医生进行治疗性的自我表露和同行支持。
