Choosing your words carefully - How physicians would disclose harmful medical errors to patients
Choosing your words carefully - How physicians would disclose harmful medical errors to patients
复制标题
DOI：
10.1001/archinte.166.15.1585
复制
发表时间：
2006-08-14
影响因子：
--
通讯作者：
Levinson, Wendy
中科院分区：
文献类型：
--
作者：
Gallagher, Thomas H.;Garbutt, Jane M.;Levinson, Wendy
背景：患者希望被告知医疗错误的愿望与目前的做法之间存在差距。人们对医生如何披露信息知之甚少。本研究的目的是描述医生如何向患者披露错误。方法：对美国（密苏里州和华盛顿州）和加拿大（全国样本）的 2637 名内科和外科医师进行邮寄调查。参与者收到了描述严重错误的 4 个场景中的 1 个，这些错误因专业（医疗和手术场景）以及如果不披露而对患者而言的明显程度（更明显与不那么明显）而异。五个问题衡量了受访者将使用脚本陈述披露的内容。结果：受访者将披露的信息存在很大差异。在受访者中，56% 的人选择提及不良事件但未提及错误的陈述，而 42% 的人会明确指出发生了错误。一些医生透露的信息很少：19% 的医生不会主动提供有关错误原因的任何信息，63% 的医生不会提供有关防止未来错误的具体信息。披露受到错误性质和医生专业的影响。在收到较明显错误的受访者中，有 51% 明确提及该错误，而收到较不明显错误的受访者中有 32% (P < .001)； 58% 的医学专家明确提及该错误，而外科专家的这一比例为 19% ( P
Background: A gap exists between patients' desire to be told about medical errors and present practice. Little is known about how physicians approach disclosure. The objective of the present study was to describe how physicians disclose errors to patients.Methods: Mailed survey of 2637 medical and surgical physicians in the United States ( Missouri and Washington) and Canada ( national sample). Participants received 1 of 4 scenarios depicting serious errors that varied by specialty ( medical and surgical scenarios) and by how obvious the error would be to the patient if not disclosed ( more apparent vs less apparent). Five questions measured what respondents would disclose using scripted statements.Results: Wide variation existed regarding what information respondents would disclose. Of the respondents, 56% chose statements that mentioned the adverse event but not the error, while 42% would explicitly state that an error occurred. Some physicians disclosed little information: 19% would not volunteer any information about the error's cause, and 63% would not provide specific information about preventing future errors. Disclosure was affected by the nature of the error and physician specialty. Of the respondents, 51% who received the more apparent errors explicitly mentioned the error, compared with 32% who received the less apparent errors ( P < .001); 58% of medical specialists explicitly mentioned the error, compared with 19% of surgical specialists ( P