PDF(Sci-hub)
Abstract：
OBJECTIVE: To evaluate the relationship between burnout and perceived major medical errors among American surgeons.
BACKGROUND: Despite efforts to improve patient safety, medical errors by physicians remain a common cause of morbidity and mortality.
METHODS: Members of the American College of Surgeons were sent an anonymous, cross-sectional survey in June 2008. The survey included self-assessment of major medical errors, a validated depression screening tool, and standardized assessments of burnout and quality of life (QOL).
RESULTS: Of 7905 participating surgeons, 700 (8.9%) reported concern they had made a major medical error in the last 3 months. Over 70% of surgeons attributed the error to individual rather than system level factors. Reporting an error during the last 3 months had a large, statistically significant adverse relationship with mental QOL, all 3 domains of burnout (emotional exhaustion, depersonalization, and personal accomplishment) and symptoms of depression. Each one point increase in depersonalization (scale range, 0-33) was associated with an 11% increase in the likelihood of reporting an error while each one point increase in emotional exhaustion (scale range, 0-54) was associated with a 5% increase. Burnout and depression remained independent predictors of reporting a recent major medical error on multivariate analysis that controlled for other personal and professional factors. The frequency of overnight call, practice setting, method of compensation, and number of hours worked were not associated with errors on multivariate analysis.
CONCLUSIONS: Major medical errors reported by surgeons are strongly related to a surgeon\'s degree of burnout and their mental QOL. Studies are needed to determine how to reduce surgeon distress and how to support surgeons when medical errors occur.
BACKGROUND: Despite efforts to improve patient safety, medical errors by physicians remain a common cause of morbidity and mortality.
METHODS: Members of the American College of Surgeons were sent an anonymous, cross-sectional survey in June 2008. The survey included self-assessment of major medical errors, a validated depression screening tool, and standardized assessments of burnout and quality of life (QOL).
RESULTS: Of 7905 participating surgeons, 700 (8.9%) reported concern they had made a major medical error in the last 3 months. Over 70% of surgeons attributed the error to individual rather than system level factors. Reporting an error during the last 3 months had a large, statistically significant adverse relationship with mental QOL, all 3 domains of burnout (emotional exhaustion, depersonalization, and personal accomplishment) and symptoms of depression. Each one point increase in depersonalization (scale range, 0-33) was associated with an 11% increase in the likelihood of reporting an error while each one point increase in emotional exhaustion (scale range, 0-54) was associated with a 5% increase. Burnout and depression remained independent predictors of reporting a recent major medical error on multivariate analysis that controlled for other personal and professional factors. The frequency of overnight call, practice setting, method of compensation, and number of hours worked were not associated with errors on multivariate analysis.
CONCLUSIONS: Major medical errors reported by surgeons are strongly related to a surgeon\'s degree of burnout and their mental QOL. Studies are needed to determine how to reduce surgeon distress and how to support surgeons when medical errors occur.
摘要：
目的：评估美国外科医生的倦怠与感知到的重大医疗错误之间的关系。
背景：尽管努力改善患者安全，医生的医疗错误仍然是发病率和死亡率的常见原因。
方法：美国外科医生学院的成员被匿名发送，2008年6月的横断面调查。调查包括重大医疗差错的自我评估,一个经过验证的抑郁症筛查工具，以及职业倦怠和生活质量(QOL)的标准化评估。
结果：在7905名参与的外科医生中，700人（8.9％）表示担心他们在过去3个月中犯了重大医疗错误。超过70％的外科医生将错误归因于个人而不是系统级别的因素。在过去的3个月中报告一个错误有很大的，与精神生活质量有统计学意义的不利关系，所有3个领域的倦怠(情绪疲惫，去个性化,和个人成就感）和抑郁症状。去个性化的每增加一个点(规模范围，0-33）与报告错误的可能性增加11％相关，而情绪衰竭每增加1分（量表范围，0-54）与5%的增加有关。倦怠和抑郁仍然是在多变量分析中报告最近发生的重大医疗错误的独立预测因素，该错误控制了其他个人和专业因素。通宵的频率，练习设置,补偿方法,工作小时数与多变量分析的错误无关.
结论：外科医生报告的重大医疗错误与外科医生的倦怠程度和他们的心理生活质量密切相关。需要进行研究以确定如何减少外科医生的痛苦以及在发生医疗错误时如何支持外科医生。
背景：尽管努力改善患者安全，医生的医疗错误仍然是发病率和死亡率的常见原因。
方法：美国外科医生学院的成员被匿名发送，2008年6月的横断面调查。调查包括重大医疗差错的自我评估,一个经过验证的抑郁症筛查工具，以及职业倦怠和生活质量(QOL)的标准化评估。
结果：在7905名参与的外科医生中，700人（8.9％）表示担心他们在过去3个月中犯了重大医疗错误。超过70％的外科医生将错误归因于个人而不是系统级别的因素。在过去的3个月中报告一个错误有很大的，与精神生活质量有统计学意义的不利关系，所有3个领域的倦怠(情绪疲惫，去个性化,和个人成就感）和抑郁症状。去个性化的每增加一个点(规模范围，0-33）与报告错误的可能性增加11％相关，而情绪衰竭每增加1分（量表范围，0-54）与5%的增加有关。倦怠和抑郁仍然是在多变量分析中报告最近发生的重大医疗错误的独立预测因素，该错误控制了其他个人和专业因素。通宵的频率，练习设置,补偿方法,工作小时数与多变量分析的错误无关.
结论：外科医生报告的重大医疗错误与外科医生的倦怠程度和他们的心理生活质量密切相关。需要进行研究以确定如何减少外科医生的痛苦以及在发生医疗错误时如何支持外科医生。
