Coping with medical error: a systematic review of papers to assess the effects of involvement in medical errors on healthcare professionals' psychological well-being
MetadataShow full item record
AbstractBACKGROUND: Previous research has established health professionals as secondary victims of medical error, with the identification of a range of emotional and psychological repercussions that may occur as a result of involvement in error.2 3 Due to the vast range of emotional and psychological outcomes, research to date has been inconsistent in the variables measured and tools used. Therefore, differing conclusions have been drawn as to the nature of the impact of error on professionals and the subsequent repercussions for their team, patients and healthcare institution. A systematic review was conducted. METHODS: Data sources were identified using database searches, with additional reference and hand searching. Eligibility criteria were applied to all studies identified, resulting in a total of 24 included studies. Quality assessment was conducted with the included studies using a tool that was developed as part of this research, but due to the limited number and diverse nature of studies, no exclusions were made on this basis. RESULTS: Review findings suggest that there is consistent evidence for the widespread impact of medical error on health professionals. Psychological repercussions may include negative states such as shame, self-doubt, anxiety and guilt. Despite much attention devoted to the assessment of negative outcomes, the potential for positive outcomes resulting from error also became apparent, with increased assertiveness, confidence and improved colleague relationships reported. CONCLUSION: It is evident that involvement in a medical error can elicit a significant psychological response from the health professional involved. However, a lack of literature around coping and support, coupled with inconsistencies and weaknesses in methodology, may need be addressed in future work.
CitationSirriyeh, R., Lawton, R., Gardner, P. and Armitage, G. (2010b) Coping with medical error: a systematic review of papers to assess the effects of involvement in medical errors on healthcare professionals' psychological well-being. Qual Saf Health Care, 19 (6), e43
Link to publisher’s versionhttp://dx.doi.org/10.1136/qshc.2009.035253
Showing items related by title, author, creator and subject.
Oganisational boundaries and determinants of behaviour in organisations: A situational analysis. A conceptual and empirical inquiry into the determinants of behaviour of organisational members having direct contact with an organisation's exterior, emphasising the perception of situations which occur in work routines.Randell, Gerry; Butcher, David J. (University of BradfordPostgraduate School of Studies in Management and Administration., 2010-02-17)This study is concerned with furthering an understanding of the behaviour of organisational boundary personnel, or more exactly, with how boundaries act as psychological environments. The study has two complementary aims: to describe the psychological environment encountered by boundary personnel and to offer a theoretical model of the organisation as a psychological environment, the latter being a prerequisite of the former. It is held that a social psychological perspective is needed which can deal adequately with organisations as antecedent conditions of behaviour, and that situational analysis offers a useful social psychological framework for this purpose. The empirical investigation is an initial descriptive study of the psychological environment encountered by boundary personnel. It is argued that initial descriptive studies are necessary when dealing with largely unstudied phenomena, and that this stage in the scientific process has often been undervalued by social psychologists. A diary analysis followed by interviews were used to elicit a range of situations encountered by boundary personnel having direct and frequent contact with customers and clients. Four organisations were studied, each having a different primary task. A self-completion questionnaire was administered to elicit judgemental data, using the situations as stimuli. Multidimensional scaling was applied to analyse the data, treated as four sub-sets. This yielded the dimensions underlying each data set and the representation of situations according to these dimensions in each case. The results suggest that three common dimensions (formality, anxiety and socio-emotionality) underlie the cognitive representations of boundary personnel, and that the psychological environment encountered is complex. A taxonomy of situations is constructed and several important hypotheses relating to the psychological environment of boundary personnel formulated. Implications for future research are discussed.
Service user involvement in cancer care: the impact on service usersCotterell, P.; Harlow, G.; Morris, C.; Beresford, P.; Hanley, B.; Sargeant, Anita R.; Sitzia, J.; Staley, K. (2011)BACKGROUND: Service user involvement is embedded in the United Kingdom's National Health Service, but knowledge about the impact of involvement on service users, such as the benefits and challenges of involvement, is scant. Our research addresses this gap. OBJECTIVE: To explore the personal impact of involvement on the lives of service users affected by cancer. DESIGN: We conducted eight focus groups with user groups supplemented by nine face-to-face interviews with involved individuals active at a local, regional and national level. Thematic analysis was conducted both independently and collectively. SETTING AND PARTICIPANTS: Sixty-four participants, engaged in involvement activities in cancer services, palliative care and research, were recruited across Great Britain. RESULTS: We identified three main themes: (i) 'Expectations and motivations for involvement'- the desire to improve services and the need for user groups to have a clear purpose, (ii) 'Positive aspects of involvement'- support provided by user groups and assistance to live well with cancer and (iii) 'Challenging aspects of involvement'- insensitivities and undervaluing of involvement by staff. CONCLUSIONS: This study identified that involvement has the capacity to produce varied and significant personal impacts for involved people. Involvement can be planned and implemented in ways that increase these impacts and that mediates challenges for those involved. Key aspects to increase positive impact for service users include the value service providers attach to involvement activities, the centrality with which involvement is embedded in providers' activities, and the capacity of involvement to influence policy, planning, service delivery, research and/or practice.
Embodied ideas and divided selves: revisiting Laing via BakhtinBurkitt, Ian; Sullivan, Paul W. (2009)In this article, we apply Mikhail Bakhtin's model of a 'divided self' to R.D. Laing's eponymous work on the lived experience of divided selves in 'psychosis'. Both of these authors offer intriguing insights into the fracturing of self through its social relationships (including the 'micro-dialogues' staged for oneself) but from uniquely different perspectives. Bakhtin (1984) uses Dostoevsky's novels as his material for a theory of self, centrally concerned with moments of split identity, crisis, and personal transformation, while Laing relies on his patient's accounts of 'psychosis'. We will outline how two key Bakhtinian divisions of the self (spirit/soul and authoritative/internally persuasive discourse) help to make sense of Laing's descriptions of his patient's experiences and micro-dialogues. Conversely, when refracted through Laing's phenomenology Bakhtin's account of the self becomes richer and somewhat darkened in terms of a double-edged ontology, which describes a maximally open self but one that is consumed by ideas, unable to manage their contradictions. The implications of this for managing the dilemmas of self-identity will be drawn out.