Yıl: 2022 Cilt: 7 Sayı: 1 Sayfa Aralığı: 203 - 211 Metin Dili: İngilizce DOI: 10.5336/healthsci.2020-80713 İndeks Tarihi: 21-07-2022

Assessment of Relationship Between Physicians’ Malpractice Experience and Fear of Malpractice: Cross-Sectional Research

Öz:
Objective: The purpose of this study is to present relationships between physician’ malpractice experiences and malpractice fear. Additionally, the other purpose of this study is to evaluate whether physicians’ malpractice fear are affected by malpractice experience and socio demographic characteristics. Material and Methods: The universe of this study consists of 567 physicians working in Gülhane Training and Research Hospital as of July 21, 2017 when the research was applied. Due to the difficulty of reaching the entire universe, it was determined to reach at least 229 physicians as a result of the sample calculation made at a 95% confidence level. A total of 248 physicians (Sample Proportion: 44%) were surveyed by using a convenience sampling method. Descriptive statistics were indicated with frequency, percentage, mean, and standard deviation. To evaluate relationships between the socio-demographic characteristics and malpractice experiences of physicians and, their malpractice fears, a structural model has been conducted in the AMOS 24 statistical software. Results: According to the analysis of the data, statistically significant relationships were found between the physician’s self-experience of malpractice and their fear of malpractice (β=0.196; p=0.003) and colleague-experience of malpractice and their fear of malpractice (β=0.153; p= 0.009). Within the scope of the study, it was found that physicians' level of malpractice fear did not differ significantly in terms of gender, age, and status. Conclusion: Consequently, these findings indicate that experiences of physicians with malpractice, obtained while performing medical practice lead to fear of malpractice, which has important impacts on health systems in many ways. Particularly, the effect of physicians’ own experience of malpractice on fear of malpractice was higher than that of their colleagues' experience of malpractice.
Anahtar Kelime:

Hekimlerin Malpraktis Tecrübeleri ile Malpraktis Korkuları Arasındakiİlişkinin Değerlendirilmesi:Kesitsel Araştırma

Öz:
Bu çalışmanın amacı, hekimlerin malpraktis deneyimleriyle malpraktis korkuları arasındaki ilişkinin ortaya konmasıdır. Ayrıca çalışmanın bir diğer amacı, hekimlerin malpraktis korkularının, malpraktis tecrübeleri ve sosyodemografik özelliklerinden etkilenip etkilenmediğinin değerlendirilmesidir. Gereç ve Yöntemler: Araştırmanın evrenini, araştırmanın uygulandığı 21 Temmuz 2017 tarihi itibarıyla Gülhane Eğitim ve Araştırma Hastanesinde görev yapan 567 hekim oluşturmaktadır. Tüm evrene ulaşmanın zor olması nedeniyle %95 güven düzeyinde yapılan örneklem hesabında en az 229 gözlem sayısı tespit edilmiştir. Olasılıksız kolayda örnekleme metodu kullanılarak 248 hekime (evrene ulaşma oranı %44) ulaşılmıştır. Verilerin analizinde, tanımlayıcı istatistiklerin yanı sıra ortalama ve standart sapmalardan yararlanılmıştır. Hekimlerin sosyodemografik özelikleri ve malpraktis tecrübeleriyle malpraktis korkuları arasındaki ilişkinin değerlendirilmesi amacıyla AMOS 24 istatistik yazılımında yapısal eşitlik modeli uygulanmıştır. Bulgular: Verilerin analizine göre hekimin yanlış uygulama deneyimiyle yanlış uygulama korkusu (β=0,196; p=0,003) ve meslektaşlarının hatalı uygulama deneyimi ve hatalı uygulama korkusu arasında istatistiksel olarak anlamlı ilişkiler bulunmuştur (β=0,153; p=0,009). Çalışma kapsamında hekimlerin malpraktis korku seviyelerinin cinsiyet, yaş ve statü gibi özelliklerine göre anlamlı farklılık göstermediği bulunmuştur. Sonuç: Sonuç olarak bu bulgular, hekimlerin tıbbi uygulama yaparken edindikleri yanlış uygulama deneyimlerinin, sağlık sistemleri üzerinde pek çok açıdan önemli etkileri olan yanlış uygulama korkusuna yol açtığını göstermektedir. Özellikle hekimlerin kendi yanlış uygulama deneyimlerinin, yanlış uygulama korkusu üzerindeki etkisi, meslektaşlarının yanlış uygulama deneyiminden daha yüksektir.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Leape LL. Error in medicine. JAMA. 1994;272(23):1851-7. [Crossref] [PubMed]
  • 2. Institute of Medicine (uS) Committee on Quality of Health Care in America. To Err is Human: Building a Safer Health System. Kohn LT, Corrigan JM, Donaldson MS, editors. Washington (DC): National Academies Press (uS); 2000. [PubMed]
  • 3. Goodman JC, villarreal P, Jones B. The social cost of adverse medical events, and what we can do about it. Health Aff (Millwood). 2011;30(4):590-5. [Crossref] [PubMed]
  • 4. Sohn DH. Negligence, genuine error, and litigation. Int J Gen Med. 2013;6:49-56. [Crossref] [PubMed] [PMC]
  • 5. Gökcan HT. Tıbbi Müdahaleden Doğan Hukuki ve Cezai Sorumluluk. 2. Baskı. Ankara: Seçkin Yayıncılık; 2014. [Link]
  • 6. Antoci A, fiori Maccioni A, Russu P. The ecology of defensive medicine and malpractice litigation. PLoS One. 2016;11(3):e0150523. [Crossref] [PubMed] [PMC]
  • 7. Chawla A, Gunderman RB. Defensive medicine: prevalence, implications, and recommendations. Acad Radiol. 2008;15(7):948-9. [Crossref] [PubMed]
  • 8. Mechanic D. Some social aspects of the medical malpractice dilemma. Duke Law Journal. 1976;1975(6):1179-96. [Crossref]
  • 9. Hauser MJ, Commons ML, Bursztajn HJ, Gutheil TG. fear of malpractice liability and its role in clinical decision making. Decision Making in Psychiatry and The Law. uS: Williams & Wilkins Co.; 1991. p.209-26. [Link]
  • 10. SIT | Digital Collections [Internet]. [Cited: May 1, 2017]. Independent Study Project (ISP) Collection. Hwang JY. Physicians' perspectives on the current handling of medical malpractice in Jordan. 2014. Available from: [Link]
  • 11. Jena AB, Seabury S, Lakdawalla D, Chandra A. Malpractice risk according to physician specialty. N Engl J Med. 2011;365(7):629-36. [Crossref] [PubMed] [PMC]
  • 12. Tümer AR. 1995-2000 yılları arasında Yüksek Sağlık Şurası tarafından değerlendirilen cerrahi vakalarının komplikasyon ve malpraktis yönünden araştırılması. Ankara: Ankara Üniversitesi Tıp fakültesi Adli Tıp Anabilim Dalı; 2002.
  • 13. Cannon WB. The James-Lange theory of emotions: a critical examination and an alternative theory. By Walter B. Cannon, 1927. Am J Psychol. 1987;100(3-4):567-86. [Crossref] [PubMed]
  • 14. Papez JW. A proposed mechanism of emotion. Arch NeurPsych. 1937;38(4):725-43. [Crossref]
  • 15. Schachter S, Singer JE. Cognitive, social, and physiological determinants of emotional state. Psychol Rev. 1962;69:379-99. [Crossref] [PubMed]
  • 16. Steimer T. The biology of fear- and anxiety-related behaviors. Dialogues Clin Neurosci. 2002;4(3):231-49. [Crossref] [PubMed] [PMC]
  • 17. Bay EJ, Algase DL. fear and anxiety: a simultaneous concept analysis. Nurs Diagn. 1999;10(3):103-11. [Crossref] [PubMed]
  • 18. Summerton N. Positive and negative factors in defensive medicine: a questionnaire study of general practitioners. BMJ. 1995;310(6971):27-9. [Crossref] [PubMed] [PMC]
  • 19. Reschovsky JD, Saiontz-Martinez CB. Malpractice claim fears and the costs of treating medicare patients: a new approach to estimating the costs of defensive medicine. Health Serv Res. 2018;53(3):1498-516. [Crossref] [PubMed] [PMC]
  • 20. Sonnenberg A, Boardman CR. Costs of fear. Am J Gastroenterol. 2013;108(2):173-5. [Crossref] [PubMed]
  • 21. Mello MM, Studdert DM, DesRoches CM, Peugh J, Zapert K, Brennan TA, et al. Effects of a malpractice crisis on specialist supply and patient access to care. Ann Surg. 2005;242(5):621-8. [Crossref] [PubMed] [PMC]
  • 22. Konetzka RT, Park J, Ellis R, Abbo E. Malpractice litigation and nursing home quality of care. Health Serv Res. 2013;48(6 Pt 1):1920-38. [Crossref] [PubMed] [PMC]
  • 23. Ball JR. The medical malpractice threat: a study of defensive medicine. Duke Law Journal. 1971;939:939-93. [Crossref]
  • 24. Montanera D. The importance of negative defensive medicine in the effects of malpractice reform. Eur J Health Econ. 2016;17(3):355-69. [Crossref] [PubMed]
  • 25. vandersteegen T, Marneffe W, vandijck D. Defensive medicine: implications for clinical practice, patients and healthcare policy. Acta Clin Belg. 2015;70(6):396-7. [Crossref] [PubMed]
  • 26. Katz DA, Williams GC, Brown RL, Aufderheide TP, Bogner M, Rahko PS, et al. Emergency physicians' fear of malpractice in evaluating patients with possible acute cardiac ischemia. Ann Emerg Med. 2005;46(6):525-33. [Crossref] [PubMed] [PMC]
  • 27. fiscella K, franks P, Zwanziger J, Mooney C, Sorbero M, Williams GC. Risk aversion and costs. Journal of family Practice. 2000;49(1):12-8. [Link]
  • 28. franks P, Williams GC, Zwanziger J, Mooney C, Sorbero M. Why do physicians vary so widely in their referral rates? J Gen Intern Med. 2000;15(3):163-8. [Crossref] [PubMed] [PMC]
  • 29. Reed DA, Windish DM, Levine RB, Kravet SJ, Wolfe L, Wright SM. Do fears of malpractice litigation influence teaching behaviors? Teach Learn Med. 2008;20(3):205-11. [Crossref] [PubMed]
  • 30. Benbassat J, Pilpel D, Schor R. Physicians' attitudes toward litigation and defensive practice: development of a scale. Behav Med. 2001;27(2):52-60. [Crossref] [PubMed]
  • 31. Carrier ER, Reschovsky JD, Mello MM, Mayrell RC, Katz D. Physicians' fears of malpractice lawsuits are not assuaged by tort reforms. Health Aff (Millwood). 2010;29(9):1585-92. [Crossref] [PubMed]
  • 32. Christensen Jf, Levinson W, Dunn PM. The heart of darkness: the impact of perceived mistakes on physicians. J Gen Intern Med. 1992;7(4):424-31. [Crossref] [PubMed]
  • 33. Hickson GB, federspiel Cf, Pichert JW, Miller CS, Gauld-Jaeger J, Bost P. Patient complaints and malpractice risk. JAMA. 2002;287(22):2951-7. [Crossref] [PubMed]
  • 34. Blanchard RJ, Blanchard DC, Griebel G, Nutt D. Introduction to the handbook on fear and anxiety. In: Huston JP. Handbook of Behavioral Neuroscience. 2nd ed. Netherlands: Academic Press; 2008. p.3-7. [Crossref]
  • 35. Öhman A. fear and anxiety. Overlaps and dissociations. In: Lewis M, Haviland-Jones JM, Barrett Lf, eds. Handbook of Emotions. 3rd ed. New York, London: The Guilford Press; 2008. p.709-28. [Link
APA UĞRAK U, Isik O (2022). Assessment of Relationship Between Physicians’ Malpractice Experience and Fear of Malpractice: Cross-Sectional Research. , 203 - 211. 10.5336/healthsci.2020-80713
Chicago UĞRAK UĞUR,Isik Oguz Assessment of Relationship Between Physicians’ Malpractice Experience and Fear of Malpractice: Cross-Sectional Research. (2022): 203 - 211. 10.5336/healthsci.2020-80713
MLA UĞRAK UĞUR,Isik Oguz Assessment of Relationship Between Physicians’ Malpractice Experience and Fear of Malpractice: Cross-Sectional Research. , 2022, ss.203 - 211. 10.5336/healthsci.2020-80713
AMA UĞRAK U,Isik O Assessment of Relationship Between Physicians’ Malpractice Experience and Fear of Malpractice: Cross-Sectional Research. . 2022; 203 - 211. 10.5336/healthsci.2020-80713
Vancouver UĞRAK U,Isik O Assessment of Relationship Between Physicians’ Malpractice Experience and Fear of Malpractice: Cross-Sectional Research. . 2022; 203 - 211. 10.5336/healthsci.2020-80713
IEEE UĞRAK U,Isik O "Assessment of Relationship Between Physicians’ Malpractice Experience and Fear of Malpractice: Cross-Sectional Research." , ss.203 - 211, 2022. 10.5336/healthsci.2020-80713
ISNAD UĞRAK, UĞUR - Isik, Oguz. "Assessment of Relationship Between Physicians’ Malpractice Experience and Fear of Malpractice: Cross-Sectional Research". (2022), 203-211. https://doi.org/10.5336/healthsci.2020-80713
APA UĞRAK U, Isik O (2022). Assessment of Relationship Between Physicians’ Malpractice Experience and Fear of Malpractice: Cross-Sectional Research. Türkiye Klinikleri Sağlık Bilimleri Dergisi, 7(1), 203 - 211. 10.5336/healthsci.2020-80713
Chicago UĞRAK UĞUR,Isik Oguz Assessment of Relationship Between Physicians’ Malpractice Experience and Fear of Malpractice: Cross-Sectional Research. Türkiye Klinikleri Sağlık Bilimleri Dergisi 7, no.1 (2022): 203 - 211. 10.5336/healthsci.2020-80713
MLA UĞRAK UĞUR,Isik Oguz Assessment of Relationship Between Physicians’ Malpractice Experience and Fear of Malpractice: Cross-Sectional Research. Türkiye Klinikleri Sağlık Bilimleri Dergisi, vol.7, no.1, 2022, ss.203 - 211. 10.5336/healthsci.2020-80713
AMA UĞRAK U,Isik O Assessment of Relationship Between Physicians’ Malpractice Experience and Fear of Malpractice: Cross-Sectional Research. Türkiye Klinikleri Sağlık Bilimleri Dergisi. 2022; 7(1): 203 - 211. 10.5336/healthsci.2020-80713
Vancouver UĞRAK U,Isik O Assessment of Relationship Between Physicians’ Malpractice Experience and Fear of Malpractice: Cross-Sectional Research. Türkiye Klinikleri Sağlık Bilimleri Dergisi. 2022; 7(1): 203 - 211. 10.5336/healthsci.2020-80713
IEEE UĞRAK U,Isik O "Assessment of Relationship Between Physicians’ Malpractice Experience and Fear of Malpractice: Cross-Sectional Research." Türkiye Klinikleri Sağlık Bilimleri Dergisi, 7, ss.203 - 211, 2022. 10.5336/healthsci.2020-80713
ISNAD UĞRAK, UĞUR - Isik, Oguz. "Assessment of Relationship Between Physicians’ Malpractice Experience and Fear of Malpractice: Cross-Sectional Research". Türkiye Klinikleri Sağlık Bilimleri Dergisi 7/1 (2022), 203-211. https://doi.org/10.5336/healthsci.2020-80713