Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-13T06:50:06.820Z Has data issue: false hasContentIssue false

A Qualitative Study of Attitudes Toward Error in Patients Facing Brain Tumour Surgery

Published online by Cambridge University Press:  16 February 2016

Mark Bernstein*
Affiliation:
Division of Neurosurgery, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON Canada Joint Center for Bioethics, University of Toronto, Toronto, ON Canada
Dawn Potvin
Affiliation:
Division of Neurosurgery, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON Canada
Douglas K. Martin
Affiliation:
Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON Canada Joint Center for Bioethics, University of Toronto, Toronto, ON Canada
*
Department of Surgery, University of Toronto, Division of Neurosurgery, Toronto Western Hospital, 399 Bathurst Street, 4W451, Toronto, Ontario M5T2S8 Canada
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Background:

Medical error is an extremely important component of patient safety and requires intense study. The present investigation undertook to examine patients' perceptions and attitudes regarding medical error.

Methods:

Qualitative case study methodology was used. We conducted 30 face-to-face interviews with patients within one week of undergoing a neurosurgical operation for a brain tumour. Interviews were audiotaped and transcribed and the data subjected to thematic analysis.

Results:

Three overarching themes emerged from the data: 1) trust in the patient's surgeon was of paramount importance; 2) patients'views toward medical error varied between fear and vulnerability to no concern; and 3) discussion of error was felt to be beneficial as it could help the medical profession decrease future errors and could help dispel the patient's fear and anxiety about the upcoming surgery.

Conclusions:

Patients'trust in their physician/surgeon is of paramount importance in allaying their fears about the possible occurrence and impact of medical error during their treatment. The level of concern about error varies among patients, but most felt that discussion of error was a good thing.

Type
Original Article
Copyright
Copyright © The Canadian Journal of Neurological 2004

References

1.Cabantog, A, Bernstein, M. Complications of first craniotomy for intra-axial brain tumor. Can J Neurol Sci 1994; 21:213218.CrossRefGoogle Scholar
2.de Laval, MR, Carthey, J, Wright, DJ, et al. Human factors and cardiac surgery: a multicenter study. J Thor Cardiovasc Surg 2000; 119:661672.CrossRefGoogle Scholar
3.Etchells, E, Bernstein, M. Improving patient safety: just do it. Healthcare Papers 2001; 2:5965.CrossRefGoogle ScholarPubMed
4.Gawande, AA, Thomas, EJ, Zinner, MJ, Brennan, TA. The incidence and nature of surgical adverse events in Colorado and Utah in 1992. Surgery 1999; 126:6675.CrossRefGoogle ScholarPubMed
5.Hobgood, C, Peck, CR, Gilbert, B, Chappell, K, Zou, B. Medical errors — what and when: what do patients want to know? Acad Emerg Med 2002; 9:11561161.CrossRefGoogle ScholarPubMed
6.Latham, SR. System and responsibility: three readings of the IOM report on medical error. Am J Law & Med 2001; 27:163179.CrossRefGoogle ScholarPubMed
7.Leape, LL, Brennan, TA, Laird, N, et al. The nature of adverse events in hospitalized patients. Results of the Harvard Medical Practice Study II. N Engl J Med 1991; 324:377384.CrossRefGoogle ScholarPubMed
8.Vincent, C, Neale, G, Woloshynowych, M. Adverse events in British hospitals: preliminary retrospective record review. Br Med J 2001; 322:517519.CrossRefGoogle ScholarPubMed
9.Witman, AB, Park, DM, Hardin, SB. How do patients want physicians to handle mistakes? A survey of internal medicine patients in an academic setting. Arch Intern Med 1996; 156:25652569.CrossRefGoogle Scholar
10.Bernstein, M, Massicotte E: Prospective error recording in surgery: a feasibility study in 500 neurosurgical cases. Evidence-Based Surgery 2003; 1:5762.Google Scholar
11.Fung, D, Cohen, M. What do patients value most in their anesthesia care? Can J Anesth 2001; 48:1219.CrossRefGoogle ScholarPubMed
12.Holzner, B, Kemmler, G, Kopp, M, et al. Preoperative expectations and postoperative quality of life in liver transplant survivors. Arch Phys Med Rehabil 2001; 82:7379.CrossRefGoogle ScholarPubMed
13.Jacobson, JA, Kasworm, EM, Battin, MP, et al. Decedents’ reported preferences for physician-assisted death: a survey of informants listed on death certificates in Utah. J Clin Ethics 1995; 6:184192.CrossRefGoogle Scholar
14.Singer, PA, Martin, DK, Kelner, M. Quality end-of-life care. Patients’ perspectives. JAMA 1999; 281:163168.CrossRefGoogle ScholarPubMed
15.Wilson, SJ, Saling, MM, Kincade, P, Bladin, PF. Patient expectations of temporal lobe surgery. Epilepsia 1998; 39:167174.CrossRefGoogle ScholarPubMed
16.Babbie, ER. Survey Research Methods. Wadsworth, Inc., 1990:118139.Google Scholar
17.Britten, N. Qualitative interviews in medical research. Br Med J 1995; 311:251255.CrossRefGoogle ScholarPubMed
18.Pellegrino, ED. The limitation of empirical research in ethics. J Clin Ethics 1995; 6:161162.CrossRefGoogle ScholarPubMed
19.Gallagher, TH, Waterman, AD, Ebers, AG, Fraser, VJ, Levinson, W. Patients’ and physicians’ attitudes regarding the disclosure of medical errors. JAMA 2003; 289:10011007.CrossRefGoogle ScholarPubMed
20.McKneally, MF, Martin, DK. An entrustment model of consent for s u rgical treatment of life-threatening illness: perspective of patients requiring esophagectomy. J Thorac Cardiovasc Surg 2000; 120:264269.CrossRefGoogle Scholar
21.Scott, G, Whyler, N, Grant, G. A study of family carers of people with a life-threatening illness 1: the carers’needs analysis. Int J Palliat Nurs 2001; 7:290291.CrossRefGoogle ScholarPubMed
22.Strauss, A, Corbin, J. Basics of Qualitative Research: Grounded Theory Procedures and Techniques. Beverly Hills: Sage Publications Inc; 1990: 188.Google Scholar
23.Bernstein, M, Hebert, PC, Etchells, E. Patient safety in neurosurgery: detection of errors, prevention of errors, and disclosure of errors. Neurosurgery Quarterly 2003; 13:125137.CrossRefGoogle Scholar
24.Strauss, A, Corbin, J. Basics of Qualitative Research: Techniques and Procedures of Developing Grounded Theory. Thousand Oaks, CA: Sage Publications Inc., 1998: 55242.Google Scholar
25.Altheide, DL, Johnson, JM. Criteria for assessing interpretive validity in qualitative research. In: Denzin, NK, Lincoln, YS, eds. Handbook of Qualitative Research. Thousand Oaks, Sage Publications Inc, 1994: 485499.Google Scholar
26.Mays, N, Pope, C. Rigour and qualitative research. Br Med J 1995; 311:109112.CrossRefGoogle ScholarPubMed
27.Chin, JJ. Doctor-patient relationship: a covenant of trust. Singapore Med J 2001; 42:579581.Google ScholarPubMed
28.Helmes, AW, Bowen, DJ, Bengel, J. Patient preferences of decision-making in the context of genetic testing for breast cancer risk. Genet Med 2002; 4:150157.CrossRefGoogle ScholarPubMed
29.Bell, RA, Kravitz, RL, Thom, D, Krupat, E, Azari, R. Unmet expectations for care and the patient-physician relationship. J Gen Intern Med 2002; 17:817824.CrossRefGoogle ScholarPubMed
30.de Raeve, L. The modification of emotional responses: a problem for trust in the nurse-patient relationship. Nurs Ethics 2002; 9:465471.CrossRefGoogle Scholar
31.Peter, E, Watt-Watson, J. Unrelieved pain: an ethical and epistemological analysis of distrust in patients. Can J Nurs Res 2002; 34:6580.Google ScholarPubMed
32.Hall, MA, Zheng, B, Dugan, E, et al. Measuring patients’trust in their primary care providers. Med Care Res Rev 2002; 59:293, 318.CrossRefGoogle ScholarPubMed
33.Anheier, H, Kendall, J. Interpersonal trust and voluntary associations: examining three approaches. Br J Sociol 2002; 53:343362.CrossRefGoogle ScholarPubMed
34.Mollering, G. The nature of trust: from Georg Simmel to a theory of expectation, interpretation, and suspension. Sociology 2001; 35:403420.CrossRefGoogle Scholar