Parental Concern for Errors During a Child's Hospitalization
Parental Concern for Errors During a Child's Hospitalization
Objective: (1) To determine the proportion of parents concerned about medical errors during a child's hospitalization; and (2) the association between this concern and parental self-efficacy with physician interactions.
Study design: Cross-sectional survey.
Setting: Tertiary care children's hospital.
Participants: Parents of children admitted to the general medical service.
Outcome measure: Parental concern about medical errors.
Methods: Parents were asked their agreement with the statement "When my child is in the hospital I feel that I have to watch over the care that he/she is receiving to make sure that mistakes aren't made." We used multivariate logistic regression to examine the association between parents' self-efficacy with physician interactions and the need "to watch over a child's care," adjusting for parent and child demographics, English proficiency, past hospitalization, and social desirability bias.
Results: Of 278 eligible parents, 130 completed surveys and 63% reported the need to watch over their child's care to ensure that mistakes were not made. Parents with greater self-efficacy with physician interactions were less likely to report this need (odds ratio [OR], 0.83; 95% confidence interval [CI], 0.72–0.92). All parents who were "very uncomfortable" communicating with doctors in English reported the need to watch over their child's care to prevent mistakes.
Conclusions: Nearly two-thirds of surveyed parents felt the need to watch over their child's hospital care to prevent mistakes. Parents with greater self-efficacy with physician interactions were less likely to report the need to watch over their child's care while parents with lower English proficiency were more likely to report this need.
The Institute of Medicine report linking between 48,000 and 98,000 deaths annually to medical errors has raised awareness about medical errors across all areas of medicine. In pediatrics, medical errors in hospitalized children are associated with significant increases in length of stay, healthcare costs, and death. While much attention has been paid to the use of hospital systems to prevent medical errors, there has been considerably less focus on the experiences of patients and their potential role in preventing errors.
Studies have suggested that a significant majority of adult patients are concerned about medical errors during hospitalization. However, a similar assessment of parents' concerns about medical errors in pediatrics is lacking. Admittedly, for concern to be constructive it must be linked to action. The Joint Commission and the Agency for Healthcare Research and Quality (AHRQ) currently recommend that parents help prevent errors by becoming "active, involved and informed" members of their healthcare team and "taking part in every decision about (their) child's health care." However, the extent to which parental concern about medical errors is related to a parent's self-efficacy, or confidence, interacting with physicians is unknown.
Self-efficacy is a construct used in social cognitive theory to explain behavior change. It refers to an individual's "belief in (his/her) capabilities to organize and execute the courses of action required to produce given attainments" or a desired outcome. Self-efficacy is not a general concept; it must be discussed in reference to a specific activity. In healthcare it has been associated not only with willingness to adopt preventive strategies, but also with treatment adherence, behavior change, and with greater patient participation in healthcare decision-making.
In this study we had 2 objectives. First, we sought to assess the proportion of parents of hospitalized children who are concerned about medical errors. Second, we attempted to examine whether a parent's self-efficacy interacting with physicians was associated with their concern about medical errors for their child. Given that parents with greater self-efficacy interacting with physicians might feel more empowered to prevent errors and, as such, be more inclined to take an active role to do so, we hypothesized that such parents would be less concerned about medical errors during a pediatric hospitalization.
Abstract and Introduction
Abstract
Objective: (1) To determine the proportion of parents concerned about medical errors during a child's hospitalization; and (2) the association between this concern and parental self-efficacy with physician interactions.
Study design: Cross-sectional survey.
Setting: Tertiary care children's hospital.
Participants: Parents of children admitted to the general medical service.
Outcome measure: Parental concern about medical errors.
Methods: Parents were asked their agreement with the statement "When my child is in the hospital I feel that I have to watch over the care that he/she is receiving to make sure that mistakes aren't made." We used multivariate logistic regression to examine the association between parents' self-efficacy with physician interactions and the need "to watch over a child's care," adjusting for parent and child demographics, English proficiency, past hospitalization, and social desirability bias.
Results: Of 278 eligible parents, 130 completed surveys and 63% reported the need to watch over their child's care to ensure that mistakes were not made. Parents with greater self-efficacy with physician interactions were less likely to report this need (odds ratio [OR], 0.83; 95% confidence interval [CI], 0.72–0.92). All parents who were "very uncomfortable" communicating with doctors in English reported the need to watch over their child's care to prevent mistakes.
Conclusions: Nearly two-thirds of surveyed parents felt the need to watch over their child's hospital care to prevent mistakes. Parents with greater self-efficacy with physician interactions were less likely to report the need to watch over their child's care while parents with lower English proficiency were more likely to report this need.
Introduction
The Institute of Medicine report linking between 48,000 and 98,000 deaths annually to medical errors has raised awareness about medical errors across all areas of medicine. In pediatrics, medical errors in hospitalized children are associated with significant increases in length of stay, healthcare costs, and death. While much attention has been paid to the use of hospital systems to prevent medical errors, there has been considerably less focus on the experiences of patients and their potential role in preventing errors.
Studies have suggested that a significant majority of adult patients are concerned about medical errors during hospitalization. However, a similar assessment of parents' concerns about medical errors in pediatrics is lacking. Admittedly, for concern to be constructive it must be linked to action. The Joint Commission and the Agency for Healthcare Research and Quality (AHRQ) currently recommend that parents help prevent errors by becoming "active, involved and informed" members of their healthcare team and "taking part in every decision about (their) child's health care." However, the extent to which parental concern about medical errors is related to a parent's self-efficacy, or confidence, interacting with physicians is unknown.
Self-efficacy is a construct used in social cognitive theory to explain behavior change. It refers to an individual's "belief in (his/her) capabilities to organize and execute the courses of action required to produce given attainments" or a desired outcome. Self-efficacy is not a general concept; it must be discussed in reference to a specific activity. In healthcare it has been associated not only with willingness to adopt preventive strategies, but also with treatment adherence, behavior change, and with greater patient participation in healthcare decision-making.
In this study we had 2 objectives. First, we sought to assess the proportion of parents of hospitalized children who are concerned about medical errors. Second, we attempted to examine whether a parent's self-efficacy interacting with physicians was associated with their concern about medical errors for their child. Given that parents with greater self-efficacy interacting with physicians might feel more empowered to prevent errors and, as such, be more inclined to take an active role to do so, we hypothesized that such parents would be less concerned about medical errors during a pediatric hospitalization.