1.Parental preferences with regards to disclosure following adverse events occurring in relation to medication use or diagnosis in the care of their children – perspectives from Malaysia
Chin Hoong Wong ; Tock Rei Tan ; Hian Yue Heng ; Thangatorai Ramesh ; Pey Woei Ting ; Wei Shien Lee, Cheong Lieng Teng ; Nalliah Sivalingam ; Kah Kee Tan
The Medical Journal of Malaysia 2016;71(4):186-192
Introduction: Open disclosure is poorly understood in
Malaysia but is an ethical and professional responsibility.
The objectives of this study were to determine: (1) the
perception of parents regarding the severity of medical error
in relation to medication use or diagnosis; (2) the preference
of parents for information following the medical error and its
relation to severity; and (3) the preference of parents with
regards to disciplinary action, reporting, and legal action.
Methods: We translated and contextualised a questionnaire
developed from a previous study. The questionnaire
consisted of four case vignettes that described the
following: medication error with a lifelong complication;
diagnostic error with a lifelong complication; diagnostic
error without lifelong effect; and medication error without
lifelong effect. Each case vignette was followed by a series
of questions examining the subject’s perception on the
above areas. We also determined the content validity of the
questionnaire. We invited parents of Malaysian children
admitted to the paediatric wards of Tuanku Jaafar Hospital to
participate in the study.
Results: One hundred and twenty-three parents participated
in the study. The majority of parents wanted to be told
regarding the event. As the severity of the case vignettes
increased, the desire for information, remedial action,
acknowledgement of responsibility, compensation,
punishment, legal action, and reporting to a higher agency
also increased. The findings did not have strong evidence of
a relationship with subject’s demographics.
Conclusion: This study gives insights into previously
unexplored perspectives and preferences of parents in
Malaysia regarding open disclosure. It also highlights the
opportunity for more research in this area with potentially
broad applications.
Disclosure
;
Professional-Patient Relations
;
Patient Rights
2.Views of faculty members in a medical school with regards to error disclosure and reporting to parents and/or higher authorities
Chin Hoong Wong ; Amanda Cheng Li Phuah ; Nathaniel Shiang Yann Naik ; Weng Shen Choo ; Helen Siew Yean Ting ; Shaun Mun Leong Kuan ; Cheong Lieng Teng ; Nalliah Sivalingam
The Medical Journal of Malaysia 2016;71(5):244-249
Background: Little is known about the views of faculty
members who train medical students concerning open
disclosure.
Objectives: The objectives of this study were to determine
the views of faculty in a medical school on: 1 what
constitutes a medical error and the severity of such an error
in relation to medication use or diagnosis; 2 information
giving following such an adverse event, based on severity;
and 3 acknowledgement of responsibility, remedial action,
compensation, disciplinary action, legal action, and
reporting to a higher body in relation to such adverse event.
Methods: We adapted and contextualized a questionnaire
developed from a previous study. The questionnaire had 4
case vignettes that described 1 clear medication error with
lifelong disability; 2 possible diagnostic error with lifelong
disability; 3 possible diagnostic error without harm; and 4
clear medication error without harm. We invited all faculty
members attached to the medical school at the International
Medical University to participate in the study.
Results: Seventy faculty members took part. Faculty
members viewed a medical error as having taken place
depending on how clearly an error had occurred (94% and
73% versus 53% and 27%). They viewed cases as more
severe based on the severity of complications (85% and 46%
versus 5% and 10%). With increasing severity, they tended to
attribute responsibility for the event and the duty to disclose
towards more senior clinicians. They were also more
agreeable with remedial action, compensation, disciplinary
action, and reporting to a higher agency. There was no
strong evidence of association between these areas and the
demographics of faculty members.
Conclusions: Faculty members are more likely to perceive
an error had occurred depending on the clarity of the
circumstances. They viewed severity based on the presence
of complications. Severity determined how they attributed
responsibility, duty to disclose, and other areas related to
open disclosure.