Perceptions of the general public and physicians regarding open disclosure in Korea: a qualitative study

Abstract

BackgroundExperience with open disclosure and its study are restricted to certain western countries. In addition, there are concerns that open disclosure may be less suitable in non-western countries. The present study explored and compared the in-depth perceptions of the general public and physicians regarding open disclosure in Korea.MethodsWe applied the COREQ (Consolidated Criteria for Reporting Qualitative Research) checklist to this qualitative study. We conducted 20 in-depth interviews and four focus group discussions with 16 physicians and 18 members of the general public. In-depth interviews and focus group discussions were performed according to semi-structured guidelines developed according to a systematic review of open disclosure. We conducted a directed content analysis by analyzing the verbatim transcripts and field notes in accordance with the predetermined guidelines.ResultsOpen disclosure perceptions were summarized in terms of the “five Ws and one H” (who, what, where, when, why, and how). All physician and general public participants acknowledged the normative justifiability of open disclosure. The participants mostly agreed on the known effects of open disclosure, but the physicians had negative opinions on its expected effects, such as decreased intention of the general public to file lawsuits and increased credibility of medical professionals. Generally, the participants thought that open disclosure is required for medical errors causing major harm. However, the physicians and general public had conflicting opinions on the need for open disclosure of near misses. Most physicians did not know how to conduct open disclosure and some physicians had bad experiences due to inappropriate or incomplete open disclosure.ConclusionPhysicians and the general public in Korea acknowledge the need for open disclosure. Guidelines according to the type of patient safety incident are required to encourage physicians to more readily conduct open disclosure. Furthermore, hospitals need to consider organizing a dedicated team and hiring experts for open disclosure.Electronic supplementary materialThe online version of this article (doi:10.1186/s12910-016-0134-0) contains supplementary material, which is available to authorized users.

The relationship of moral sensitivity and patient safety attitudes with nursing students’ perceptions of disclosure of patient safety incidents: A cross-sectional study

“…The results of this study differ from those of the previous studies in terms of how likely participants were to determine the importance of open disclosure based on the severity of the incident in question and whether the information would be helpful to the patient and their family. In this study, nursing students' perception of disclosure of patient safety incidents was found to be similar to that of Korean doctors, nurses, and the general public in previous studies [24,28]. Responses regarding negative consequences of open disclosure showed low scores, implying that nursing students may be more reluctant to disclose patient safety incidents based on the severity of the incident, that is, if incidents are less severe or less harmful.…”

“…Research in China and Japan has shown that nurses experience ethical and moral dilemmas due to conflict between patients' rights and the need to protect themselves, their colleagues, and the institution [29,30]. In other studies, open disclosure of medical errors has been shown to cause healthcare providers concern regarding potential reputation damage, conflict, and litigation [13,28]. Creating a positive culture that encourages reporting of patient safety events should help alleviate the psychological burden experienced by healthcare providers [26].…”

Korean physicians’ perceptions regarding disclosure of patient safety incidents: A cross-sectional study

“…"When a patient safety incident occurs, medical professionals preemptively explain the incident to the patients and their caregivers, express sympathy and regret for the incident, deliver an apology and compensation appropriately if needed, and promise to prevent recurrence [2]." The emphasis on DPSI in the field of patient safety is based both on ethical considerations [1,3] and on various known beneficial effects including reduced number of medical lawsuits and related costs; reduced intention to discipline medical staff; stronger physician-patient relationships; increased intention to revisit and recommend medical staff; higher assessment scores for quality of care; and reduced guilt among medical staff [4].…”

“…However, it is known to be difficult for medical staff to perform DPSI in actual clinical practice [2,5].…”

“…Medical staffs are reluctant to perform DPSI even under situations when DPSI is needed due to fears about medical lawsuits and disciplinary actions, as well as about losing the trust of patients and colleagues [4]. In particular, among physicians, who are in the most critical position with regard to performing DPSI, not having accurate perceptions of DPSI and doubting its effects and benefits act as a major barrier to proper execution of DPSI [2]. It is known that physicians, who are often in a position to lead and supervise the entire patient treatment process, are highly likely to proactively decide how to handle patient safety incidents, and that patients and their caregivers want to hear an explanation about the patient safety incident from physicians [2].…”