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首页> 外文期刊>AJOB Primary Research >Understanding the Severity of Wrongdoing in Health Care Delivery and Research: Lessons Learned From a Historiometric Study of 100 Cases
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Understanding the Severity of Wrongdoing in Health Care Delivery and Research: Lessons Learned From a Historiometric Study of 100 Cases

机译：了解医疗保健提供和研究中的错误行为的严重性：从对100例病例的历史计量研究中吸取的教训

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Background: Wrongdoing among physicians and researchers causes myriad problems for patients and research participants. While many articles have been published on professional wrongdoing, our literature review found no studies that examined the rich contextual details of large sets of historical cases of wrongdoing. Methods:We examined 100 cases of wrongdoing in health care delivery and research using historiometricmethods,which involve the statistical description and analysis of coded historical narratives. We used maximum-variation, criterion-based sampling to identify cases involving 29 kinds of wrongdoing contained in a taxonomy of wrongdoing developed for the project. We coded the presence of a variety of environmental and wrongdoer variables and rated the severity of wrongdoing found in each case. This approach enabled us to (a) produce rich descriptions of variables characterizing cases, (b) identify factors influencing the severity of wrongdoing, and (c) test the hypothesis that professional wrongdoing is a unified, relatively homogeneous phenomenon such as "organizational deviance." Results: Some variables were consistently found across cases (e.g., wrongdoers were male and cases lasted more than 2 years), and some variables were consistently absent across cases (e.g., cases did not involve wrongdoers who were mistreated by institutions or penalized for doing what is right). However, we also found that some variables associated with wrongdoing in research (such as ambiguous legal and ethical norms) differ from those associated with wrongdoing in health care delivery (such as wrongdoers with a significant history of professional misbehavior). Conclusions: Earlier intervention from colleagues might help prevent the pattern we observed of repeated wrongdoing across multiple years. While some variables characterize the vast majority of highly publicized cases of wrongdoing in health care delivery and research-regardless of the kind of wrongdoing-it is important to examine and compare sets of relatively homogeneous cases in order to identify factors associated with wrongdoing.
机译：背景：医生和研究人员的不当行为会给患者和研究参与者带来无数问题。尽管已经发表了许多有关职业过失的文章，但我们的文献综述发现，没有研究检查过大量历史过错案例的丰富背景细节。方法：我们采用历史计量学方法检查了100例在医疗保健提供和研究中不当行为的案例，其中涉及对历史叙述的编码的统计描述和分析。我们使用基于标准的最大变异抽样来识别涉及为该项目开发的不当行为分类法中包含29种不当行为的案例。我们对各种环境和不法行为变量的存在进行了编码，并对每种情况下发现的不当行为的严重性进行了评估。这种方法使我们能够（a）对表征案件的变量进行丰富的描述，（b）识别影响违法行为严重性的因素，以及（c）检验以下假设：职业违法行为是一种统一的，相对同质的现象，例如“组织偏差”。 ”结果：在各个案例中始终发现一些变量（例如，不法行为者为男性且持续时间超过2年），并且在各个案例中始终存在一些变量（例如，案例不涉及因机构而受到虐待或因做事而受到处罚的不法行为者是对的）。但是，我们还发现，与研究中的不当行为相关的一些变量（例如法律和道德规范不明确）与医疗保健服务中的不当行为相关的变量（例如具有严重的专业不当行为的过失者）。结论：同事的更早干预可能有助于防止我们观察到多年重复犯错的情况。尽管某些变量是医疗保健提供过程中绝大多数广为宣传的不当行为的特征，并且无论何种不当行为都进行了研究，但重要的是检查和比较相对同类的案例，以识别与不当行为相关的因素。

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