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Qual Health Care. 1993 June; 2(2): 77–82.
PMCID: PMC1055088

Patients' experience of surgical accidents.


OBJECTIVE--To examine the psychological impact of surgical accidents and assess the adequacy of explanations given to the patients involved. DESIGN--Postal questionnaire survey. SETTING--Subjects were selected from files held Action for Victims of Medical Accidents. PATIENTS--154 surgical patients who had been injured by their treatment, who considered that their treatment had fallen below acceptable standards. MAIN MEASURES--Adequacy of explanations given to patients and responses to standard questionnaires assessing pain, distress, psychiatric morbidity, and psychosocial adjustment (general health questionnaire, impact of events scale, McGill pain questionnaire, and psychosocial adjustment to illness scale). RESULTS--101 patients completed the questionnaires (69 women, 32 men; mean age 44 (median 41.5) years. Mean scores on the questionnaires indicated that these injured patients were more distressed than people who had suffered serious accidents or bereavements; their levels of pain were comparable, over a year after surgery, to untreated postoperative pain; and their psychosocial adjustment was considerably worse than in patients with serious illnesses. They were extremely unsatisfied with the explanations given about their accident, which they perceived as lacking in information, unclear, inaccurate, and given unsympathetically. Poor explanations were associated with higher levels of disturbing memories and poorer adjustment. CONCLUSIONS--Surgical accidents have a major adverse psychological impact on patients, and poor communication after the accident may increase patients' distress. IMPLICATIONS--Communication skills in dealing with such patients should be improved to ensure the clear and comprehensive explanations that they need. Many patients will also require psychological treatment to help their recovery.

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Selected References

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  • Hiatt HH, Barnes BA, Brennan TA, Laird NM, Lawthers AG, Leape LL, Localio AR, Newhouse JP, Peterson LM, Thorpe KE, et al. A study of medical injury and medical malpractice. N Engl J Med. 1989 Aug 17;321(7):480–484. [PubMed]
  • Malt U. The long-term psychiatric consequences of accidental injury. A longitudinal study of 107 adults. Br J Psychiatry. 1988 Dec;153:810–818. [PubMed]
  • Landsman IS, Baum CG, Arnkoff DB, Craig MJ, Lynch I, Copes WS, Champion HR. The psychosocial consequences of traumatic injury. J Behav Med. 1990 Dec;13(6):561–581. [PubMed]
  • Goldberg DP, Hillier VF. A scaled version of the General Health Questionnaire. Psychol Med. 1979 Feb;9(1):139–145. [PubMed]
  • Horowitz M, Wilner N, Alvarez W. Impact of Event Scale: a measure of subjective stress. Psychosom Med. 1979 May;41(3):209–218. [PubMed]
  • Rosser R, Dewar S, Thompson J. Psychological aftermath of the King's Cross fire. J R Soc Med. 1991 Jan;84(1):4–8. [PubMed]
  • Melzack R. The short-form McGill Pain Questionnaire. Pain. 1987 Aug;30(2):191–197. [PubMed]
  • Derogatis LR. The psychosocial adjustment to illness scale (PAIS). J Psychosom Res. 1986;30(1):77–91. [PubMed]
  • Cain EN, Kohorn EI, Quinlan DM, Latimer K, Schwartz PE. Psychosocial benefits of a cancer support group. Cancer. 1986 Jan 1;57(1):183–189. [PubMed]
  • Langeluddecke P, Fulcher G, Baird D, Hughes C, Tennant C. A prospective evaluation of the psychosocial effects of coronary artery bypass surgery. J Psychosom Res. 1989;33(1):37–45. [PubMed]
  • Donaldson LJ, Cavanagh J. Clinical complaints and their handling: a time for change? Qual Health Care. 1992 Mar;1(1):21–25. [PMC free article] [PubMed]

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