The role of anesthesiologists' perceived self-efficacy in anesthesia-related adverse events

Feng Xu; Linlin Han; Shuai Zhao; Yafeng Wang; Qingtong Zhang; Erfeng Xiong; Shiqian Huang; Guixing Zhang; Hong He; Shiyu Deng; Yingjie Che; Yan Li; Liping Xie; Xiangdong Chen

doi:10.1186/s12871-022-01732-3

The role of anesthesiologists' perceived self-efficacy in anesthesia-related adverse events

BMC Anesthesiol. 2022 Jun 20;22(1):190. doi: 10.1186/s12871-022-01732-3.

Authors

Feng Xu¹, Linlin Han¹, Shuai Zhao¹, Yafeng Wang¹, Qingtong Zhang², Erfeng Xiong³, Shiqian Huang¹, Guixing Zhang⁴, Hong He⁵, Shiyu Deng⁶, Yingjie Che⁷, Yan Li², Liping Xie², Xiangdong Chen⁸

Affiliations

¹ Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China.
² Department of Anesthesiology, The First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, 832002, China.
³ Department of Anesthesiology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510630, China.
⁴ Department of Anesthesiology, Taihe Hospital, Hubei University of Medicine, Shiyan, 442000, China.
⁵ Department of Anesthesiology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, 610072, China.
⁶ Department of Anesthesiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, China.
⁷ Department of Anesthesiology, The Eight Division Shihezi General Hospital, Shihezi, 832002, China.
⁸ Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China. xdchen@hust.edu.cn.

Abstract

Background: Self-efficacy, as the vital determinant of behavior, influencing clinicians' situation awareness, work performance, and medical decision-making, might affect the incidence of anesthesia-related adverse events (ARAEs). This study was employed to evaluate the association between perceived self-efficacy level and ARAEs.

Methods: A cross-sectional study was performed in the form of an online self-completion questionnaire-based survey. Self-efficacy was evaluated via validated 4-point Likert scales. Internal reliability and validity of both scales were also estimated via Cronbach's alpha and validity analysis. According to the total self-efficacy score, respondents were divided into two groups: normal level group and high level group. Propensity score matching and multivariable logistic regression were employed to identify the relationship between self-efficacy level and ARAEs.

Results: The response rate of this study was 34%. Of the 1011 qualified respondents, 38% were women. The mean (SD) age was 35.30 (8.19) years. The Cronbach's alpha of self-efficacy was 0.92. The KMO (KMO and Bartlett's test) value of the scale was 0.92. ARAEs occurred in 178 (33.0%) of normal level self-efficacy group and 118 (25.0%) of high level self-efficacy group. Before adjustment, high level self-efficacy was associated with a decreased incidence of ARAEs (RR [relative risk], 0.76; 95% CI [confidence interval], 0.62-0.92). After adjustment, high level self-efficacy was also associated with a decreased incidence of ARAEs (aRR [adjusted relative risk], 0.63, 95% CI, 0.51-0.77). In multivariable logistic regression, when other covariates including years of experience, drinking, and the hospital ranking were controlled, self-efficacy level (OR [odds ratio], 0.62; 95% CI, 0.46-0.82; P = 0.001) was significantly correlated with ARAEs.

Conclusions: Our results found a clinically meaningful and statistically significant correlation between self-efficacy and ARAEs. These findings partly support medical educators and governors in enhancing self-efficacy construction in clinical practice and training.

Keywords: Anesthesia; Anesthesia-related adverse events; Anesthesiologist; Self-confidence; Self-efficacy.

MeSH terms

Adult
Anesthesia*
Anesthesiologists*
Cross-Sectional Studies
Female
Humans
Male
Reproducibility of Results
Self Efficacy
Surveys and Questionnaires