PURPOSE The purpose of this study was to investigate the reporting habits of clinicians who have been exposed to disruptive behaviour in the operating room (OR) and assess their satisfaction with management's responses to this issue. METHODS Ethics committee approval was obtained. This was a pre-specified sub-study of a larger survey examining disruptive behaviour, which was distributed to OR clinicians in seven countries. Using Likert-style questions, this study ascertained the proportion of disruptive intraoperative behaviour that clinicians reported to management, as well as their degree of satisfaction with management's responses. Binomial logistic regression identified socio-demographic, exposure-related, and behavioural predictors that a clinician would never report disruptive behaviour. RESULTS Four thousand, seven hundred and seventy-five respondents were part of the sub-study. Disruptive behaviour was under-reported by 96.5% (95% confidence interval [CI], 95.9 to 97.0) of respondents, and never reported by 30.9% (95% CI, 29.6 to 32.2) of respondents. Only 21.0% (95% CI, 19.8 to 22.2) of respondents expressed satisfaction with management's responses. Numerous socio-demographic, exposure-related, and behavioural predictors of reporting habits were identified. Socio-demographic groups who had higher odds of never reporting disruptive behaviour included younger clinicians, clinicians without management responsibilities, both anesthesiologists and surgeons (compared with nurses), biological females, and heterosexuals (all P < 0.05). CONCLUSIONS Disruptive behaviour was under-reported by nearly all clinicians surveyed, and only one in five were satisfied with management's responses. For healthcare systems to meaningfully address the issue of disruptive behaviour, management must create reporting systems that clinicians will use. They must also respond in ways that clinicians can rely on to affect necessary change.

中文翻译：

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手术室的破坏性行为被低估：一项国际调查。

目的这项研究的目的是调查暴露于手术室（OR）破坏性行为的临床医生的报告习惯，并评估他们对管理层对该问题的反应的满意度。方法获得伦理委员会的批准。这是一项较大规模调查破坏性行为的调查的预先指定子研究，该调查已分发给七个国家的OR临床医生。本研究使用李克特式问题，确定了临床医生向管理人员报告的破坏术中行为的比例，以及他们对管理人员的反应满意的程度。二项式逻辑回归确定了社会人口统计学，与暴露相关的行为预测因素，而临床医生从不报告破坏性行为。结果四千，子研究中有757名受访者。96.5％（95％置信区间[CI]，95.9至97.0）的受访者报告了破坏性行为，而从未报告过30.9％（95％CI，29.6至32.2）的受访者。只有21.0％（95％CI，19.8至22.2）的受访者对管理层的回应表示满意。确定了报告习惯的许多社会人口统计学，与暴露相关的行为预测因素。从未报告破坏行为几率更高的社会人口统计学人群包括年轻的临床医生，没有管理责任的临床医生，麻醉师和外科医生（与护士相比），生物学上的女性和异性恋者（所有P <0.05）。结论几乎所有接受调查的临床医生都没有报告破坏性行为，只有五分之一的受访者对管理层的回应感到满意。为了使医疗保健系统有效地解决破坏性行为的问题，管理层必须创建临床医生将使用的报告系统。他们还必须以临床医生可以依靠的方式做出影响，以做出必要的改变。