Medical error frequently occurs in ambulatory care, and healthcare professionals may encounter situations in which they need to speak up to ensure better practice. This study aims to investigate the factors that influenced the intention to speak up about medical errors among healthcare professionals in primary care settings. Data were generated through a national cross-sectional survey of primary healthcare centres in the Republic of Chile. A research instrument was designed using the constructs of the theory of planned behaviour and was analysed using the structural equation model technique. In total, 203 healthcare professionals were recruited between March and May 2020. The model showed that the intention to speak up was directly and positively influenced by attitudes towards speaking up and perceived control (standard deviation [SD] = 0.284 and 0.576, respectively). Subjective norms indirectly and negatively influenced the intention to speak up through attitudes towards speaking up and perceived control (total effect SD = –0.303). The exploratory construct of willingness to change self-behaviour positively influenced the attitude towards behaviour. The intention to speak up strongly influenced the speaking up behaviour (total effect SD = 0.631). The proposed model explained 40% of the variance in behaviour. Based on this model, it was concluded that the intention to speak up strongly influenced the speaking up behaviour and predicted it by 40%. Factors that modify the intention to speak up are expected to influence the occurrence of this behaviour. This knowledge will inform strategies to enhance communication among healthcare professionals, improve speaking up behaviour and improve patient care.

中文翻译：

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发表智利初级保健机构医疗差错的意愿的决定因素

医疗错误经常发生在门诊护理中，医疗保健专业人员可能会遇到需要大声说出来以确保更好的实践的情况。本研究旨在调查影响初级保健机构医疗保健专业人员就医疗错误发表意见的意愿的因素。数据是通过对智利共和国初级保健中心的全国性横断面调查生成的。使用计划行为理论的结构设计了一种研究仪器，并使用结构方程模型技术进行了分析。在 2020 年 3 月至 2020 年 5 月期间，总共招募了 203 名医疗保健专业人员。该模型表明，直言不讳的意愿受到对直言不讳的态度和感知控制的直接和积极影响（标准差 [SD ] = 0.284 和 0.576，分别）。主观规范通过对直言不讳和感知控制的态度间接和负面地影响直言不讳的意图（总效应SD  = –0.303）。改变自我行为意愿的探索性建构对行为态度产生了积极影响。发声的意图强烈影响了发声行为（总效应SD = 0.631)。所提出的模型解释了 40% 的行为差异。基于这个模型，得出的结论是，说话的意图强烈影响了说话的行为，并预测了 40%。改变说话意图的因素预计会影响这种行为的发生。这些知识将为加强医疗保健专业人员之间的沟通、改善直言不讳的行为和改善患者护理的策略提供信息。