AI Summary & Key Takeaways
AI InsightExploratory findings suggest that institutional factors may also warrant consideration, although confirmation with more reliable instruments is needed.
📌 3 Key Takeaways
Abstract
Aims: Although Turkiye has one of the highest cesarean section rates among OECD countries, the influence of malpractice anxiety on cesarean decision-making has not been adequately characterized. This study examined the associations between malpractice anxiety, defensive medical practices, and primary cesarean rate using a parallel-group design that simultaneously evaluated specialist self-reports and independent resident observations. Methods: This cross-sectional analytical study was conducted at a tertiary referral center and included 258 participants: 86 specialists (response rate 86.0%) and 172 residents (response rate 87.8%). Data were collected using the Modified Defensive Medicine Practices Attitude Scale adapted to the obstetric setting (mDMPAS-OB). Statistical analyses were performed using the Mann-Whitney U test, Spearman rank correlation, and multivariable linear regression. Results: Composite defensive practice scores did not differ significantly between specialists and residents (p=0.130). Malpractice anxiety scores were significantly higher among residents (p=0.001). In exploratory analyses, the institutional factors subscale was correlated with primary cesarean rate (Spearman ρ=0.432, p<0.001), although its poor internal consistency (α=0.434) precluded its inclusion as an independent predictor and necessitates cautious interpretation. Physicians with prior malpractice experience had significantly higher mDMPAS-OB and malpractice anxiety scores (p=0.011 and p=0.003, respectively). Conclusion: Malpractice anxiety was associated with defensive attitudes in obstetric practice. The parallel-group design supports that defensive behaviors are observable in clinical practice. Exploratory findings suggest that institutional factors may also warrant consideration, although confirmation with more reliable instruments is needed.