Lee Won, Pyo Jeehee, Jang Seung Gyeong, Choi Ji Eun, Ock Minsu
Asian Institute for Bioethics and Health Law, Seoul, Republic of Korea.
Department of Medical Humanities and Social Sciences, Division of Medical Law and Bioethics, Yonsei University College of Medicine, Seoul, Republic of Korea.
BMC Health Serv Res. 2019 Feb 6;19(1):100. doi: 10.1186/s12913-019-3936-1.
Healthcare professionals who experience trauma due to patient safety incidents can be considered second victims, and they also suffer from various difficulties. In order to support second victims, it is necessary to determine the circumstances of the incidents in question, along with the symptoms that the victims are experiencing and the support they require. A qualitative study on healthcare professionals of various occupations, such as physicians and nurses working in Korea, was conducted, and the experiences and response methods and processes of second victims were examined.
In-depth interviews were conducted with 16 healthcare professionals (six physicians, eight nurses, and two pharmacists) who had experienced a patient safety incident. All interviews were recorded and transcribed, and the data analysis was conducted in accordance with Strauss and Corbin's grounded theory. Both open coding and axial coding were performed. Consolidated criteria for reporting qualitative research (COREQ) were applied in this study.
The results of the open coding demonstrated that the experiences of second victims can be categorized into "the reactions of the first victim and surrounding people after the incident," "Influence of factors aside from the incident," "the initial complex responses of the participants to the incident," "open discussion of the incident," "the culture in medical institutions regarding early-stage incident response," "the coping responses of the participants after incidents," and "living with the incident." Then, the seven categories in the open coding stage were rearranged according to the paradigm model, and the reaction process of the second victims was analyzed through process analysis, being divided into the "entanglement stage," "agitating stage," "struggling stage," "managing stage," and "indurating stage."
This research is significant because it provides a comprehensive understanding of second victims' experiences in the eastern region of Korea, by obtaining data using a qualitative research method. The findings of the study also highlight the five stages of the second victim response process, and can be used to design a specialized second victim support program in Korea.
因患者安全事件而遭受创伤的医护人员可被视为二次受害者,他们也会面临各种困难。为了支持二次受害者,有必要确定相关事件的情况,以及受害者正在经历的症状和他们所需的支持。对韩国的各类医护人员,如医生和护士进行了一项定性研究,考察了二次受害者的经历、应对方法及过程。
对16名经历过患者安全事件的医护人员(6名医生、8名护士和2名药剂师)进行了深入访谈。所有访谈均进行了录音和转录,并根据施特劳斯和科尔宾的扎根理论进行数据分析。同时进行了开放式编码和轴心式编码。本研究采用了定性研究报告的统一标准(COREQ)。
开放式编码的结果表明,二次受害者的经历可分为“事件发生后首例受害者及周围人的反应”“事件以外因素的影响”“参与者对事件最初的复杂反应”“对事件的公开讨论”“医疗机构关于事件早期应对的文化”“事件发生后参与者的应对反应”以及“与事件共存”。然后,根据范式模型对开放式编码阶段的七个类别进行重新排列,并通过过程分析对二次受害者的反应过程进行分析,分为“纠结阶段”“激动阶段”“挣扎阶段”“应对阶段”和“硬化阶段”。
本研究具有重要意义,因为它通过定性研究方法获取数据,全面了解了韩国东部地区二次受害者的经历。研究结果还突出了二次受害者反应过程的五个阶段,可用于设计韩国专门的二次受害者支持项目。