韩国护士对患者安全事件的经历：一项横断面研究。
Nurses' experiences of patient safety incidents in Korea: a cross-sectional study.
作者信息
Choi Eun Young, Pyo Jeehee, Lee Won, Jang Seung Gyeong, Park Young-Kwon, Ock Minsu, Lee Sang-Il
机构信息
Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea.
Department of Nursing, Graduate School of Chung-Ang University, Seoul, Republic of Korea.
出版信息
BMJ Open. 2020 Oct 31;10(10):e037741. doi: 10.1136/bmjopen-2020-037741.
OBJECTIVES
The aim of this study was to investigate the scope and severity of the second victim problem among nurses by examining the experiences and effects of patient safety incidents (PSIs) on them.
PARTICIPANTS/SETTING: 492 nurses who had experienced PSIs and provide direct care in South Korean medical institutions.
DESIGN
A cross-sectional study with anonymous online self-report questionnaires was conducted to nurses in order to examine the experiences and effects of PSIs. Scales measuring post-traumatic stress disorder (PTSD) and post-traumatic embitterment disorder (PTED) were used for a more quantitative examination of the effects of PSIs. A χ test was administered to find any difference in responses to difficulties due to PSIs between the direct and indirect experience of PSIs. Furthermore, linear regression analysis was conducted to investigate the factors related to scores on the PTSD and PTED scales.
RESULTS
A statistically significant difference was observed for participants who reported having experienced sleeping disorders, with those with direct experience showing 42.4% sleeping disorders and indirect experience at 21.0%. Also, there was a statistically significant difference between the 34.3% with direct experience and the 22.1% with indirect experience regarding having considered duty or job changes (resignation). Regression analysis showed total PTSD scores for indirect experience at 11.97 points (95% CI: -17.31 to -6.63), lower than direct experience. Moreover, those who thought the medical error was not involved in PSI had a total PTED score 4.39 points (95% CI: -7.23 to -1.55) lower than those who thought it was involved.
CONCLUSIONS
A considerable number of nurses experienced psychological difficulties due to PSIs at levels that could interfere with their work. The effect of PSIs on nurses with direct experience of PSIs was greater compared with those with indirect experience. There need to be psychological support programmes for nurses to alleviate the negative effects of PSIs.
目的
本研究旨在通过考察患者安全事件（PSI）对护士的经历和影响，来调查护士群体中“二次受害者”问题的范围和严重程度。
参与者/研究背景：492名在韩国医疗机构经历过PSI并提供直接护理服务的护士。
设计
对护士进行了一项采用匿名在线自我报告问卷的横断面研究，以考察PSI的经历和影响。使用测量创伤后应激障碍（PTSD）和创伤后痛苦障碍（PTED）的量表对PSI的影响进行更量化的考察。进行χ检验以找出PSI直接经历者和间接经历者在应对因PSI导致的困难方面的反应差异。此外，进行线性回归分析以调查与PTSD和PTED量表得分相关的因素。
结果
报告有睡眠障碍经历的参与者存在统计学显著差异，直接经历者中有42.4%有睡眠障碍，间接经历者为21.0%。在考虑过职责或工作变动（辞职）方面，直接经历者的34.3%与间接经历者的22.1%之间也存在统计学显著差异。回归分析显示，间接经历者的PTSD总得分是11.97分（95%置信区间：-17.31至-6.63），低于直接经历者。此外，认为医疗差错未涉及PSI的人PTED总得分比认为涉及的人低4.39分（95%置信区间：-7.23至-1.55）。
结论
相当数量的护士因PSI经历了可能干扰其工作的心理困难。与间接经历者相比，PSI对有直接经历的护士的影响更大。需要为护士制定心理支持计划，以减轻PSI的负面影响。
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