Sun Lianrong, Deng Juan, Xu Jixin, Ye Xuchun
Nursing College, Naval Medical University, Shanghai, China.
Tianhua College, Shanghai Normal University, Shanghai, China.
Front Psychol. 2022 May 3;13:860902. doi: 10.3389/fpsyg.2022.860902. eCollection 2022.
Nurses can experience psychological trauma after adverse nursing events, making it likely for them to become second victims (SVs). This negatively impacts patient safety and nurses' development. This study aims to understand the status of psychological trauma and recovery of nurses as SVs in domestic China and examine the influencing mechanism of cognitive rumination during their recovery from psychological damage. This was a cross-sectional survey. An online questionnaire was completed by 233 nurses from across China. Data were collected using Chinese versions of the Second Victim Experience and Support Evaluation Scale, the Incident-related Rumination Meditation Questionnaire, and the post-traumatic growth (PTG) Rating Scale. Descriptive statistics, correlation, and regression, as well as mediation analysis, were used for different analyses in this study. Participants experienced apparent psychological traumas (4.65 ± 0.5583) with a certain degree of PTG (76.18 ± 16.0040); they reported a strong need for psychological support (95.7%). Psychological trauma was positively and negatively correlated with rumination and PTG ( = 0.465, < 0.001; = -0.155, < 0.05) respectively. Both psychologically impaired experience and rumination had significant predictive effects on participants' PTG (both, < 0.001). Nurses' active rumination significantly mediated their psychological recovery from trauma to PTG ( < 0.05), but the effect of invasive rumination was not significant ( > 0.05). The specific manifestations of the mechanism of invasive rumination are not clarified in this study. The present study investigated the psychological trauma of SV nurses as well as their support needs, and explored the role of cognitive rumination in the psychological repair and PTG of SV nurses. Results showed that SV nurses' active rumination on adverse nursing events could promote their recovery from psychological trauma, but invasive rumination could not. This study provides a trauma-informed approach to care at the clinical level for nurses who experience psychological trauma caused by adverse events.
护士在发生不良护理事件后可能会经历心理创伤，这使得他们很可能成为“二次受害者”（SVs）。这对患者安全和护士发展产生负面影响。本研究旨在了解中国国内护士作为二次受害者的心理创伤和恢复状况，并探讨认知反刍在其心理创伤恢复过程中的影响机制。这是一项横断面调查。来自中国各地的233名护士完成了一份在线问卷。使用中文版的《二次受害者经历与支持评估量表》《事件相关反刍沉思问卷》和《创伤后成长（PTG）评定量表》收集数据。本研究采用描述性统计、相关性分析、回归分析以及中介分析进行不同的分析。参与者经历了明显的心理创伤（4.65±0.5583），并有一定程度的创伤后成长（76.18±16.0040）；他们报告对心理支持有强烈需求（95.7%）。心理创伤与反刍和创伤后成长分别呈正相关和负相关（r = 0.465，p < 0.001；r = -0.155，p < 0.05）。心理受损经历和反刍对参与者的创伤后成长均有显著预测作用（均p < 0.001）。护士的积极反刍显著介导了他们从创伤到创伤后成长的心理恢复（p < 0.05），但侵入性反刍的作用不显著（p > 0.05）。本研究未阐明侵入性反刍机制的具体表现。本研究调查了二次受害者护士的心理创伤及其支持需求，并探讨了认知反刍在二次受害者护士心理修复和创伤后成长中的作用。结果表明，二次受害者护士对不良护理事件的积极反刍可促进其从心理创伤中恢复，但侵入性反刍则不能。本研究为经历不良事件所致心理创伤的护士提供了一种基于创伤知情的临床护理方法。
