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护士的“二次受害者”经历、工作不安全感与离职意愿:一项潜在剖面分析

Nurses' second victim experience, job insecurity, and turnover intention: A latent profile analysis.

作者信息

Shao Yanru, Li Shanshan, Wei Lili, Shan Xinzhi, Zhou Dan, Zhang Yan, Wei Holly

机构信息

Graduate Department, School of Nursing, Qingdao University, Qingdao, China.

Neurosurgery Intensive Care Unit, The Affiliated Hospital of Qingdao University, Qingdao, China.

出版信息

Res Nurs Health. 2023 Jun;46(3):360-373. doi: 10.1002/nur.22313. Epub 2023 Apr 22.

Abstract

Nurses are greatly affected by patient safety incidents, but little is known about the classifications of nurses' second victim experiences and their effects on job insecurity and turnover intention. This study aimed to identify the profiles of nurses' second victim experiences, including perceived support and distress, and explore the effects of the different experiences on nurses' job insecurity and turnover intention. A convenience sample of 2000 nurses, who were directly involved in patient safety incidents within a year at 25 hospitals in 13 provinces in China, was invited to participate. The online surveys included the Second Victim Experience and Support Tool-Chinese version, job insecurity scale, and turnover intention scale. Data were analyzed using regression and latent profile analysis to identify second-victim nurses' different experience predictors and examine the relationships among the factors. A total of 1298 valid questionnaires were obtained. Three profiles of second victim experiences were identified. Univariate analysis demonstrated that nurses' experience, education level, hospital type, specialty, working hours, credentials, clinical ladder, type of employment, income, training on adverse events, and the type of adverse event were statistically significant (p < 0.05) variables differentiating the three profiles. After controlling these significant variables, the multiple regression analysis showed that the higher the support and the lower the distress level of the second victim, the lower the job insecurity and turnover intention. This study highlights the significance of nurse' leader and organizational support. Nursing leaders should recognize nurses' second-victim experiences, provide the support nurses need, and help them reduce job insecurity and turnover intention.

摘要

护士深受患者安全事件的影响,但对于护士“二次受害者”经历的分类及其对工作不安全感和离职意愿的影响却知之甚少。本研究旨在确定护士“二次受害者”经历的特征,包括感知到的支持和痛苦,并探讨不同经历对护士工作不安全感和离职意愿的影响。研究邀请了来自中国13个省份25家医院的2000名护士作为便利样本,这些护士在一年内直接参与了患者安全事件。在线调查包括《二次受害者经历与支持工具》中文版、工作不安全感量表和离职意愿量表。采用回归分析和潜在剖面分析对数据进行分析,以确定“二次受害者”护士不同经历的预测因素,并检验各因素之间的关系。共获得1298份有效问卷。确定了三种“二次受害者”经历类型。单因素分析表明,护士的工作经验、教育水平、医院类型、专业、工作时间、资质、临床晋升阶梯、就业类型、收入、不良事件培训以及不良事件类型是区分这三种类型的具有统计学意义(p < 0.05)的变量。在控制这些显著变量后,多元回归分析表明,“二次受害者”获得的支持越高,痛苦程度越低,工作不安全感和离职意愿就越低。本研究强调了护士领导者和组织支持的重要性。护理领导者应认识到护士的“二次受害者”经历,提供护士所需的支持,帮助他们降低工作不安全感和离职意愿。

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