González-González A, Redondo-González O, Domínguez-Osorio I, Quero Palomino V, León Velasco M, Polo Montes F
Servicio de Endocrinología y Nutrición, Hospital Universitario Río Hortega, Valladolid, España.
Servicio de Medicina Preventiva, Hospital Universitario de Guadalajara, Guadalajara, España.
J Healthc Qual Res. 2023 Nov-Dec;38(6):329-337. doi: 10.1016/j.jhqr.2023.06.002. Epub 2023 Jul 6.
To analyze the occupational and psychological consequences suffered by healthcare workers who are considered second victims (SV).
Observational, descriptive and cross-sectional study among the healthcare workers of a university hospital. The answers collected in a specifically designed questionnaire about psychological consequences at work and the result of a post-traumatic stress scale, "Impact of Event Scale-Revised (IES-R, spanish version)" were evaluated. The variables between the groups were compared using the Chi square test (or Fisher's exact test) when both were qualitative and with the Student's T (or the Mann-Whitney U test for independent data), when one of them was quantitative. The level of statistical significance was P<.05.
75.5% (148/207) of the participants in the study suffered some adverse event (AE) and, of these, 88.5% (131/148) were considered SV. Physicians had a 2.2 times higher risk of feeling SV than nurses (95% CI: 1.88-2.52). The impact on the patient related to the AE explained why the professionals involved in it felt SV (P=.037). 80.6% (N=104) of the SVs presented post-traumatic stress. Women were 2.4 times more likely to suffer from it (OR: 2.4; 95% CI: 1.5-4.0). Intrusive thoughts in the SV were almost three times more frequent when the damage suffered by the patient was permanent or death (OR: 2.5; 95% CI: 0.2-3.6).
Many healthcare workers, especially physicians, considered themselves to be SV, and many of them suffered from post-traumatic stress. The impact on the patient related to the AE was a risk factor for being SV and for suffering psychological consequences.
分析被视为二次受害者(SV)的医护人员所遭受的职业和心理后果。
对一家大学医院的医护人员进行观察性、描述性和横断面研究。对专门设计的关于工作中心理后果的问卷收集的答案以及创伤后应激量表“事件影响量表修订版(IES-R,西班牙语版)”的结果进行评估。当两组变量均为定性变量时,使用卡方检验(或费舍尔精确检验)进行比较;当其中一个变量为定量变量时,使用学生 t 检验(或独立数据的曼-惠特尼 U 检验)进行比较。统计学显著性水平为 P<0.05。
研究中的参与者有75.5%(148/207)遭遇过某种不良事件(AE),其中88.5%(131/148)被视为二次受害者。医生感觉自己是二次受害者的风险比护士高2.2倍(95%置信区间:1.88 - 2.52)。与不良事件相关的对患者的影响解释了涉事专业人员感觉自己是二次受害者的原因(P = 0.037)。80.6%(N = 104)的二次受害者表现出创伤后应激。女性患创伤后应激的可能性是男性的2.4倍(比值比:2.4;95%置信区间:1.5 - 4.0)。当患者遭受的损害为永久性或死亡时,二次受害者的侵入性思维频率几乎高出三倍(比值比:2.5;95%置信区间:0.2 - 3.6)。
许多医护人员,尤其是医生,认为自己是二次受害者,其中许多人患有创伤后应激障碍。与不良事件相关的对患者的影响是成为二次受害者以及遭受心理后果的一个风险因素。