Cohen Rinat, Sela Yael, Halevi Hochwald Inbal, Nissanholz-Gannot Rachel
Department of Health Systems Management, Ariel University, Ariel 4076405, Israel.
Nursing Department, Ramat Gan Academic College, Ramat Gan 5211401, Israel.
Healthcare (Basel). 2023 Jul 7;11(13):1961. doi: 10.3390/healthcare11131961.
The 'second victim' phenomenon, (SVP) refers to a health professional who was involved in an adverse event (AE) and continues to suffer from the event to the detriment of personal and professional functioning. The second victims' natural history of recovery model predicts stages of the phenomenon from AE occurrence until the 'moving on' stage and serves as a suitable structure for many organizational support programs worldwide.
Using the second victims' natural history of recovery model to examine the impact of the SVP on Israeli nurses, with a specific focus on the organizational support they felt they required compared with the support they felt that they had received from their organizations.
Fifteen in-depth interviews were conducted, using a semi-structured questionnaire, among nurses who had experienced the SVP. The interviews were recorded subject to the interviewees' consent, transcribed, and analyzed using thematic content analysis.
Throughout all six stages of recovery, all interviewees reported physical and emotional manifestations following exposure to an AE, regardless of the type of event or severity. They also reported difficulty in emotion regulation, as well as damage to functioning and overall quality of life. Most of the nurse interviewees reported a need to share the events with someone, but, despite this desire to receive appropriate support, almost none of them proactively requested help from a professional source, nor did their organizational management initiate proactive support. This lack of referral for further assistance is possibly explained through limited awareness of the SVP as a valid response to an AE, a perceived lack of legitimacy to receive organizational support, and personal barriers that accompany the phenomenon.
Appropriate organizational support, offered proximal to an AE as well as over time, is essential for the nurse, the patient, and the organization. Personal barriers, together with limited awareness, may challenge the identification and provision of appropriate assistance. Hence, it is important to address the phenomenon as part of the general organizational policy to improve the quality of care and patient safety.
“第二受害者”现象（SVP）指的是参与了不良事件（AE）并持续受到该事件影响，进而损害个人和职业功能的医疗专业人员。第二受害者恢复的自然史模型预测了该现象从不良事件发生到“继续前行”阶段的各个阶段，并为全球许多组织支持项目提供了合适的框架。
运用第二受害者恢复的自然史模型来研究SVP对以色列护士的影响，特别关注他们认为所需的组织支持与他们所感受到的来自组织的支持之间的差异。
采用半结构化问卷，对经历过SVP的护士进行了15次深度访谈。访谈在征得受访者同意后进行录音、转录，并采用主题内容分析法进行分析。
在所有六个恢复阶段中，所有受访者均报告称，接触不良事件后出现了身体和情绪上的表现，无论事件类型或严重程度如何。他们还报告了情绪调节困难，以及功能和整体生活质量受损。大多数受访护士表示需要与他人分享这些事件，但是，尽管有获得适当支持的愿望，几乎没有人主动向专业机构寻求帮助，他们的组织管理层也没有主动提供支持。这种缺乏进一步援助转介的情况，可能是由于对SVP作为对不良事件的有效反应的认识有限、认为缺乏获得组织支持的合法性，以及该现象所伴随的个人障碍所致。
在不良事件发生后及时并长期提供适当的组织支持，对护士、患者和组织来说至关重要。个人障碍以及有限的认识可能会对识别和提供适当援助构成挑战。因此，将该现象作为一般组织政策的一部分加以应对，对于提高护理质量和患者安全非常重要。
