Balogun James Ayokunle, Adekanmbi Adefisayo Ayoade, Balogun Folusho Mubowale
Division of Neurosurgery, Department of Surgery, College of Medicine, University of Ibadan, No. 1, Queen Elizabeth road, University College Hospital Campus, Ibadan, 200001, Nigeria.
Department of Neurosurgery, University College Hospital, Ibadan, Nigeria.
Patient Saf Surg. 2023 Jul 18;17(1):18. doi: 10.1186/s13037-023-00370-z.
The "second victim" phenomenon refers to the distress and other negative consequences that physicians experience when they commit medical error. There has been increasing awareness about this phenomenon and efforts are being made to address it. However, there is dearth of information about it in developing countries. This study explored the experiences of surgical resident doctors of the University College Hospital in Ibadan, Nigeria about the "second victim" phenomenon and the support they had following medical errors.
This is a phenomenology study in which qualitative data were obtained from interviews with 31 resident doctors across 10 surgical units/departments. Interviews were transcribed verbatim, and data were coded inductively. Data were analyzed using content analysis method. Themes and subthemes were generated using axial coding. The themes were then integrated using selective coding.
There were 31 participants and 10(32.3%) were females. All had witnessed other physicians encountering medical errors while 28(90.3%) had been directly involved in medical errors. Most of the errors were at the inter-operative stage. Prolonged work hours with inadequate sleep were identified as major causes of most medical errors. The feelings following medical errors were all negative and was described as 'stressful'. Most of the residents got support from their colleagues, mostly contemporaries following medical errors, and many viewed medical errors as a learning point to improve their practice. However, there was a general belief that the systemic support following medical errors was inadequate.
The "second victim" phenomenon was common among the study group with consequent negative effects. Normalizing discussions about medical errors, reduction of work hours and meticulous intraoperative guidance may reduce medical errors and its consequences on the surgical residents. Steps should be taken within the system to address this issue effectively.
“第二受害者”现象是指医生在发生医疗差错时所经历的痛苦及其他负面后果。人们对这一现象的认识日益增加，并正在努力解决这一问题。然而，发展中国家对此现象的相关信息匮乏。本研究探讨了尼日利亚伊巴丹大学学院医院外科住院医生关于“第二受害者”现象的经历以及他们在发生医疗差错后所获得的支持。
这是一项现象学研究，通过对10个外科科室的31名住院医生进行访谈获取定性数据。访谈内容逐字转录，数据进行归纳编码。采用内容分析法进行数据分析。使用轴心编码生成主题和子主题，然后通过选择编码将主题整合起来。
共有31名参与者，其中10名（32.3%）为女性。所有人都目睹过其他医生遭遇医疗差错，28名（90.3%）曾直接参与医疗差错。大多数差错发生在手术中阶段。工作时间过长且睡眠不足被确定为大多数医疗差错的主要原因。医疗差错后的感受均为负面，被描述为“压力巨大”。大多数住院医生在医疗差错后从同事那里获得了支持，主要是同龄人，许多人将医疗差错视为改进实践的学习点。然而，普遍认为医疗差错后的系统性支持不足。
“第二受害者”现象在研究组中很常见，并产生了相应的负面影响。规范关于医疗差错的讨论、减少工作时间以及细致的术中指导可能会减少医疗差错及其对外科住院医生的影响。应在系统内采取措施有效解决这一问题。
