Bushuven Stefan, Trifunovic-Koenig Milena, Bunz Maxie, Weinmann-Linne Patrick, Klemm Victoria, Strametz Reinhard, Müller Beate Sigrid
Training Center for Emergency Medicine (NOTIS e.V), 78234 Engen, Germany.
Department of Anesthesiology and Critical Care, Faculty of Medicine, Medical Center-University of Freiburg, University of Freiburg, 79106 Freiburg, Germany.
Healthcare (Basel). 2024 Jan 30;12(3):351. doi: 10.3390/healthcare12030351.
The second victim phenomenon and moral injury are acknowledged entities of psychological harm for healthcare providers. Both pose risks to patients, healthcare workers, and medical institutions, leading to further adverse events, economic burden, and dysfunctionality. Preceding studies in Germany and Austria showed a prevalence of second victim phenomena exceeding 53 percent among physicians, nurses, emergency physicians, and pediatricians. Using two German instruments for assessing moral injury and second victim phenomena, this study aimed to evaluate their feasibility for general practitioners and healthcare assistants.
We conducted a nationwide anonymous online survey in Germany among general practitioners and healthcare assistants utilizing the SeViD (Second Victims in Deutschland) questionnaire, the German version of the Second Victim Experience and Support Tool Revised Version (G-SVESTR), and the German version of the Moral Injury Symptom and Support Scale for Health Professionals (G-MISS-HP).
Out of 108 participants, 67 completed the survey. In G-SVESTR, the collegial support items exhibited lower internal consistency than in prior studies, while all other scales showed good-quality properties. Personality traits, especially neuroticism, negatively correlated to age, seem to play a significant role in symptom count and warrant further evaluation. Multiple linear regression indicated that neuroticism, agreeableness, G-SVESTR, and G-MISS-HP were significant predictors of symptom count. Furthermore, moral injury partially mediated the relationship between second victim experience and symptom count.
The results demonstrate the feasible use of the questionnaires, except for collegial support. With respect to selection bias and the cross-sectional design of the study, moral injury may be subsequent to the second victim phenomenon, strongly influencing symptom count in retrospect. This aspect should be thoroughly evaluated in future studies.
二次受害者现象和道德伤害是医疗服务提供者心理伤害的公认形式。二者都会给患者、医护人员和医疗机构带来风险，进而导致更多不良事件、经济负担和功能失调。德国和奥地利之前的研究表明，医生、护士、急诊医生和儿科医生中二次受害者现象的发生率超过53%。本研究使用两种德国工具来评估道德伤害和二次受害者现象，旨在评估其在全科医生和医疗助理中的可行性。
我们在德国对全科医生和医疗助理进行了一项全国性匿名在线调查，使用了SeViD（德国的二次受害者）问卷、二次受害者经历与支持工具修订版的德语版本（G-SVESTR）以及医疗专业人员道德伤害症状与支持量表的德语版本（G-MISS-HP）。
108名参与者中，67人完成了调查。在G-SVESTR中，同事支持项目的内部一致性低于之前的研究，而所有其他量表都显示出良好的质量特性。人格特质，尤其是神经质，与年龄呈负相关，似乎在症状数量方面起着重要作用，值得进一步评估。多元线性回归表明，神经质、宜人性、G-SVESTR和G-MISS-HP是症状数量的重要预测因素。此外，道德伤害部分介导了二次受害者经历与症状数量之间的关系。
结果表明，除同事支持外，这些问卷的使用是可行的。考虑到选择偏倚和研究的横断面设计，道德伤害可能发生在二次受害者现象之后，在回顾时强烈影响症状数量。这一方面应在未来的研究中进行全面评估。
