探索中国患者安全事件后护士作为第二受害者的经历与支持：一种混合方法研究
Exploring the Experiences and Support of Nurses as Second Victims After Patient Safety Events in China: A Mixed-Method Approach.
作者信息
Tang Wenzhen, Xie Yuanxi, Yan Qingfeng, Teng Yanjuan, Yu Li, Wei Liuying, Li Jinmei, Chen Yuhui, Huang Xiaolin, Yang Shaoli, Jia Kui
机构信息
The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530021, People's Republic of China.
The Sanming Second Hospital, Sanming, Fujian Province, 366099, People's Republic of China.
出版信息
Risk Manag Healthc Policy. 2024 Mar 12;17:573-586. doi: 10.2147/RMHP.S451766. eCollection 2024.
AIM
To investigate the current status of experience and support of nurses as second victims and explore its related factors in nurses.
DESIGN
A sequential, explanatory, mixed-method study was applied.
METHODS
A total of 406 nurses from seven tertiary hospitals in China were chosen as participants between September to October 2023. The Chinese version of the Second Victim Experience and Support Questionnaire (SVEST), Somatic Complaints of Sub-health Status Questionnaire (SCSSQ) and Generalized Anxiety Disorder (GAD-7) were applied to collect quantitative data. Eight nurses were selected for a qualitative study through in-depth interviews. Through interpretive phenomenological analysis, the interview data were analysed to explore the experience and support of nurses as second victims.
RESULTS
Practice distress (15.74 ± 4.97) and psychological distress (15.48 ± 3.74) were the highest dimensions, indicating Chinese nurses experienced second victim-related practice and psychological distress. Nurses with different gender, age, education, marital status, income, working hours, professional titles, and unit types have different levels of second victim-related experience and support ( < 0.05). In addition, the score of SVEST was positively associated with SCSSQ ( = 0.444) and GAD-7 ( = 0.490) ( < 0.05). This qualitative study found that the experience and support of nurses as second victims included nurses' perceptions and needs for patient safety events; psychological, physical and practice distress of nurses; and nurses and hospitals coping style after patient safety events.
DISCUSSION
Our findings suggest that nurses who are second victims of patient safety events experience severe practice and psychological distress, indicating that nursing managers should pay attention to psychological and practice distress of nurses after patient safety events and provide effective preventive measures.
目的
调查护士作为“二次受害者”的经历和获得支持的现状，并探讨其相关因素。
设计
采用序列解释性混合方法研究。
方法
选取2023年9月至10月间来自中国7家三级医院的406名护士作为研究对象。应用中文版的“二次受害者经历与支持问卷”（SVEST）、“亚健康状态躯体症状问卷”（SCSSQ）和“广泛性焦虑障碍量表”（GAD-7）收集定量数据。通过深入访谈选取8名护士进行定性研究。通过解释现象学分析对访谈数据进行分析，以探讨护士作为“二次受害者”的经历和获得的支持。
结果
实践困扰（15.74±4.97）和心理困扰（15.48±3.74）得分最高，表明中国护士经历了与“二次受害者”相关的实践和心理困扰。不同性别、年龄、学历、婚姻状况、收入、工作时长、职称和单位类型的护士在与“二次受害者”相关的经历和获得支持方面存在不同水平（P<0.05）。此外，SVEST得分与SCSSQ（r=0.444）和GAD-7（r=0.490）呈正相关（P<0.05）。该定性研究发现，护士作为“二次受害者”的经历和获得的支持包括护士对患者安全事件的认知和需求；护士的心理、身体和实践困扰；以及患者安全事件后护士和医院的应对方式。
讨论
我们的研究结果表明，作为患者安全事件“二次受害者”的护士经历了严重的实践和心理困扰，这表明护理管理者应关注患者安全事件后护士的心理和实践困扰，并提供有效的预防措施。
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