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急症护理护士的二次受害者经历及影响:一项探索性研究。

Second victim experiences and impact among acute care nurses: An exploratory study.

作者信息

Lim Siew Hoon, Zainal Humairah, Lee Li Jing, Binte Sunari Raden Nurheryany, Choh Andrea Chau Lin, Teo Kai Yunn, Tan Min Yi, Ang Shin Yuh, Aloweni Fazila

机构信息

Division of Nursing, Singapore General Hospital, Singapore, Singapore.

Health Services Research Unit, Singapore General Hospital, Singapore, Singapore.

出版信息

Int Nurs Rev. 2025 Mar;72(1):e12999. doi: 10.1111/inr.12999. Epub 2024 Jun 7.

Abstract

AIM

To explore the experience of second victim symptoms and adverse outcomes among nurses working in public healthcare institutions; understand the preferred components of a structured support programme; and explore the barriers to accessing existing support strategies.

BACKGROUND

The second victim phenomenon is experienced by nurses during patient-related adverse events, requiring further exploration.

METHODS

A mixed-methods design. Second Victim Experience and Support Tool and semi-structured individual interviews were used among nurses involved in adverse events that occurred from January 2022 to April 2023. Descriptive statistics was used to describe sociodemographic characteristics and survey responses. Thematic analysis was used to analyse qualitative data.

RESULTS

Nurses (n = 12) experienced second victim-related physical, psychological and professional distress (58.3% to 83.3%) within one month after the event. Nurses continued to experience second victim-related distress (58.3%) three months after and turnover intentions (58.4%). Having a respected peer to discuss what happened was the most desired component of a support programme (75.0%). Five qualitative themes: (i) whirlwind of immediate emotions, (ii) lasting impact of adverse events, (iii) organisational barriers, (iv) coping resources at organisational level and (v) positive individual coping strategies.

DISCUSSION

Nurses experienced immediate and profound distress, highlighting the pervasive and distressing nature of the second victim phenomenon.

CONCLUSION

It is critical to recognise the second victim phenomenon and improve organisational climate to provide adequate support to affected nurses.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Organisations can establish a structured second victim support system, allowing nurses to seek emotional aid during the occurrence of adverse events. Establishing national policies as guidelines for organisations to refer to, raise awareness of the second victim phenomenon, and provide a standardised approach for identification and intervention for affected nurses.

摘要

目的

探讨在公共医疗机构工作的护士出现“二次受害者”症状及不良后果的经历;了解结构化支持项目的首选组成部分;并探究获取现有支持策略的障碍。

背景

护士在与患者相关的不良事件中会经历“二次受害者”现象,需要进一步探究。

方法

采用混合方法设计。对参与2022年1月至2023年4月期间发生的不良事件的护士使用“二次受害者经历与支持工具”及半结构化个人访谈。描述性统计用于描述社会人口学特征和调查回复。主题分析用于分析定性数据。

结果

事件发生后一个月内,护士(n = 12)经历了与“二次受害者”相关的身体、心理和职业困扰(58.3%至83.3%)。事件发生三个月后,护士仍经历与“二次受害者”相关的困扰(58.3%)和离职意向(58.4%)。有一位受尊敬的同行可以讨论所发生的事情是支持项目中最需要的组成部分(75.0%)。五个定性主题:(i)即时情绪的旋风,(ii)不良事件的持久影响,(iii)组织障碍,(iv)组织层面的应对资源,以及(v)积极的个人应对策略。

讨论

护士经历了即时且深刻的困扰,凸显了“二次受害者”现象的普遍性和令人痛苦的本质。

结论

认识到“二次受害者”现象并改善组织氛围以向受影响的护士提供充分支持至关重要。

对护理和卫生政策的启示

组织可以建立结构化的“二次受害者”支持系统,使护士在不良事件发生时能够寻求情感援助。制定国家政策作为组织参考的指南,提高对“二次受害者”现象的认识,并为受影响护士的识别和干预提供标准化方法。

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