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“双重受害者现象”:德国家庭护理人员中第二受害者的全国试点调查结果(SeViD-VI 研究)。

The "Double Victim Phenomenon": Results From a National Pilot Survey on Second Victims in German Family Caregivers (SeViD-VI Study).

机构信息

Wiesbaden Institute for Healthcare Economics and Patient Safety, Wiesbaden Business School, Rhein-Main University of Applied Sciences, Wiesbaden, Germany.

Hegau Jugendwerk Gailingen, Health Care Association District of Constance, Gailingen, Germany, Health Care Association District of Constance.

出版信息

J Patient Saf. 2024 Sep 1;20(6):410-419. doi: 10.1097/PTS.0000000000001251. Epub 2024 Jul 25.

Abstract

INTRODUCTION

Second-victim phenomena may lead to severe reactions like depression or posttraumatic disorder, as well as dysfunction and absenteeism. Medical error as a cause for second victims is not limited to professionals, as family caregivers care for millions of patients at home. It remains unclear whether these are first, second, or double victims in case of error. This explorative study investigated whether second victim effects and signs of moral injury are detectable in family caregivers and whether existing instruments are applicable in lay persons.

METHODS

In an open convenience sampling online survey, we recruited 66 German family caregivers. Propensity score matching was conducted to obtain a balanced sample of family caregivers and qualified nurses who took part in the previous study by adjusting for age and sex. The groups were compared regarding the German Version of the Second Victim Experience and Support Tool-Revised and the German version of the Moral Injury Symptom and Support Scale for Health Professionals.

RESULTS

Sixty-six caregivers participated, of whom 31 completed the survey. Of all, 58% experienced a second victim-like effect, 35% experienced a prolonged effect, and 45% reported to still suffer from it. In a matched sample (22 family caregivers and 22 nurses), no significant differences were observed between the groups.

DISCUSSION

Regarding the limitations of this pilot study, demanding for resampling in larger populations, we could show that second victim effects and moral injury are detectable in family caregivers by validated instruments and are not inferior to professionals' experiences. Concerning the demand for further studies, we confirmed the applicability of the testing instruments but with need for item reduction to lower response burden.

摘要

简介

第二受害者现象可能导致严重的反应,如抑郁或创伤后障碍,以及功能障碍和缺勤。医疗错误作为第二受害者的原因不仅限于专业人员,因为家庭护理人员在家中照顾数百万患者。在发生错误的情况下,这些人是第一、第二还是双重受害者尚不清楚。这项探索性研究调查了家庭护理人员中是否可以检测到第二受害者效应和道德伤害的迹象,以及现有的工具是否适用于非专业人士。

方法

在一项开放的便利抽样在线调查中,我们招募了 66 名德国家庭护理人员。通过调整年龄和性别,对参加先前研究的家庭护理人员和合格护士进行倾向评分匹配,以获得平衡的家庭护理人员和合格护士样本。比较了德国第二受害者体验和支持工具修订版和德国卫生专业人员道德伤害症状和支持量表的德语版本。

结果

共有 66 名护理人员参加,其中 31 人完成了调查。在所有参与者中,58%经历了类似第二受害者的影响,35%经历了延长的影响,45%报告仍在遭受影响。在匹配样本(22 名家庭护理人员和 22 名护士)中,两组之间没有观察到显著差异。

讨论

鉴于这项初步研究的局限性,需要在更大的人群中进行重新采样,我们可以通过验证过的工具证明第二受害者效应和道德伤害在家庭护理人员中是可检测的,并不逊于专业人员的经验。关于进一步研究的需求,我们证实了测试工具的适用性,但需要减少项目以降低响应负担。

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