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医疗机构中安全文化、“二次受害者”现象及负面工作结果的探究

An Exploration of Safety Culture, Second Victim Phenomenon and Negative Work Outcomes in Health Care Settings.

作者信息

Lee Hanseulgi, Lee Nam-Ju

机构信息

College of Nursing, Seoul National University, Seoul, South Korea.

The Research Institute of Nursing Science, Seoul National University, Seoul, South Korea.

出版信息

J Nurs Scholarsh. 2025 May;57(3):472-485. doi: 10.1111/jnu.13048. Epub 2025 Mar 13.

Abstract

PURPOSE

The aim of the study was to explore the impact of patient safety culture on nurses' negative work outcomes resulting from patient safety incidents, as well as the mediating roles of second victim support and distress.

DESIGN

A cross-sectional survey was conducted. The participants included 208 nurses, each with over a year of clinical experience, working in hospitals across South Korea.

METHODS

Data were collected through self-reported questionnaires on general characteristics, patient safety culture, second victim support and distress, and negative work outcomes. The collected data were analyzed using descriptive statistics, the t-test, ANOVA, the Scheffé test, and Pearson correlation coefficients. Additionally, model 6 of Hayes' PROCESS macro and the Sobel test were employed to determine the mediating effect.

RESULTS

Mediation analysis revealed significant indirect effects of patient safety culture on the work outcomes experienced by nurses following patient safety incidents, mediated by second victim distress, after controlling for participants' marital status, position, and the severity of patient safety incidents.

CONCLUSIONS

This study demonstrates that in healthcare settings, patient safety culture that supports the second victim and alleviates second victim distress mitigates the negative work outcomes resulting from patient safety incidents. The findings highlight the significance of culturally sensitive support systems, particularly considering the diverse impacts on Korean nurses. Based on this study, healthcare leaders are recommended to develop strategies to support nurses and reduce their second victim distress, which can ultimately improve patient safety and the quality of nursing care.

CLINICAL RELEVANCE

The findings of this study can be used to develop strategies to support second victims in addressing their distress. Taking steps to alleviate the distress of second victims will help prevent negative work outcomes in nurses.

摘要

目的

本研究旨在探讨患者安全文化对因患者安全事件导致的护士负面工作结果的影响,以及二次受害者支持和痛苦的中介作用。

设计

进行了一项横断面调查。参与者包括208名护士,他们都有一年以上的临床经验,在韩国各地的医院工作。

方法

通过自我报告问卷收集有关一般特征、患者安全文化、二次受害者支持和痛苦以及负面工作结果的数据。使用描述性统计、t检验、方差分析、谢弗检验和皮尔逊相关系数对收集到的数据进行分析。此外,采用海斯PROCESS宏的模型6和索贝尔检验来确定中介效应。

结果

中介分析显示,在控制参与者的婚姻状况、职位和患者安全事件的严重程度后,患者安全文化通过二次受害者痛苦对护士在患者安全事件后的工作结果产生显著的间接影响。

结论

本研究表明,在医疗环境中,支持二次受害者并减轻二次受害者痛苦的患者安全文化可减轻因患者安全事件导致的负面工作结果。研究结果凸显了文化敏感支持系统的重要性,尤其是考虑到对韩国护士的不同影响。基于本研究,建议医疗领导者制定策略来支持护士并减少他们的二次受害者痛苦,这最终可以提高患者安全和护理质量。

临床意义

本研究结果可用于制定支持二次受害者应对其痛苦的策略。采取措施减轻二次受害者的痛苦将有助于预防护士的负面工作结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8564/12064839/35c228509c77/JNU-57-472-g001.jpg

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