Ong Timothy Sheng Khai, Goh Celeste Natasha, Tan Erel Kane Yun En, Sivanathan Kavin Abimanyu, Tang Ansel Shao Pin, Tan Hiang Khoon, Ng Qin Xiang
NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Wallace Wurth, University of New South Wales, New South Wales, Australia.
J Healthc Leadersh. 2025 Jun 3;17:225-239. doi: 10.2147/JHL.S526565. eCollection 2025.
Second Victim Syndrome (SVS) refers to the significant emotional and psychological distress experienced by healthcare professionals following adverse patient events. While numerous interventions have been developed to support second victims, their effectiveness remains poorly understood. This systematic review aimed to synthesize the evidence on the outcomes of available interventions targeting SVS.
We systematically searched MEDLINE, Embase, and the Cochrane Library databases, covering all records up to July 7, 2024. We included studies that evaluated the impact of SVS interventions on psychological, professional, and institutional outcomes. We assessed the quality of the included studies using the Joanna Briggs Institute (JBI) critical appraisal tool and evaluated the certainty of evidence using the GRADE framework. Due to heterogeneity in study designs and outcome measures, we opted for a narrative synthesis.
Fifteen studies were included, predominantly of moderate quality. Peer support programs were the most commonly implemented interventions, often structured around the Scott Three-Tiered Model. These programs demonstrated consistent short-term benefits, such as reduced emotional distress and perceived isolation. However, evidence for long-term outcomes-including professional resilience, burnout reduction, and retention-was mixed and generally of low certainty. Structured psychological interventions, including cognitive behavioral therapy (CBT) and mindfulness-based programs, showed more promising long-term results but remain underexplored. Standardized outcome measures, such as the Second Victim Experience and Support Tool (SVEST), were infrequently used, limiting comparability across studies.
SVS interventions, particularly peer support, offer short-term relief but limited long-term impact. There is a critical need for longitudinal research using standardized outcome measures to better evaluate effectiveness. This review highlights the need for system-wide, evidence-based interventions and standardized evaluation metrics to support healthcare professionals effectively.
第二受害者综合征（SVS）是指医疗保健专业人员在发生不良患者事件后所经历的重大情绪和心理困扰。虽然已经开发了许多干预措施来支持第二受害者，但其有效性仍知之甚少。本系统评价旨在综合针对SVS的现有干预措施效果的证据。
我们系统检索了MEDLINE、Embase和Cochrane图书馆数据库，涵盖截至2024年7月7日的所有记录。我们纳入了评估SVS干预措施对心理、职业和机构结局影响的研究。我们使用乔安娜·布里格斯研究所（JBI）的批判性评价工具评估纳入研究的质量，并使用GRADE框架评估证据的确定性。由于研究设计和结局测量的异质性，我们选择了叙述性综合分析。
纳入了15项研究，质量大多为中等。同伴支持计划是最常用的干预措施，通常围绕斯科特三层模型构建。这些计划显示出一致的短期益处，如减少情绪困扰和感知到的孤立感。然而，关于长期结局的证据——包括职业复原力、减少倦怠和留用率——参差不齐，总体确定性较低。结构化心理干预措施，包括认知行为疗法（CBT）和基于正念的计划，显示出更有前景的长期结果，但仍未得到充分探索。标准化结局测量工具，如第二受害者经历与支持工具（SVEST），很少使用，限制了各研究之间的可比性。
SVS干预措施，尤其是同伴支持，能提供短期缓解，但长期影响有限。迫切需要使用标准化结局测量工具进行纵向研究，以更好地评估有效性。本综述强调了需要全系统、基于证据的干预措施和标准化评估指标，以有效支持医疗保健专业人员。
