The psychological process of second victims in medical adverse events_West China Medical Journal

Authors：

CHEN Xiaojuan ¹ ,  WANG Yiping ² , ZENG Sulan ³ , WANG Bingli ⁴ , WANG Hua ⁵ , LIU Lamei ⁶ , GAO Hui ⁷

1. Surgical Anesthesiology Department, the First People’s Hospital of Ziyang, Ziyang, Sichuan 641300, P. R. China;
2. West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
3. Nursing Department, the First People’s Hospital of Ziyang, Ziyang, Sichuan 641300, P. R. China;
4. Endocrinology Department, the First People’s Hospital of Ziyang, Ziyang, Sichuan 641300, P. R. China;
5. Neurology Department, the First People’s Hospital of Ziyang, Ziyang, Sichuan 641300, P. R. China;
6. Rehabilitation Department, the First People’s Hospital of Ziyang, Ziyang, Sichuan 641300, P. R. China;
7. Gastroenterology Department, the First People’s Hospital of Ziyang, Ziyang, Sichuan 641300, P. R. China;

Corresponding?author：

WANG Yiping, Email: 18980601182@163.com

Keywords：

Medical adverse events; Second victim; Psychological process; Emotional experience; Qualitative research

DOI：

10.7507/1002-0179.201910068

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Objective To explore the psychological process and needs of the second victims of medical adverse events after the occurrence of adverse events, so as to provide reference for the psychological intervention strategies of medical institutions for the second victims of medical adverse events.Methods The second victims of medical adverse events in the First People’s Hospital of Ziyang were selected from April to July 2019. Qualitative research method was used to conduct semi-structured in-depth interviews with the second victims. Colaizzi method was used to analyze the transcripts through reading and rereading, coding, and thematizing. Results A total of 22 second victims of medical adverse events were interviewed. The second victims of medical adverse events experienced negative emotional experience, and the desire to seek emotional support was urgent. The psychological process of the second victims of medical adverse events mainly involved five stages: fear, anxiety, depression, guilt and recovery. Emotional support hada positive effect on regression. Conversely, negative or lack of emotional support had a negative effect on regression. Conclusions The emotional experience of the second victims of medical adverse events is relatively staged, and the recovery and regression are greatly affected by internal and external factors. Hospital administrators should take active measures and establish an emotional support mechanism for adverse events in order to reduce psychosomatic injuries and improve medical quality and efficiency.

Citation： CHEN Xiaojuan, WANG Yiping, ZENG Sulan, WANG Bingli, WANG Hua, LIU Lamei, GAO Hui. The psychological process of second victims in medical adverse events. West China Medical Journal, 2021, 36(7): 913-918. doi: 10.7507/1002-0179.201910068 Copy

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8.	盛媛, 葛淑芝. 糾紛或差錯事故后醫護人員心理健康的Meta分析. 中華現代護理雜志, 2012, 18(23): 2747-2750.
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15.	田雨睛, 譚曦, 劉琰, 等. 醫務工作者焦慮情緒對臨床決策的影響及對策. 醫學與社會, 2015, 28(8): 89-91.
16.	Scott SD, McCoig MM. Care at the point of impact: insights into the second-victim experience. J Healthc Risk Manag, 2016, 35(4): 6-13.
17.	Scott SD, Hirschinger LE, Cox KR, et al. The natural history of recovery for the healthcare provider “second victim” after adverse patient events. Qual Saf Health Care, 2009, 18(5): 325-330.
18.	Hanan Edrees, Frank Federico. 發生醫療差錯后, 醫務人員也需要幫助: 第二受害者的需求常常被忽視. 黃鸝, 譯. 英國醫學雜志(中文版), 2015, 18(10): 551-553.

1. Koehn AR, Ebright PR, Draucker CB. Nurses’ experiences with errors in nursing. Nurs Outlook, 2016, 64(6): 566-574.
2. 中國醫院協會. T/CHAS10-4-6-2018中國醫院質量安全管理, 2018.
3. Grissinger M. Too many abandon the “second victims” of medical errors. P T, 2014, 39(9): 591-592.
4. Wu AW. Medical error: the second victim. The doctor who makes the mistake needs help too. BMJ, 2000, 320(7237): 726-727.
5. Hall LW, Scott SD. The second victim of adverse health care events. Nuts Clin North Am, 2012, 47(3): 383-393.
6. 徐晶, 陳榮鳳, 鄭微艷, 等. 醫療不良事件中第二受害者及其組織支持的研究現狀與啟示. 中華護理雜志, 2017, 52(4): 485-488.
7. 金玉梅, 何曉君. 兒科護士在護理不良事件中作為第二受害者的心理體驗. 中國護理管理, 2019, 19(4): 501-504.
8. 盛媛, 葛淑芝. 糾紛或差錯事故后醫護人員心理健康的Meta分析. 中華現代護理雜志, 2012, 18(23): 2747-2750.
9. Patton MQ. Qualitative research and evaluation methods. 3rd ed. Thousand Oaks, CA: Sage Publications, 2002: 230-247.
10. 劉明. 護理質性研究, 北京: 人民衛生出版社, 2008: 211-213.
11. 伍威·弗里克. 質性研究導引. 孫進, 譯. 重慶: 重慶大學出版社, 2018: 248-256.
12. Mayring P. Qualitative inhaltsanalyse//Flick U, Kardoff Ev, Steinke I. Qualitative forschung: ein handbuch. Hamburg: Rowohlt Tb, 2000: 468-475.
13. 樊榮. 醫療糾紛中不可忽視的另一方—醫務人員的心理危機與干預. 中國醫學人文, 2018, 4: 16-20.
14. Seys D, Wu AW, van Gerven E, et al. HeaIth care professionals as second victims after adverse events: a systematic review. Eval Health Prof, 2013, 36(2): 135-162.
15. 田雨睛, 譚曦, 劉琰, 等. 醫務工作者焦慮情緒對臨床決策的影響及對策. 醫學與社會, 2015, 28(8): 89-91.
16. Scott SD, McCoig MM. Care at the point of impact: insights into the second-victim experience. J Healthc Risk Manag, 2016, 35(4): 6-13.
17. Scott SD, Hirschinger LE, Cox KR, et al. The natural history of recovery for the healthcare provider “second victim” after adverse patient events. Qual Saf Health Care, 2009, 18(5): 325-330.
18. Hanan Edrees, Frank Federico. 發生醫療差錯后, 醫務人員也需要幫助: 第二受害者的需求常常被忽視. 黃鸝, 譯. 英國醫學雜志(中文版), 2015, 18(10): 551-553.

West China Medical Journal

The psychological process of second victims in medical adverse events

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