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Kappes M, Romero-Garcia M, Sanchez M, Delgado-Hito P. Coping trajectories of intensive care nurses as second victims: A grounded theory. Aust Crit Care 2024; 37:606-613. [PMID: 38360471 DOI: 10.1016/j.aucc.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 12/27/2023] [Accepted: 01/03/2024] [Indexed: 02/17/2024] Open
Abstract
A qualitative study that provides evidence of the institutional support required by intensive care unit (ICU) nurses as second victims of adverse events (AEs). BACKGROUND The phenomenon of second victims of AE in healthcare professionals can seriously impact professional confidence and contribute to the ongoing occurrence of AEs in hospitals. OBJECTIVES The objective of this study was to describe the coping trajectories of second victims among nurses working in ICUs in public hospitals in Chile. METHODS Conducting qualitative research through the grounded theory method, this study focused on high-complexity hospitals in Chile, using theoretical sampling. The participants consisted of 11 nurses working in ICUs. Techniques used included in-depth interviews conducted between March and May 2023, as well as a focus group interview. Analysis, following the grounded theory approach proposed by Strauss and Corbin, involved constant comparison of data. Open, axial, and selective coding were applied until theoretical data saturation was achieved. The study adhered to reliability and authenticity criteria, incorporating a reflexive process throughout the research. Ethical approval was obtained from the ethics committee, and the study adhered to the consolidated criteria for reporting qualitative research. RESULTS From the interviews, 29 codes were identified, forming six categories: perception of support when facing an AE, perception of helplessness when facing an AE, initiators of AE, responses when facing an AE, professional responsibility, and perception of AE. The perception of support when facing an AE emerged as the main category, determining whether the outcome was stagnation or overcoming of the phenomenon after the AE. CONCLUSIONS For the coping process of ICU nurses following an AE, the most crucial factor is the support from colleagues and supervisors.
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Affiliation(s)
- Maria Kappes
- Faculty of Health Care Sciences, Universidad San Sebastian, Puerto Montt, Chile.
| | - Marta Romero-Garcia
- Fundamental and Clinical Nursing Department, Faculty of Nursing, University of Barcelona, Barcelona, Spain; IDIBELL, Bellvitge Biomedical Research Institute, Avinguda de la Granvia, L'Hospitalet de Llobregat, Spain; International Research Project: HU-CI Project, Collado Villalba, Spain.
| | - Maria Sanchez
- Faculty of Health Care Sciences, Universidad San Sebastian, Puerto Montt, Chile.
| | - Pilar Delgado-Hito
- Fundamental and Clinical Nursing Department, Faculty of Nursing, University of Barcelona, Barcelona, Spain; IDIBELL, Bellvitge Biomedical Research Institute, Avinguda de la Granvia, L'Hospitalet de Llobregat, Spain; International Research Project: HU-CI Project, Collado Villalba, Spain.
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Tang W, Xie Y, Yan Q, Teng Y, Yu L, Wei L, Li J, Chen Y, Huang X, Yang S, Jia K. Exploring the Experiences and Support of Nurses as Second Victims After Patient Safety Events in China: A Mixed-Method Approach. Risk Manag Healthc Policy 2024; 17:573-586. [PMID: 38501130 PMCID: PMC10944798 DOI: 10.2147/rmhp.s451766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 02/29/2024] [Indexed: 03/20/2024] Open
Abstract
Aim To investigate the current status of experience and support of nurses as second victims and explore its related factors in nurses. Design A sequential, explanatory, mixed-method study was applied. Methods A total of 406 nurses from seven tertiary hospitals in China were chosen as participants between September to October 2023. The Chinese version of the Second Victim Experience and Support Questionnaire (SVEST), Somatic Complaints of Sub-health Status Questionnaire (SCSSQ) and Generalized Anxiety Disorder (GAD-7) were applied to collect quantitative data. Eight nurses were selected for a qualitative study through in-depth interviews. Through interpretive phenomenological analysis, the interview data were analysed to explore the experience and support of nurses as second victims. Results Practice distress (15.74 ± 4.97) and psychological distress (15.48 ± 3.74) were the highest dimensions, indicating Chinese nurses experienced second victim-related practice and psychological distress. Nurses with different gender, age, education, marital status, income, working hours, professional titles, and unit types have different levels of second victim-related experience and support (p < 0.05). In addition, the score of SVEST was positively associated with SCSSQ (r = 0.444) and GAD-7 (r = 0.490) (p < 0.05). This qualitative study found that the experience and support of nurses as second victims included nurses' perceptions and needs for patient safety events; psychological, physical and practice distress of nurses; and nurses and hospitals coping style after patient safety events. Discussion Our findings suggest that nurses who are second victims of patient safety events experience severe practice and psychological distress, indicating that nursing managers should pay attention to psychological and practice distress of nurses after patient safety events and provide effective preventive measures.
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Affiliation(s)
- Wenzhen Tang
- The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530021, People’s Republic of China
| | - Yuanxi Xie
- The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530021, People’s Republic of China
| | - Qingfeng Yan
- The Sanming Second Hospital, Sanming, Fujian Province, 366099, People’s Republic of China
| | - Yanjuan Teng
- The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530021, People’s Republic of China
| | - Li Yu
- The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530021, People’s Republic of China
| | - Liuying Wei
- Nanning Fourth People’s Hospital, Nanning, Guangxi Zhuang Autonomous Region, 530021, People’s Republic of China
| | - Jinmei Li
- Wanxiu District Chengnan Community Health Service Center, Wuzhou, Guangxi Zhuang Autonomous Region, 543000, People’s Republic of China
| | - Yuhui Chen
- The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530021, People’s Republic of China
| | - Xiaolin Huang
- The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530021, People’s Republic of China
| | - Shaoli Yang
- The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530021, People’s Republic of China
| | - Kui Jia
- The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530021, People’s Republic of China
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Kappes M, Delgado-Hito P, Contreras VR, Romero-García M. Prevalence of the second victim phenomenon among intensive care unit nurses and the support provided by their organizations. Nurs Crit Care 2023; 28:1022-1030. [PMID: 37614030 DOI: 10.1111/nicc.12967] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 07/24/2023] [Accepted: 08/04/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND Health professionals can be 'second victims' of adverse patient events. Second victimhood involves a series of physical and psychological signs and symptoms of varying severity and is most prevalent among nurses and women and in intensive care units (ICUs). Previous research has described personal and organizational coping strategies. AIM The objective of this research is to determine the prevalence of second victimhood, focusing on psychological distress, among Chilean adult intensive care nurses and its relationship with the support provided by their organizations. STUDY DESIGN A descriptive, correlational and cross-sectional study was conducted in seven intensive care units of Chilean hospitals. RESULTS Of a sample of 326 nurses, 90.18% reported having been involved in an adverse event and 67% reported psychological distress resulting from the adverse event. Embarrassment was the most prevalent psychological symptom (69%). Only 2.8% reported that their organization had an action plan for professionals in the event of a serious adverse event. Participants who had spent longer working in an ICU reported more support from their organization around adverse events. CONCLUSION Two-thirds of Chilean adult intensive care unit nurses report psychological stress following an adverse event. These results should be assessed internationally because second victims have major implications for the well-being of health professionals and, therefore, for retention and the quality of care. RELEVANCE TO CLINICAL PRACTICE Critical care leaders must actively promote a safe environment for learning from adverse events, and hospitals must establish a culture of quality that includes support programmes for second victims.
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Affiliation(s)
- Maria Kappes
- Faculty of Health Care Sciences, Universidad San Sebastian, Puerto Montt, Chile
| | - Pilar Delgado-Hito
- Fundamental and Clinical Nursing Department, Faculty of Nursing, University of Barcelona, Barcelona, Spain
- IDIBELL, Bellvitge Biomedical Research Institute, Avinguda de la Granvia, L'Hospitalet de Llobregat, Spain
- International Research Project: Proyecto HU-CI, Collado Villalba, Spain
| | | | - Marta Romero-García
- Fundamental and Clinical Nursing Department, Faculty of Nursing, University of Barcelona, Barcelona, Spain
- IDIBELL, Bellvitge Biomedical Research Institute, Avinguda de la Granvia, L'Hospitalet de Llobregat, Spain
- International Research Project: Proyecto HU-CI, Collado Villalba, Spain
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Xu H, Cao X, Jin QX, Wang RS, Zhang YH, Chen ZH. Distress, support and psychological resilience of psychiatric nurses as second victims after violence: A cross-sectional study. J Nurs Manag 2022; 30:1777-1787. [PMID: 35689407 DOI: 10.1111/jonm.13711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 05/16/2022] [Accepted: 06/07/2022] [Indexed: 11/26/2022]
Abstract
AIM The aim is to explore the impact of violence and psychological resilience on psychiatric nurses as second victims. BACKGROUND Workplace violence is a public health concern, seriously influencing medical staff's physical and mental health. However, few pieces of research have concentrated on psychiatric nurses as second victims. METHOD The socio-demographic data, violence-related data, psychological resilience scale, the Chinese version of the Second Victim Experience and Support Tool were applied to conduct a cross-sectional survey on nurses from psychiatric hospitals. The multiple linear regression model identified significant variables associated with violence-related injury and resilience. RESULTS A total of 683 nurses completed the survey, of whom 88.3% were women. The average scores of the second victims' experience and support, support and distress were 3.45 ± 0.43, 3.71 ± 0.57 and 3.19 ± 0.67, respectively. Physical violence, psychological violence, psychological influence and nursing work environment were positively correlated with the experience and support of the second victims, and innocuous violence was a negative factor, which explains 20.6% of the variation. Moreover, physical injury, nursing work environment, resilience restructuring, physical violence, psychological violence, psychological impact and disagreement about the existence of violence explained 14.8% of the distress. The innocuous violence, psychological violence and nursing work environment explained 46.2% of the support. CONCLUSIONS Our findings suggest that nurses who are second victims after the violence mainly suffer from severe psychological distress and receive the least support for the same. IMPLICATION FOR NURSING MANAGEMENT The study provides clues to help nursing managers' emphasis on the distress and support of second victims and provides targeted intervention based on the relevant factors and these results. The article is a cross-sectional study of psychiatric nurses, which has been approved by the ethics committee of the hospital before the survey. All the nurses who participated in the survey have been informed and agreed.
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Affiliation(s)
- Hua Xu
- Department of Adult Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xiang Cao
- Department of Adult Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Quan-Xiang Jin
- Department of Adult Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Rui-Shi Wang
- Department of Adult Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yan-Hong Zhang
- Department of Nursing, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Zhao-Hong Chen
- Department of Adult Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
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Sun L, Deng J, Xu J, Ye X. Rumination's Role in Second Victim Nurses' Recovery From Psychological Trauma: A Cross-Sectional Study in China. Front Psychol 2022; 13:860902. [PMID: 35592176 PMCID: PMC9110963 DOI: 10.3389/fpsyg.2022.860902] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 04/13/2022] [Indexed: 11/19/2022] Open
Abstract
Background: Nurses can experience psychological trauma after adverse nursing events, making it likely for them to become second victims (SVs). This negatively impacts patient safety and nurses’ development. This study aims to understand the status of psychological trauma and recovery of nurses as SVs in domestic China and examine the influencing mechanism of cognitive rumination during their recovery from psychological damage. Methods: This was a cross-sectional survey. An online questionnaire was completed by 233 nurses from across China. Data were collected using Chinese versions of the Second Victim Experience and Support Evaluation Scale, the Incident-related Rumination Meditation Questionnaire, and the post-traumatic growth (PTG) Rating Scale. Descriptive statistics, correlation, and regression, as well as mediation analysis, were used for different analyses in this study. Results: Participants experienced apparent psychological traumas (4.65 ± 0.5583) with a certain degree of PTG (76.18 ± 16.0040); they reported a strong need for psychological support (95.7%). Psychological trauma was positively and negatively correlated with rumination and PTG (r = 0.465, p < 0.001; r = −0.155, p < 0.05) respectively. Both psychologically impaired experience and rumination had significant predictive effects on participants’ PTG (both, p < 0.001). Nurses’ active rumination significantly mediated their psychological recovery from trauma to PTG (p < 0.05), but the effect of invasive rumination was not significant (p > 0.05). Limitation: The specific manifestations of the mechanism of invasive rumination are not clarified in this study. Conclusion: The present study investigated the psychological trauma of SV nurses as well as their support needs, and explored the role of cognitive rumination in the psychological repair and PTG of SV nurses. Results showed that SV nurses’ active rumination on adverse nursing events could promote their recovery from psychological trauma, but invasive rumination could not. This study provides a trauma-informed approach to care at the clinical level for nurses who experience psychological trauma caused by adverse events.
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Affiliation(s)
- Lianrong Sun
- Nursing College, Naval Medical University, Shanghai, China.,Tianhua College, Shanghai Normal University, Shanghai, China
| | - Juan Deng
- Nursing College, Naval Medical University, Shanghai, China
| | - Jixin Xu
- Academic Library, Shanghai Normal University, Shanghai, China
| | - Xuchun Ye
- Nursing College, Naval Medical University, Shanghai, China
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Kappes M, Romero-García M, Delgado-Hito P. Coping strategies in health care providers as second victims: A systematic review. Int Nurs Rev 2021; 68:471-481. [PMID: 34118061 DOI: 10.1111/inr.12694] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 02/05/2021] [Accepted: 05/04/2021] [Indexed: 01/16/2023]
Abstract
AIM To analyze personal and organizational strategies described in the literature for dealing with the second victim phenomenon among healthcare providers. BACKGROUND The second victim phenomenon involves many associated signs and symptoms, which can be physical, psychological, emotional, or behavioral. Personal and organizational strategies have been developed to deal with this phenomenon. MATERIALS AND METHODS A systematic review was carried out in PubMed, Cochrane Library, Web of Science, Scopus, PsycINFO, Science Direct, and Cumulative Index to Nursing and Allied Health Literature databases, searching for evidence published between 2010 and 2019 in Spanish, English, German, and Portuguese. RESULTS Seven hundred and eighty-three articles were identified. After eliminating duplicates, applying inclusion and exclusion criteria and critical analysis tools of the Joanna Briggs Institute, 16 research articles were included: 10 quantitative studies (design: descriptive, correlational, systematic, or integrative review) and six qualitative studies (descriptive, systematic review). There are several different personal and organizational strategies for dealing with the second victim phenomenon. Among these, peer support and learning from adverse events are highly valued. In personal strategies stands out the internal analysis of the adverse event that the professional performs to deal with the generated negative feelings. In organizational strategies, the most valued are second victim support programs with rapid response teams and made up of peers. CONCLUSIONS The main organizational coping strategies for tackling this phenomenon are online programs in countries such as the United States, Spain, and other European countries. Formal evaluation of these programs and research is required in Latin America. IMPLICATIONS FOR NURSING AND HEALTH POLICIES Adequately coping with the second victim phenomenon allows health professionals and organizations to learn from adverse events. Furthermore, by supporting health professionals who suffer from the second victim phenomenon, the organization takes care of its most valuable resource, its human capital. This contributes toward building a culture of healthcare quality in organizations, which will reduce adverse events in the future.
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Affiliation(s)
- Maria Kappes
- Faculty of Healthcare Sciences, Nursing School, Universidad San Sebastián, Puerto Montt, Chile
| | - Marta Romero-García
- Fundamental Care and Medical-Surgical Nursing Department, School of Nursing, L'Hospitalet de Llobregat, University of Barcelona, Barcelona, Spain.,IDIBELL, L'Hospitalet de Llobregat, Bellvitge Biomedical Research Institute, Barcelona, Spain.,Collado Villalba, International Research Project-Proyecto HU-CI, Madrid, Spain
| | - Pilar Delgado-Hito
- Fundamental Care and Medical-Surgical Nursing Department, School of Nursing, L'Hospitalet de Llobregat, University of Barcelona, Barcelona, Spain.,IDIBELL, L'Hospitalet de Llobregat, Bellvitge Biomedical Research Institute, Barcelona, Spain.,Collado Villalba, International Research Project-Proyecto HU-CI, Madrid, Spain
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Bohomol E. Além da segurança do paciente, a segurança dos profissionais. ACTA PAUL ENFERM 2019. [DOI: 10.1590/1982-0194201900066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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