儿科护士作为第二受害者的感知及影响因素分析

Perception and influencing factors of pediatric nurses as the second victims

目的调查儿科护士作为第二受害者的经历与支持现状,并分析影响因素。方法采用横断面调查研究、便利抽样方法选取2019年3—6月河南省2所三级甲等医院的221名儿科护士作为研究对象,采用一般资料调查表、第二受害者经历与支持测评量表(Second Victim Experience and SupportTool,SVEST)对其进行调查。采用单因素方差分析、多重线性回归分析对儿科护士作为第二受害者的影响因素进行分析。共发放问卷500份,有效回收462份,有效回收率92.4%,将经历过不良事件、医疗差错和患者安全隐患事件的问卷221份(47.8%)纳入研究分析。结果儿科护士第二受害者经历与支持量表总分为(80.63±10.27)分;单因素分析结果显示,不同工作年限、科室、每周工作时间、职业生涯经历不良事件数的儿科护士第二受害者经历与支持得分比较,差异均有统计学意义(P<0.05);多因素分析结果显示,工作年限、科室、职业生涯经历不良事件数、患者护理方面问题、管理及人际关系方面的问题对儿科护士第二受害者经历与支持具有预测作用,共解释总变异的50.7%。结论儿科护士作为第二受害者经历的负面影响较严重,可获得的支持较少,医院管理者应重视第二受害者的身心健康,建立员工支持项目为其提供情感和信息支持,尽可能地减少不良医疗事件对儿科护士的伤害。

Objective To investigate the experience and support status of pediatric nurses as second victims and to analyze the influencing factors.Methods From March to June 2019,a total of 221 pediatric nurses from two ClassⅢGrade A hospitals in Henan Province were selected as research objects by the crosssectional study and convenient sampling method.The general data questionnaire and Second Victim Experience and Support Tool(SVEST)were used to investigate them.Single factor analysis of variance and multiple linear regression analysis were used to analyze the influencing factors of pediatric nurses as the second victims.A total of 500 questionnaires were issued and 462 were effectively recovered,with an effective recovery rate of 92.4%.A total of 221 questionnaires(47.8%)that experienced adverse events,medical errors,and hidden safety risks were included in the study analysis.Results The total score of SVEST of pediatric nurses was(80.63±10.27).The results of single factor analysis showed that SVEST scores of pediatric nurses with different working years,departments,working hours per week and number of adverse events in their career had statistically significant differences(P<0.05).The results of multivariate analysis showed that working years,departments,number of adverse events in their career,nursing issues of patients,management and interpersonal issues had predictive effects on experience and support of pediatric nurses as the second victims,which explained 50.7%of the total variation.Conclusions Pediatric nurses experience more severe negative effects as second victims and receive less support.Hospital managers should pay attention to the physical and mental health of the second victims,establish staff support programs to provide emotional and informational support and minimize the harm of adverse medical events to pediatric nurses.