基于混合研究视角的住院病人自杀事件中第二受害者体验和支持需求调查

Investigation of experience and support needs of second victims in suicide events of inpatients:from the perspective of mixed study

[目的]了解综合医院病人自杀事件中第二受害者的体验和支持需求。[方法]选择湖北省武汉市某三级甲等综合医院15名病人自杀事件第二受害者的护士为访谈对象,进行半结构式深入访谈。并采用病人自杀事件中第二受害者体验和支持需求调查问卷对来自湖北省8所医院的4901名护士进行调查,其中经历病人自杀事件的护士共736名。[结果]访谈结果显示,第二受害者存在不同程度的负性体验、容易出现职业倦怠感、外源性支持不足。问卷总均分为(3.32±0.46)分,处于中等偏上水平,5个维度的得分为自身困扰(3.45±0.85)分、亲朋好友支持(3.68±0.76)分、工作相关支持(3.52±0.60)分、组织系统支持(3.16±0.46)分、职业自我效能感(2.54±0.89)分。[结论]医院病人自杀事件中的第二受害者职业自我效能感较强,但具有较多的负性自身感受,需要较多的支持资源,呼吁管理者关注第二受害者的身心状况,医院应积极建立第二受害者支持体系。

Objective:To understand the experience and support needs of second victims in inpatient suicide incidents in general hospital.Methods:A semi-structured in-depth interview was conducted among 15 second victims from the tertiary grade A hospital in Wuhan,Hubei province.In addition,totally 4 901 nurses from 8 hospitals in Hubei province were investigated with the Second Victims’ Experlence and Support Needs of Inpatients’ Suicide Questionnaire.Among which,736 nurses experienced patients’ suicide.Results:Interview result showed that there were different degrees of negative experience,tendency to having occupational burnout,and inadequacy of external support among the second vitims.The total score of the questionnaire was 3.32±0.46,which was above the average level.The score of self-distress dimensions was 3.45±0.85,support from friends and family was 3.68±0.76,work-related support was 3.52±0.60,organizational support was 3.16±0.46,and professional self-efficacy was 2.54±0.89.Conclusion:The second victim of inpatients’ suicide had a strong sense of professional self-efficacy and more negative self-feelings.They need more support resources.And the managers were called to pay attention to the physical and mental condition of the second victim.The second victim support system should be actively established in the hospitals.