我国精神科护士作为第二受害者经历与支持的现状及其影响因素

Analysis on the current situation and influencing factors of experience and support of psychiatric nurses as second victims in China

目的:了解精神科护士在不良事件中作为第二受害者经历与支持现状,并分析影响第二受害者经历与支持的因素。方法:于2021年6-7月,采用便利抽样法,选取全国10个省份26家公立精神专科医院经历过不良事件的2275护士进行调查,采用一般资料调查问卷、第二受害者经历与支持量表、心理韧性量表调查分析第二受害者经历与支持现状及其影响因素。结果:精神科护士作为第二受害者经历与支持总分为67.50±10.79,各维度标准得分率由低到高分别为管理支持(16.40±4.78,46.86%),同事支持(7.25±1.97,48.33%),亲友支持(4.97±1.64,49.70%),生理困扰(8.66±2.90,57.73%),执业困扰(15.52±4.42,62.08%),心理困扰(14.70±2.97,73.50%)。Pearson相关分析显示第二受害者经历与支持同心理韧性呈显著负相关(r=-0.437,P<0.001)。多元线性回归分析显示,性别、医院级别、工作年限、班次、需要照料老人的情况、交通情况、心理韧性是精神科护士作为第二受害者经历与支持的影响因素,共解释总变异的23.1%。结论:精神科护士在经历不良事件后心理困扰程度较高,所获亲友支持较低。管理者应重视精神科护士作为第二受害者的心理体验和支持系统,针对不同影响因素采取针对性的措施,以减轻不良事件对护士第二受害者的负性影响。

Objective:To understand the experience and support status of psychiatric nurses as the second victim in adverse events,and analyze the factors affecting the experience and support of their second victim.Methods:From June to July 2021,2275 nurses who had experienced adverse events in 26 public psychiatric hospitals in 10 provinces across the country were selected by convenient sampling method to conduct a survey.The general information questionnaire,the second victim experience and support scale,and the psychological resilience scale were used to investigate and analyze the current situation of the second victim experience and support and its influencing factors.Results:The total score of experience and support of psychiatric nurses as the second victim was(67.50±10.79),and the standard score rate of each dimension from low to high was:Management support(16.40±4.78,46.86%),colleague support(7.25±1.97,48.33%),relatives and friends support(4.97±1.64,49.70%),physiological distress(8.66±2.90,57.73%),practice distress(15.52±4.42,62.08%),psychological distress(14.70±2.97,73.50%).Pearson correlation analysis showed that the experience and support of the second victim were significantly negatively correlated with psychological resilience(r=-0.437,P<0.001).Multiple linear regression analysis showed that gender,hospital level,working years,shift,the situation of the elderly in need of care,traffic conditions,and psychological resilience were the influencing factors of psychiatric nurses'experience and support as the second victim,accounting for 22.9%of the total variance.Conclusion:Psychiatric nurses have a high degree of psychological distress after experiencing adverse events and receive low support from relatives and friends.Managers should pay attention to the psychological experience and support system of psychiatric nurses as the second victims,and take targeted measures against different influencing factors to reduce the negative impact of adverse events on the second victims of nurses.