护士第二受害者的心理复苏路径和支持需求质性研究

A qualitative study on the psychological recovery pathway and support needs of the second victim of nurses

目的采用质性研究,探讨经历医疗不良事件的护士第二受害者的心理复苏路径和支持需求。方法2022年6—12月,运用目的性抽样方法,在湖北省3所三级甲等医院和四川省1所三级甲等医院选取经历过Ⅲ级及以上不良事件且自愿参加本研究的护士作为研究对象,共20人。对研究对象进行半结构式访谈,通过主题分析法对资料进行分析。结果经历医疗不良事件的护士心理复苏路径会经历3个阶段,包括平台期、应激反应期以及应对与成长期。护士第二受害者希望获得科室环境文化、组织氛围和非惩罚式文化支持,平台期的护士对前两项支持的需要更强烈;应激反应期更希望获得上级、同事、家人/朋友的情感支持;应对与成长期则更希望获得知识学习和培训支持。结论护士第二受害者的心理复苏会经历平台期、应激反应期以及应对与成长期,各时期的支持需求存在差异,应制定更有针对性的干预方案。

Objective To explore the psychological recovery pathway and support needs of second victims of nurses who have experienced medical adverse events through qualitative research.Methods From June to December 2022,a purposive sampling method was used to select 20 nurses who had experienced levelⅢor above adverse events and voluntarily participated in this study from 3 grade A tertiary hospitals in Hubei Province and 1 grade A tertiary hospital in Sichuan Province.Semi-structured interviews were conducted with the research subjects and the data was analyze by using thematic analysis.Results The psychological recovery path of nurses who had experienced medical adverse events included three stages,named as the plateau period,stress response period,and coping and growth period.The second victim of nurses hoped to receive support from the department′s environmental culture,organizational atmosphere,and non punitive culture,and nurses in the platform stage had a stronger need for the first two types of support;the nurses preferred emotional support from superiors,colleagues,family/friends during the stress response period,and preferred knowledge learning and training support during the coping and growth period.Conclusions The psychological recovery of the second victim of nurses will go through a plateau period,a stress response period,and a coping and growth period.There are differences in support needs during each period,and more targeted intervention plans should be developed.