The Effect of Second-Victim-Related Distress and Support on Work-Related Outcomes in Tertiary Care Hospitals in Kelantan, Malaysia

Abstract

After a patient safety incident, the involved healthcare providers may experience sustained second-victim distress and reduced professional efficacy, with subsequent negative work-related outcomes and the cultivation of resilience. This study aims to investigate the factors affecting negative work-related outcomes and resilience with a hypothetical triad of support as the mediators: colleague, supervisor, and institutional support. This cross-sectional study recruited 733 healthcare providers from three tertiary care hospitals in Kelantan, Malaysia. Three steps of hierarchical linear regression were developed for both outcomes (negative work-related outcomes and resilience). Four multiple mediator models of the support triad were analyzed. Second-victim distress, professional efficacy, and the support triad contributed significantly in all the regression models. Colleague support partially mediated the relationship defining the effects of professional efficacy on negative work-related outcomes and resilience, whereas colleague and supervisor support partially mediated the effects of second-victim distress on negative work-related outcomes. Similar results were found regarding resilience, with all support triads producing similar results. As mediators, the support triads ameliorated the effect of second-victim distress on negative work-related outcomes and resilience, suggesting an important role of having good support, especially after encountering patient safety incidents.

Exploring the Experiences and Support of Nurses as Second Victims After Patient Safety Events in China: A Mixed-Method Approach

“… 22 This finding proves that the psychological, physical and practice distress of nurses in China are higher than those of other health care providers, which is consistent with the results of foreign studies. 23 Therefore, understanding the level of nurse experience and support as a second victim after patient safety events is important.…”

Das Second-Victim-Phänomen in der Intensivpflege

“…Nach der Theorie des Second-Victim-Phänomens entsteht bei Gesundheitsdienstleistenden nach negativen Patientenereignissen Stress, der sich durch physische sowie psychische Beschwerden und ein verändertes Erleben der eigenen Professionalität äußern kann. Unterstützung durch Kollegen, Vorgesetzte und die Institution kann Stress und möglichen Konsequenzen wie Absentismus und berufliche Veränderung, aber auch einer Behinderung der positiven beruflichen Weiterentwicklung vorbeugen [13][14][15].…”

“…Zu den negativen beruflichen Konsequenzen gehören beispielsweise berufliche Veränderung im Sinne eines Ausstiegs aus dem Beruf oder eines Bereichswechsels und Absentismus [10] [13]. Zu den positiven beruflichen Konsequenzen gehören unter anderem Wissenszuwachs, eine Steigerung der Versorgungsqualität und eine gesteigerte Aufmerksamkeit während der Arbeit [10] [15]. Dabei scheint die Möglichkeit, aus medizinischen Fehlern zu lernen, sich positiv auf die erlebte Belastung auszuwirken und die berufliche Weiterentwicklung zu fördern [20].…”

Second Victim Symptoms and Desired Support Strategies Among Italian Health Care Workers in Friuli-Venezia Giulia: Cross-Sectional Survey and Latent Profile Analysis

“…11,37,39,40 After involvement in an adverse event, clinicians require both professional reaffirmation and personal reassurance: peer or supervisor support is the most desired need in a confidential and nonjudgmental environment. 7,9,24,[44][45][46][47][48][49] Nevertheless, such support is generally inadequate, 21,27,45 and employees rarely use existing infrastructure because of stigma and blaming culture. 7,50,51 Because solutions and support strategies are required at multiple levels of the health care system 26,52 and interventions are time-consuming and expensive, assessment of existing programs and HCWs needs is necessary to organize support resources and design new programs.…”

“…Several organizations have structured and implemented support programs specifically addressing second victims 11,37,39,40 . After involvement in an adverse event, clinicians require both professional reaffirmation and personal reassurance: peer or supervisor support is the most desired need in a confidential and nonjudgmental environment 7,9,24,44–49 . Nevertheless, such support is generally inadequate, 21,27,45 and employees rarely use existing infrastructure because of stigma and blaming culture 7,50,51 .…”