严重医疗不良事件中第二受害者认知与心理体验的质性研究

目的了解医务人员在严重医疗不良事件中作为第二受害者的认知与心理体验,为医疗不良事件管理体系相关研究提供依据。方法采用质性研究中的现象学研究法,于2019年1—2月,选取3所三级医院9名经历过严重医疗不良事件医务人员进行访谈,根据Colaizzi 7步分析法对访谈资料进行整理分析。结果提炼出4个主题:各种负性体验的经历、对职业认知的改变、认同完善预防不良事件系统的重要性、渴求设立第二受害者支持体系。结论主管部门应关注到医疗不良事件中涉事医务人员的困境,积极构建第二受害者的支持体系,以此来降低他们在医疗不良事件中受到的伤害,从而确保医疗安全。

A qualitative study on the cognition and psychological experience of the second victim in serious medical adverse events

Objective To explore the cognitive and psychological experience of medical staff as the second victims in serious adverse events,so as to provide the basis for the related research on the management system of medical adverse events.Methods Using the phenomenological approach in qualitative research,from January to February 2019,9 medical staff from 3 ClassⅢhospitals who had experienced adverse events were interviewed as the second victims.The data were analyzed according to Colaizz 7 steps analysis method.Results A total of 4 themes were refined,including the experiences of various negative experiences,the change of occupational cognition,the importance of identifying and improving the system of prevention of adverse events and the desire to establish a support system for the second victims.Conclusions The competent authorities should pay attention to the plight of medical personnel involved in medical adverse events,and actively construct a support system for the second victim,so as to reduce the harm of the second victims in medical adverse events and ensure medical safety.