我國醫療不良事件中第二受害者研究現狀分析及未來展望

摘 要 通過梳理我國第二受害者相關文獻，分析我國醫療不良事件中第二受害者的研究現狀及熱點，為未來第二受害者相關研究提供方向。將“第二受害者”作為搜索關鍵詞，在中國知網、萬方、維普數據庫中進行檢索，利用數據庫計量可視化分析工具，對文獻發表時間、研究內容、研究方法等進行對比分析，歸納總結國內第二受害者研究現狀。研究共納入102篇文獻，自2017年起文獻呈明顯上升趨勢，其中有75篇文獻明確表明將護士作為第二受害人研究對象，涉及精神科、重癥監護室、急診等科室。研究熱點包括經驗與支持、影響因素、心理體驗、患者安全文化等。我國第二受害者相關研究起步較晚，多數局限于對護士群體的研究，根據經歷及支持量表對第二受害者體驗及支持需求進行質性研究。今后的研究需持續擴大并細化群體，建設醫療機構患者安全文化，根據群體差異性探索干預工具及改善療法并研究實施效果，促進更多組織支持實踐，為醫務工作者的人身安全及心理健康提供支持和保障。

關鍵詞：第二受害者；不良事件；患者安全；經歷與支持；組織支持需求

中圖分類號：F062.5 文獻標志碼：A" " " ""文章編號：1005-9679（2024）01-0-06

Analysis of The Current Status and Future Prospects of Research on Second Victims in Domestic Adverse Medical Events

YIN Ziwei JIANG Hong

（Shanghai General Hospital，Shanghai，200080）

Abstract：By sorting out the relevant literature on second victims in China，we analyze the research status and hot spots of second victims in domestic adverse medical events，in order to provide directions for future research on second victims. Using \"second victim\" as a search keyword，search in CNKI，Wanfang，and VIP databases，and use database measurement visual analysis tools to conduct comparative analysis on literature time，research content，research methods，etc.，and summarize the current state of domestic second victim research. A total of 102 documents were included in this study，and the research has shown an obvious upward trend since 2017. Among them，75 documents clearly stated that nurses were used as secondary victim research subjects，involving departments such as psychiatry，intensive care units，and emergency departments. Research hot spots include experience and support，influencing factors，psychological experience，patient safety culture，etc. Domestic research on second victims started relatively late，and most of them are limited to research on nurse groups and qualitative research on the experience and support needs based on experience and support scales. Future research needs to continue to expand and refine the groups，build a patient safety culture in medical institutions，improve non-punitive management systems，explore intervention tools and improved therapies based on group differences and study the implementation effects，promote more organizational support practices，and provide support and protection for workers’personal safety and mental health.

Key words：second victim；adverse events；patient safety；experience and support；organizational support needs

一直以來，患者安全是醫療服務的核心。在患者安全事件中，患者及其家屬是“第一受害者”，而作為“第二受害者”，涉及不良事件的醫務工作人員同樣也會遭受到身心創傷，出現緊張、焦慮、痛苦、憤怒等心理情緒。2000年，Wu最早提出“第二受害者”的概念，并將其定義為在患者安全事件中受到負面影響的醫務人員。……