Abstract：Objective To explore the second victim experiences of nurses in medical adverse events and its impact on job insecurity.Methods There were 283 second victim nurses selected from 3 tertiary hospitals from a city from June to August 2022 with convenience sampling method. The basic information questionnaire, Chinese version of the Second Victim Experience and Support Tool and Job Insecurity Scale were used in the investigation.Results The average score of the second victim's experience and support was （73.35±16.49）, among which the average score of distress subscale was （41.42±11.12） and that of support subscale was （31.38±6.35）. The average score of job insecurity items was （2.98±0.77）, among which the average score of job quality insecurity items was （3.21±0.82）, and the average score of job quantity insecurity items was （2.68±0.70）. Multiple linear regression analysis showed that gender and secondvictim distress affected the job insecurity of clinical nurses. The way of employment affected the job quantity insecurity of clinical nurses. Second victim experience and support influenced overall job insecurity of clinical nurses.Conclusion Nursing managers should pay attention to the influence of adverse events on the second victim nurses, especially male nurses, and formulate support and management programs from the risk management, organizational support, emotional guidance and other levels, eliminate the concerns about influence of adverse events on career development, and reduce their job insecurity.
陈菲菲，缪大宏，徐洋洋. 医疗不良事件后临床护士第二受害者经历与支持对工作不安全感的影响[J]. 中国医院统计, 2022, 29(6): 459-465.
Chen Feifei， Miao Dahong， Xu Yangyang. Experience and support of secondary victims of clinical nurses after adverse medical events and the impact on job insecurity. journal1, 2022, 29(6): 459-465.
［1］韩怡茹，何剑琴．医疗不良事件中第二受害者的国内外研究现状与启示［J］．中华医院管理杂志，2018，34(10)：877-880．DOI: 10.3760/cma.j.issn.10006672.2018.10.021.
［2］韩燕，钱一平，侯学媛，等．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［J］．中华现代护理杂志，2020，26(4)：486-490．DOI: 10.3760/cma.j.issn.1674-2907.2020.04.011.
［3］张纪豪，郭舒婕，李永鑫．工作不安全感对护士心理健康的影响：工作倦怠与组织支持的作用［J］．中国临床心理学杂志，2017，25(6)：1152-1155．DOI: 10.16128/j.cnki.1005-3611.2017.06.034.
［4］于晨晨．企业员工工作不安全感研究［D］．南京：南京师范大学，2010．DOl:10.7666/d．y1726807.
［5］董甜甜，陈维政，陈玉玲．组织变革、群体工作不安全感与组织绩效［J］．财经问题研究，2019(11)：129-136．DOI: 10.19654/j.cnki.cjwtyj.2019.11.016.
［6］陈少雄，郑秀慧．医疗安全不良事件的原因分析与管理对策［J］．中国现代医生，2018，56(15)：143-145．
［7］陈娇娇，杨巧，赵庆华，等．中文版第二受害者经历与支持测评量表信度效度检验［J］．中国护理管理，2019，19(7)：991-995．DOI: 10.3969/j.issn.1672-1756.2019.07.008.
［8］BURLISON J D, SCOTT S D, BROWNE E K, et al. The second victim experience and support tool: Validation of an organizational resource for assessing second victim effects and the quality of support resources［J］. J Patient Saf, 2017, 13(2):93-102. DOI: 10.1097/PTS.0000000000000129.
［9］HELLGREN J, SVERKE M, ISAKSSON K. A twodimensional approach to job insecurity: Consequences for employee attitudes and wellbeing［J］. Eur J Work Organ Psychol, 1999, 8(2):179-195. DOI: 10.1080/135943299398311.
［10］王慧卿，王舒扬，刘东明．不同用工形式护士工作不安全感与工作投入关系研究［J］．中国医院管理，2016，36(3)：74-76．
［11］BUSCH I M, MORETTI F, PURGATO M, et al. Psychological and psychosomatic symptoms of second victims of adverse events: A systematic review and meta-analysis［J］. J Patient Saf, 2020, 16(2):e61-e74. DOI: 10.1097/PTS.0000000000000589.
［12］GUPTA K, LISKER S, RIVADENEIRA N A, et al. Decisions and repercussions of second victim experiences for mothers in medicine: SAVE DR MoM［J］. BMJ Qual Saf, 2019, 28(7):564-573. DOI: 10.1136/bmjqs-2018-008372.
［13］陈娇娇．第二受害者经历与支持测评量表的汉化及应用［D］．重庆：重庆医科大学，2020．
［14］张平娜．护理不良事件中护士作为第二受害者的心理体验［J］．中国城乡企业卫生，2020，35(9)：157-159．DOI: 10.16286/j.1003-5052.2020.09.061.
［15］陈娇娇，杨巧，赵庆华，等．患者安全事件中护士作为第二受害者的经历与支持现状［J］．中华护理杂志，2020，55(6)：894-899．DOI: 10.3761/j.issn.0254-1769.2020.06.019.
［16］徐晶，顾岩，陈荣凤．医疗不良事件中护士成为第二受害者体验的质性研究［J］．卫生职业教育，2018，36(15)：116-118．
［17］RAFTER N, HICKEY A, CONDELL S, et al. Adverse events in healthcare: Learning from mistakes［J］. QJM, 2015, 108(4):273-277. DOI: 10.1093/qjmed/hcu145.
［18］ULLSTRM S, ANDREEN SACHS M, HANSSON J, et al. Suffering in silence: A qualitative study of second victims of adverse events［J］. BMJ Qual Saf, 2014, 23(4):325-331. DOI: 10.1136/bmjqs-2013-002035.
［19］魏静，唐蕾，姜燕，等．儿科护士作为第二受害者的感知及影响因素分析［J］．中华现代护理杂志，2020，26(13)：1764-1768．DOI: 10.3760/cma.j.cn115682-20191012-03658.
［20］翟云霄，丁舒，游兆媛．患者安全事件中第二受害者相关支持系统研究进展［J］．中华现代护理杂志，2020，26(19)：2640-2644．DOI: 10.3760/cma.j.cn115682-20190823-03038.
［21］张克标，古满平，夏利华．男护士职业认知调查及对男护生护理职业教育的启示［J］．护理学杂志，2015，30(23)：55-57．DOI: 10.3870/j.issn.1001-4152.2015.23.055.
［22］胡曼曼．护士职业认知的性别差异研究［D］．蚌埠：蚌埠医学院，2019．
［23］樊婧，张红菊，卓娜，等．男护士职业认知现状分析及对策［J］．中国实用医药，2012，7(23)：267-268．DOI: 10.14163/j.cnki.11-5547/r.2012.23.065.
［24］潘世华，孙慧敏，陈贵儒．医务人员作为第二受害者的临床表现及影响因素的研究进展［J］．中华现代护理杂志，2020，26(25)：3539-3543．DOI: 10.3760/cma.j.cn11568220190914-03331.
［25］景雪冰，刘红，房晓杰，等．危重症专科护士工作压力源、心理资本与职业生涯相关性研究［J］．护理研究，2016，30(27)：3348-3351．DOI: 10.3969/j.issn.1009-6493.2016.27.008.
［26］程瑶．合同制护士工作不安全感的研究进展与设想［J］．护理管理杂志，2009，9(6)：29-31．DOI: 10.3969/j.issn.1671-315X.2009.06.013.
［27］李洪灵．某医院合同制护士离职原因调查现状及分析［J］．天津护理，2019，27(6)：732-734．DOI: 10.3969/j.issn.1006-9143.2019.06.031.
［28］杨小爱．公立医院合同聘用制护士管理［J］．合作经济与科技，2017(16)：124-125．DOI: 10.13665/j.cnki.hzjjykj.2017.16.053.
