护理不良事件中第二受害者护士心理压力变化轨迹及影响因素OA

Objective:To explore the trajectory of psychological stress changes and its influencing factors in nurses as second victims following adverse nursing events,aiming to provide references for healthcare institutions and managers to accurately identify key intervention populations and to develop more targeted support strategies.Methods:A purposive sampling method was used to select 178 nurses who had experienced adverse nursing events from three tertiary first-class hospitals in Shandong province.Surveys were conducted using a general information questionnaire,the Perceived Stress Scale,the Second Victim Experience and Support Scale,and the Connor-Davidson Resilience Scale at four time points:upon reporting the adverse event(T1),and at 1 month(T2),2 months(T3),and 3 months(T4)post-event.Latent class growth modeling was employed to identify latent categories of psychological stress change trajectories.The Logistic regression analysis was used to examine influencing factors.Results:The psychological stress change trajectories of nurse second victims were classified into three categories:moderate-level slow-decline group(51.7%),high-level rapid-decline group(16.3%),and low-level slow-decline group(32.0%).Logistic regression analysis revealed that department type,whether the adverse event involved a verification error,nurse resilience,and second victim experience and support were significant influencing factors for the trajectory of psychological stress change(all P<0.05).Conclusions:The psychological stress changes in nurse second victims exhibit three distinct trajectories,indicating population heterogeneity.Targeted interventions can be developed based on the group characteristics and influencing factors of these stress change trajectories,enabling nurses to receive effective psychological and emotional support following adverse events.