医疗不良事件第二受害者心理历程模型建构  

The psychological process of second victims in medical adverse events

作　　者：陈晓娟[1] 王一平[2] 曾素兰 王彬郦 王华[5] 刘腊梅 高辉 CHEN Xiaojuan;WANG Yiping;ZENG Sulan;WANG Bingli;WANG Hua;LIU Lamei;GAO Hui(Surgical Anesthesiology Department,the First People’s Hospital of Ziyang,Ziyang,Sichuan 641300,P.R.China;West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China;Nursing Department,the First People’s Hospital of Ziyang,Ziyang,Sichuan 641300,P.R.China;Endocrinology Department,the First People’s Hospital of Ziyang,Ziyang,Sichuan 641300,P.R.China;Neurology Department,the First People’s Hospital of Ziyang,Ziyang,Sichuan 641300,P.R.China;Rehabilitation Department,the First People’s Hospital of Ziyang,Ziyang,Sichuan 641300,P.R.China;Gastroenterology Department,the First People’s Hospital of Ziyang,Ziyang,Sichuan 641300,P.R.China)

机构地区：[1]资阳市第一人民医院手术麻醉科,四川资阳641300 [2]四川大学华西医院,成都610041 [3]资阳市第一人民医院护理部,四川资阳641300 [4]资阳市第一人民医院内分泌科,四川资阳641300 [5]资阳市第一人民医院神经内科,四川资阳641300 [6]资阳市第一人民医院康复科,四川资阳641300 [7]资阳市第一人民医院消化内科,四川资阳641300

出　　处：《华西医学》2021年第7期913-918,共6页West China Medical Journal

基　　金：四川省医学科研青年创新课题计划(Q18012)。

摘　　要：目的研究医疗不良事件第二受害者在发生不良事件后的心理历程及需求,为医疗机构对医疗不良事件第二受害者的心理干预策略提供参考。方法2019年4月—7月,采用质性研究法对资阳市第一人民医院医疗不良事件的第二受害者进行半结构式深度访谈。运用Colaizzi法进行分析、整理并提炼主题。结果共访谈22名医疗不良事件第二受害者。医疗不良事件第二受害者经历负性情感体验,寻求情感支持的愿望迫切。其心理历程主要涉及5个阶段:恐惧期、焦虑期、抑郁期、愧疚期、回归期;在经历不良事件过程中,来自内外部的良性情感支持对回归有积极作用,负性或缺乏情感支持对回归产生消极作用。结论医疗不良事件第二受害者的情感体验具有相对阶段性,受内外部因素影响呈现不同的回归结局。医院管理者需要采取积极的应对措施,建立医疗不良事件发生后的组织情感支持机制,帮助减少心身伤害,从而提高医疗质效。Objective To explore the psychological process and needs of the second victims of medical adverse events after the occurrence of adverse events,so as to provide reference for the psychological intervention strategies of medical institutions for the second victims of medical adverse events.Methods The second victims of medical adverse events in the First People’s Hospital of Ziyang were selected from April to July 2019.Qualitative research method was used to conduct semi-structured in-depth interviews with the second victims.Colaizzi method was used to analyze the transcripts through reading and rereading,coding,and thematizing.Results A total of 22 second victims of medical adverse events were interviewed.The second victims of medical adverse events experienced negative emotional experience,and the desire to seek emotional support was urgent.The psychological process of the second victims of medical adverse events mainly involved five stages:fear,anxiety,depression,guilt and recovery.Emotional support had a positive effect on regression.Conversely,negative or lack of emotional support had a negative effect on regression.Conclusions The emotional experience of the second victims of medical adverse events is relatively staged,and the recovery and regression are greatly affected by internal and external factors.Hospital administrators should take active measures and establish an emotional support mechanism for adverse events in order to reduce psychosomatic injuries and improve medical quality and efficiency.

关 键 词：医疗不良事件 第二受害者 心理历程 情感体验 质性研究 

分 类 号：R197.32[医药卫生—卫生事业管理]