目的 深入了解护士在医疗质量不良事件中作为第二受害者的心理体验,为支持护士心理健康、改善工作体验提供依据。方法 采用描述现象学研究方法,以目的抽样法选择2024年1月至2025年1月在广州某三级甲等医院发生医疗不良事件的护士16名为研究对象,通过主题分析法对其撰写的反思日记进行分析,探究护士作为不良事件第二受害者的心理体验,并归纳提炼相关主题。结果 共获得情感负担、认知重构、安全实践意向强化和职业责任感重构4个主题和10个亚主题。结论 护士作为第二受害者的心理体验呈现多层次、多维度的复杂性;护理管理者应重视其心理健康问题,采取有效措施支持其心理恢复和职业发展。

Objective To gain an in-depth understanding of nurses' psychological experiences as second victims in medical adverse events,and to provide evidence for supporting nurses' mental health and improving their work experience. Methods A descriptive phenomenological approach was adopted.Sixteen nurses who had experienced medical adverse events at a Grade A tertiary hospital in Guangzhou from January 2024 to January 2025 were selected by purposive sampling.Thematic analysis was used to analyze the reflective journals written by these nurses,in order to explore their psychological experiences as second victims of adverse events and to extract relevant themes.Results Four themes and ten sub-themes were identified:emotional burden,cognitive reconstruction,strengthened intention for safe practice,and reconstruction of professional responsibility.Conclusions Nurses' psychological experiences as second victims are complex,characterized by multiple layers and dimensions. Nursing managers should attach importance to their mental health problems and take effective measures to support their psychological recovery and professional development.

R47

广东省医学科研基金(B2024261)