| Healthcare workers suffer physical and psychological impairments after experiencing or witnessing a medical error injury suffered by a patient,named second victim incident.The second victim incident will lead to sleep quality declining.In this study,we conduct an in-depth analysis of the relationship between the second victim incident and sleep quality,while exploring the mediation mechanism of rumination.We will use a self-made general questionnaire,a second victim experience and support scale(SVEST),a ruminative response scale,and a Pittsburgh Sleep Quality Index Scale(PSQI),using a convenient sampling method to survey 634 healthcare works,and using SPSS26.0 for data analysis and PROCESS plug-ins for mediating effect testing.Study 1 analyzes the demographic variables of second victim incident,rumination and sleep quality;Study 2 explores the relationship among the three dimensions and the mediation mechanism of rumination;Study 3 uses a qualitative research method to conduct semi-structured interviews with the 18 second victims to understand the specific process,t,dynamic psychological changes,and the impact on sleep quality.The main results are as follows:(1)52.37%of the participants say that they have witnessed the second victim incidents experienced by other people.36.28%of the participants say they have personally experienced;the total SVEST score is(85.79±11.37)in which psychological distress is(3.62±0.92)and tendency to leave is(3.26±0.91)rank first and second respectively,which indicates that psychological pain and the degree of separation are higher;non-work support(2.35±0.80)scores are the lowest,indicating that social support is mainly obtained through relatives and friend;The incident rate of sleep problems in nurse is 42.16%,and the rate in doctors is 41.57%.(2)①The second victim incident have significant differences between various marriages and frequency of the incident experiences.The second victim experience has the significant differences in different occupations,ages,marriages,witnessing experiences,personal experiences.The second victim support has significant differences in various occupations,ages.The second victim outcome has significant differences in the total frequency of second victim incident experiences.②Rumination has significant differences in marriages,personal experiences.③The sleep quality has the significant differences in ages,marriages,witnessing experiences,personal experiences and the number of experiences.(3)Mediation effect test finds that rumination plays a partial mediating effect in the second victim incident and the sleep quality,accounting for 48.84%of the total effect,which indicates that the second victim incidents have two pathways to affect the sleep quality,one is the direct effect to the sleep quality,the other is through the mediation of rumination.(4)The findings from the test taken respectively in three dimensions of the second victim incident show that:①Rumination has a complete mediation effect between the second victim experience and the sleep quality,accounting for 66.30%of the total effect.②Rumination has no significant mediation effect on the second victim support and the sleep quality.③Rumination has a suppression effect between the second victim outcome and the sleep quality.Therefore,the mediation effects of rumination all come from the dimension of the second victim experience(5)Four themes were summarized after interviews,namely negative physical-mental experiences,cognitive rumination and behavioral compulsion,social support lack,and inner desires.The findings suggest that the second victim’s main pain is psychological distress,followed by a tendency to leave;the social support received is mainly from non-work support..The hospital management department should pay attention to the second victims,help reduce rumination,and thus decreasing the impact on sleep quality. |
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