NHS doctors who become second victims - an exploratory study.

IF 1.7 4区 医学 Q3 HEALTH POLICY & SERVICES
Donna M Willis, Joanna M Yarker, Rachel Lewis, Lilith Whiley
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Abstract

Purpose: This study aimed to understand the lived experience of UK NHS doctors who encountered second victim phenomenon following an adverse event and the role that medical leadership played in their trajectory.

Design/methodology/approach: Semi-structured interviews were conducted with eight NHS doctors. Data were analysed using Interpretative Phenomenological Analysis (IPA).

Findings: There emerged three superordinate themes describing the impact on the doctor, the perceptions of colleagues and the leadership support received.

Research limitations/implications: Although the small sample size is consistent with the chosen research methodology, it remains an acknowledged limitation. This study did not specifically aim to explore suicidality among NHS doctors; however, given the importance of this issue, further research is clearly warranted. While some protected characteristics were represented in the sample, they were not sufficiently prominent to influence the findings meaningfully. Consequently, there is scope to examine potential psychosocial differences among doctors. The first author's extensive NHS career may potentially introduce bias. Finally, future research should incorporate a longitudinal research design to assess the long-term impact of second victim phenomenon on doctors and the effectiveness of support interventions.

Practical implications: The paper makes three recommendations: (1) NHS organisations should establish locally led peer support or buddy programmes. Additionally, the organisation should strive to reduce psychological morbidity through candid and open discussions about prevalence. (2) When exhibiting signs of distress, burnout or other maladaptive coping strategies are observable, medical leaders should take compassionate and deliberate action. (3) Medical leaders must demonstrate collective responsibility for fostering cultures that learn from and support doctors in their darkest hour following an adverse event.

Originality/value: This study broadens the extant knowledge base regarding second victim phenomenon among doctors, particularly doctors in the NHS. A doctor's well-being and, consequently, patient safety are jeopardised by exposure to persistent, invisible distress. In the field of medicine, incivility, abusive supervision and poor organisational and team cultures exacerbate distress.

成为第二受害者的NHS医生——一项探索性研究。
目的:本研究旨在了解英国NHS医生在不良事件后遇到第二受害者现象的生活经历,以及医疗领导在他们的轨迹中所起的作用。设计/方法/方法:对8名NHS医生进行了半结构化访谈。数据分析采用解释现象学分析(IPA)。发现:出现了三个上级主题,描述了对医生的影响,同事的看法和得到的领导支持。研究局限性/启示:虽然小样本量与所选择的研究方法一致,但它仍然是一个公认的局限性。这项研究并没有专门探讨NHS医生的自杀行为;然而,鉴于这个问题的重要性,进一步的研究显然是必要的。虽然样本中有一些受保护的特征,但它们不够突出,无法对研究结果产生有意义的影响。因此,有可能检查医生之间潜在的社会心理差异。第一作者广泛的NHS职业生涯可能会引入偏见。最后,未来的研究应纳入纵向研究设计,以评估第二受害者现象对医生的长期影响和支持干预措施的有效性。实际意义:论文提出了三个建议:(1)NHS组织应该建立地方领导的同伴支持或伙伴计划。此外,该组织应通过坦率和公开地讨论患病率,努力减少心理发病率。(2)当观察到患者表现出痛苦、倦怠或其他适应不良的应对策略时,医疗领导者应采取富有同情心和深思熟虑的行动。(3)医疗领导者必须表现出集体责任,培养在不良事件发生后最黑暗的时刻向医生学习并给予支持的文化。原创性/价值:本研究拓宽了现有的知识基础,关于第二受害者现象的医生,特别是在NHS的医生。医生的健康以及病人的安全都受到持续的、看不见的痛苦的威胁。在医学领域,不文明、滥用监管以及糟糕的组织和团队文化加剧了痛苦。
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来源期刊
CiteScore
3.20
自引率
7.10%
发文量
72
期刊介绍: ■International health and international organizations ■Organisational behaviour, governance, management and leadership ■The inter-relationship of health and public sector services ■Theories and practices of management and leadership in health and related organizations ■Emotion in health care organizations ■Management education and training ■Industrial relations and human resource theory and management. As the demands on the health care industry both polarize and intensify, effective management of financial and human resources, the restructuring of organizations and the handling of market forces are increasingly important areas for the industry to address.
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