Second victim experiences among Austrian nonphysician emergency medical services personnel : A cross-sectional analysis of symptom burden and associated factors.

Abstract

Background: Second victim experiences have been described across health professions but evidence for Austrian prehospital emergency medical services (EMS) remains limited. This study assessed the prevalence, key events and factors associated with high symptom burden among Austrian nonphysician emergency medical services personnel.

Methods: We conducted a cross-sectional study within the Second Victims in German-speaking Countries (SeViD) research program using the standardized SeViD questionnaire among Austrian nonphysician EMS personnel. The SeViD-A4 denotes the fourth Austrian study within this program and does not refer to a separate questionnaire. Second victim status was recorded dichotomously and symptom burden was dichotomized for univariate analyses and multivariable binary logistic regression. The questionnaire included demographic and occupational variables, second victim experience, key event category, support after the key event, recovery, symptom reactions, support preferences and 10-item Big Five Inventory (BFI-10) personality dimensions.

Results: A total of 1171 questionnaires were included and 60.1% of the respondents identified as second victims. Among participants with a second victim experience and valid key event data (n = 704), the most common key events were unexpected patient death or patient suicide (41.8%) and aggression by patients or relatives (18.8%). The multivariable complete case analysis included 698 participants, of whom 336 had high symptom burden. High symptom burden was associated with neuroticism (odds ratio, OR 1.44), openness (OR 1.21), patient volume per 100 additional patients per quarter (OR 1.14), professional compared with volunteer EMS work (OR 1.52), and lack of support despite seeking help (OR 5.98). Self-reported male gender was associated with lower odds of high symptom burden (OR 0.62).

Conclusion: Second victim experiences were frequent in this nationwide Austrian convenience sample. High symptom burden was associated with individual, workload-related, employment-related and support-related factors. Low-threshold peer support and structured follow-up represent plausible organizational targets but their effectiveness requires prospective evaluation.