Mediating Effects of Coping Style Between Nurse Second Victim Burnout and Hospital Patient Safety Culture in Patient Suicides.

Aim: To explore the relationship and current status of coping styles, burnout, and hospital patient safety culture in patient suicide incidents. To examine whether nurse second victim coping styles in patient suicide incidents mediate the relationship between hospital patient safety culture and burnout.

Design: A cross-sectional study. The collection of information was carried out during the same period of time.

Methods: The study recruited a sample of 425 nurses, second victims who had experienced patient suicides from 6 tertiary grade A hospitals (Shanxi, China). The General Information Questionnaire, the Coping Styles Scale, the Burnout Scale, and the Hospital Patient Safety Climate Scale were used to gather data. The Pearson correlation analysis was used to study the correlation among the 3, one-way ANOVA or independent samples t tests were used to compare differences in second victim burnout among nurses with different characteristics, and the model 4 in process was employed to establish structural equation modeling and test the influence paths of hospital patient safety culture, coping styles, and burnout.

Results: In this study, the patient safety culture score of hospital patients was (134.43±4.84), which was at a medium level; the coping score was (68.70±4.94), which was at a medium level, with positive coping score (23.03±2.94), negative coping score (22.12±2.66), and problem solving score (23.55±3.10), which was at a high level. The burnout score is (71.19±3.83), which is at a high level. Hospital patient safety culture was positively correlated with coping styles (r=0.458, P<0.001) and negatively correlated with burnout (r=-0.754, P<0.001), and coping styles were negatively correlated with burnout (r=-0.356, P<0.001). In the mediation models, the mediating effect of coping styles between hospital patient safety culture and burnout was -0.26, which accounted for 40.63% of the total effect.

Conclusions: A good hospital patient safety culture can improve the coping styles of nurse second victims and also reduce the burnout of nurse second victims. Hospital patient safety culture not only has a direct effect on burnout, but also indirectly affects burnout through coping styles, and reduces burnout by improving their coping styles; hospitals and administrators should take a variety of interventions to improve nurse second victims' coping styles and enhance hospital patient safety culture to reduce burnout.