第二受害者现象在医疗不良事件中的研究现状与本土化支持体系构建展望

Current Research Status of the Second Victim Phenomenon in Medical Adverse Events and Prospects for Building a Localized Support System

  • 摘要: 第二受害者现象是医疗不良事件中普遍存在却长期被忽视的隐性职业创伤。自“第二受害者”概念提出以来,国际相关研究已积累丰富的理论与实践经验,但我国起步较晚,仍面临认知偏差、制度缺失与资源不足等多重困境。本文系统梳理了第二受害者的定义演变、心理历程及其广泛影响,深入剖析我国医疗情境下第二受害者现象的独特诱因。在此基础上,整合国际经验,提出适合我国本土情境的“三层级精准支持体系”——涵盖普遍性预防、选择性支持与针对性治疗,并从政策保障、机构落实与个人能力3个维度构建实施路径与保障机制,以期为兼顾患者安全与医务人员福祉的本土化支持体系建设提供参考。

     

    Abstract: The second victim phenomenon represents a pervasive yet long-overlooked occupational trauma in medical adverse events. Since the introduction of the "second victim" concept, international research has accumulated substantial theoretical and practical experience. However, China started late in this field and still faces multiple challenges, including cognitive biases, institutional deficiencies, and resource constraints. This article systematically reviews the conceptual evolution of the second victim, the phased model of psychological recovery, and its multidimensional impacts, while thoroughly analyzing the unique contributing factors of this phenomenon within China's healthcare context. On this basis, and drawing on international experience, we propose a "three-tier precision support system" tailored to China's local circumstances—encompassing universal prevention, selective intervention, and targeted treatment—and construct implementation pathways and safeguarding mechanisms across three dimensions: policy support, institutional implementation, and individual capacity building. This framework is intended to serve as a reference for establishing a localized support system that balances patient safety with the well-being of healthcare professionals.

     

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