ABSTRACT
INTRODUCTION: Second-victim phenomena may lead to severe reactions like depression or posttraumatic disorder, as well as dysfunction and absenteeism. Medical error as a cause for second victims is not limited to professionals, as family caregivers care for millions of patients at home. It remains unclear whether these are first, second, or double victims in case of error. This explorative study investigated whether second victim effects and signs of moral injury are detectable in family caregivers and whether existing instruments are applicable in lay persons. METHODS: In an open convenience sampling online survey, we recruited 66 German family caregivers. Propensity score matching was conducted to obtain a balanced sample of family caregivers and qualified nurses who took part in the previous study by adjusting for age and sex. The groups were compared regarding the German Version of the Second Victim Experience and Support Tool-Revised and the German version of the Moral Injury Symptom and Support Scale for Health Professionals. RESULTS: Sixty-six caregivers participated, of whom 31 completed the survey. Of all, 58% experienced a second victim-like effect, 35% experienced a prolonged effect, and 45% reported to still suffer from it. In a matched sample (22 family caregivers and 22 nurses), no significant differences were observed between the groups. DISCUSSION: Regarding the limitations of this pilot study, demanding for resampling in larger populations, we could show that second victim effects and moral injury are detectable in family caregivers by validated instruments and are not inferior to professionals' experiences. Concerning the demand for further studies, we confirmed the applicability of the testing instruments but with need for item reduction to lower response burden.
ABSTRACT
INTRODUCTION: The second victim phenomenon that occurs after critical events poses a serious factor for patient and workplace safety. These experiences can be evaluated using the Second Victim Experience and Support Tool (SVEST), originally in English, or the translated and validated Korean or Chinese versions. In 2020, a revised version was published (SVESTR) with the addition of resilience items. The aim of this study is the validation of the German version, the G-SVESTR, in a multiprofessional setting. METHODS: The G-SVESTR questionnaire was designed according to World Health Organization recommendations. This entails translation, test for face validity, back translation, pretest, expert panel evaluation, and a test in a large population for validity and reliability. We provided an anonymous online questionnaire to physicians, nurses, paramedics, medical assistants, and physician assistants to test our developed tool. Statistics were accomplished using XL-Stats. RESULTS: Altogether, 72% (306 of 428) of the participants completed the survey. The mean time for completion was 9.4 minutes. Physician assistants and medical assistants were significantly younger than other respondents. The analysis revealed satisfactory reliability (Cronbach α = 0.844). A principal component analysis showed 11 factors with eigenvalues greater than 1. Factor loading on distinct dimensions was satisfactory with one exception, the absenteeism item (item 31), which showed cross-loadings and poor factor loading on the absenteeism dimension. The results of the G-SVESTR revealed only some differences between the professional subgroups. CONCLUSION: The G-SVESTR is a valid and reliable testing instrument for the evaluation of second victim experiences in different medical professions.