Factors Associated With Second Victim Experiences and Outcomes Among Clinical Nurses in South Korea: A...

This study aimed to examine the associations of incident-related factors (severity, reporting, disclosure), individual factors (grit), and organizational factors (speaking-up climate) with second victim experiences and outcomes among clinical nurses. A cross-sectional online survey was conducted as part of the SAFETY project. Data were analyzed from 518 clinical nurses who had directly experienced patient safety incidents within the preceding 6 months. Linear regression analyses were performed to identify factors associated with second victim experiences and outcomes. Second victim experiences and outcomes were associated with incident-related, individual, and organizational factors. Second victim distress increased with greater incident severity and higher patient-oriented intrinsic motivation, and decreased with higher levels of psychological safety. Negative job-related outcomes increased with resignation toward speaking up and decreased with sustained professional interest and psychological safety. Incident disclosure was associated with reduced psychological distress, whereas the effects of incident reporting varied across outcome groups. To mitigate second victim distress and negative job-related outcomes, the findings underscore the importance of establishing structured institutional frameworks that promote supportive organizational cultures and system-level interventions, alongside strategies to strengthen individual self-care capacity.