Navigating Recovery After Medical Adverse Events: The Role of Social Support and Cognitive Reappraisal in Second...

Healthcare providers involved in a medical adverse event, referred to as second victims, frequently suffer negative psychological distress. However, little was known about the post-traumatic growth of this population from a positive perspective.

To examine the level of post-traumatic growth among second victims of medical adverse events and to explore the factors associated with this growth.

A multisite, cross-sectional study.

Four tertiary hospitals in Changsha city, Hunan province, China.

A final sample of 237 medical staff who had been exposed to and reported at least one prior adverse event previously participated in the survey from July to October 2022.

Utilizing a two-stage stratified random sampling technique, participants were recruited to complete an online survey measuring sociodemographic characteristics, post-traumatic growth, perceived social support, and emotion regulation strategies. Multivariable linear regression analysis was conducted to identify significant correlates of post-traumatic growth.

Of the 237 valid respondents, 71.31% were nurses and 40.08% experienced a level III adverse event (resulting in no patient harm). The average total score for post-traumatic growth was 2.53 ± 1.26. The mean scores for each dimension were 2.66 ± 1.31 for personal strength, 2.66 ± 1.22 for appreciation of life, 2.54 ± 1.22 for relating to others, 2.43 ± 1.24 for new possibilities, and 2.32 ± 1.28 for spiritual change. Support from significant others, cognitive reappraisal, workplace environment, less severe adverse event, younger age, shorter length of employment, and an introverted personality type were significantly associated with post-traumatic growth.

Second victims of medical adverse events demonstrated low-to-moderate levels of post-traumatic growth. Perceived support from significant others and the use of cognitive reappraisal strategies are key factors associated with positive psychological changes among health care providers following an adverse event.

Nurse managers should prioritize hospital-based, institutional support mechanisms rather than relying solely on second victims' personal relationships. This includes implementing structured peer-support systems, conducting formal debriefing, and cultivating a nonpunitive organizational culture of psychological safety to foster post-traumatic growth following adverse clinical events.