The impact of a PERMA model-based multi-component positive psychology group intervention on nurse second victims

This study aimed to explore the application effects of a multi-component positive psychological group intervention grounded in the PERMA model on anxiety, psychological capital, and support resource efficacy among nurse second victims.

This study was a single-center randomized controlled trial. A total of 86 nurses who had experienced adverse events and met the inclusion and exclusion criteria were recruited via convenience sampling from a Class A tertiary comprehensive hospital in Shandong Province between December 2025 and February 2026. After recruitment, participants were randomly assigned to the control group (n = 43) and the intervention group (n = 43) using a computer-generated random sequence concealed in sequentially numbered opaque envelopes. Due to sample attrition during the intervention, 42 nurses in the intervention group and 41 nurses in the control group ultimately completed the study. The intervention group received a 6-week multi-component positive psychology group intervention based on the PERMA model, whereas the control group received only routine hospital support. The Generalized Anxiety Disorder-7 (GAD-7), the Psychological Capital Questionnaire-R (PCQ-R), and the Second Victim Experience and Support Tool (SVEST) were adopted to evaluate outcomes before intervention, immediately after the intervention, and at the 3-month follow-up (T3). Data were analyzed using independent sample t-tests, repeated measures ANOVA, and chi-square tests.

Immediately after the intervention and at the 3-month follow-up, the intervention group exhibited significantly lower anxiety scores and second victim experience and support scores, as well as remarkably higher psychological capital scores compared with the control group (all p < 0.05).

The multi-component positive psychology group intervention based on the PERMA model can effectively alleviate anxiety among nurse second victims and enhance their internal psychological resources and capacity to utilize external support.