Isolde M Busch1, Francesca Moretti2, Marianna Purgato, Corrado Barbui, Albert W Wu3, Michela Rimondini1. 1. From the Section of Clinical Psychology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona. 2. Section of Hygiene and Preventive Medicine, Department of Diagnostic and Public Health, University of Verona. 3. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Abstract
OBJECTIVES: Despite the critical need to understand the diverse responses by second victims to adverse events, there has not been a meta-analysis examining coping by second victims. We aimed to analyze the coping strategies applied by second victims in the aftermath of adverse events. METHODS: We performed a systematic search of nine electronic databases up to October 2018 and screened additional sources, such as gray databases. Two independent reviewers conducted the search, selection process, quality appraisal, data extraction, and synthesis. In case of dissent, a third reviewer was involved to reach consensus. Quantitative studies of the frequency with which coping strategies were applied by second victims were eligible for inclusion. We calculated the overall frequency of coping strategies and I statistic using random effects modeling. RESULTS: Of 10,705 records retrieved, 111 full-text articles were assessed for eligibility and 14 studies eventually included. The five most frequent coping strategies were Changing work attitude (89%, 95% confidence interval [CI] = 80-94), Following policies and guidelines more accurately and closely (89%, 95% CI = 54-98), Paying more attention to detail (89%, 95% CI = 78-94) (task oriented), Problem-solving/concrete action plan (77%, 95% CI = 59-89) (task oriented), and Criticizing or lecturing oneself (74%, 95% CI = 47-90) (emotion oriented). CONCLUSIONS: Second victims frequently used task- and emotion-oriented coping strategies and, to a lesser degree, avoidance-oriented strategies. To better support second victims and ensure patient safety, coping strategies should be evaluated considering the positive and negative effects on the clinician's personal and professional well-being, relationships with patients, and the quality and safety of healthcare.
OBJECTIVES: Despite the critical need to understand the diverse responses by second victims to adverse events, there has not been a meta-analysis examining coping by second victims. We aimed to analyze the coping strategies applied by second victims in the aftermath of adverse events. METHODS: We performed a systematic search of nine electronic databases up to October 2018 and screened additional sources, such as gray databases. Two independent reviewers conducted the search, selection process, quality appraisal, data extraction, and synthesis. In case of dissent, a third reviewer was involved to reach consensus. Quantitative studies of the frequency with which coping strategies were applied by second victims were eligible for inclusion. We calculated the overall frequency of coping strategies and I statistic using random effects modeling. RESULTS: Of 10,705 records retrieved, 111 full-text articles were assessed for eligibility and 14 studies eventually included. The five most frequent coping strategies were Changing work attitude (89%, 95% confidence interval [CI] = 80-94), Following policies and guidelines more accurately and closely (89%, 95% CI = 54-98), Paying more attention to detail (89%, 95% CI = 78-94) (task oriented), Problem-solving/concrete action plan (77%, 95% CI = 59-89) (task oriented), and Criticizing or lecturing oneself (74%, 95% CI = 47-90) (emotion oriented). CONCLUSIONS: Second victims frequently used task- and emotion-oriented coping strategies and, to a lesser degree, avoidance-oriented strategies. To better support second victims and ensure patient safety, coping strategies should be evaluated considering the positive and negative effects on the clinician's personal and professional well-being, relationships with patients, and the quality and safety of healthcare.
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