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Article(id=1322924525146485371, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322924415817757501, articleNumber=null, orderNo=null, doi=10.12102/j.issn.1009-6493.2026.17.005, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1760371200000, receivedDateStr=2025-10-14, revisedDate=1779120000000, revisedDateStr=2026-05-19, acceptedDate=null, acceptedDateStr=null, onlineDate=1793339385543, onlineDateStr=2026-10-30, pubDate=1788969600000, pubDateStr=2026-09-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339385543, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339385543, creator=13701087609, updateTime=1793339385543, updator=13701087609, issue=Issue{id=1322924415817757501, tenantId=1146029695717560320, journalId=1220038315760373764, year='2026', volume='40', issue='17', pageStart='2961', pageEnd='3152', issueExtLink='null', onlineDate='null', pubDate='1788969600000', pubDateStr='2026-09-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793339359478, creator='13701087609', updateTime=1793343089343, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322940060072542250, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322924415817757501, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322940060072542251, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322924415817757501, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=2990, endPage=2998, ext={EN=ArticleExt(id=1322924525377172092, articleId=1322924525146485371, tenantId=1146029695717560320, journalId=1220038315760373764, language=EN, title=Trajectory of psychological stress changes and influencing factors in nurses as second victims following adverse nursing events, columnId=1220689484526572183, journalTitle=Chinese Nursing Research, columnName=Original Articles, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the trajectory of psychological stress changes and its influencing factors in nurses as second victims following adverse nursing events,aiming to provide references for healthcare institutions and managers to accurately identify key intervention populations and to develop more targeted support strategies.

Methods

A purposive sampling method was used to select 178 nurses who had experienced adverse nursing events from three tertiary first-class hospitals in Shandong province.Surveys were conducted using a general information questionnaire,the Perceived Stress Scale,the Second Victim Experience and Support Scale,and the Connor-Davidson Resilience Scale at four time points:upon reporting the adverse event(T1),and at 1 month(T2),2 months (T3),and 3 months (T4) post-event.Latent class growth modeling was employed to identify latent categories of psychological stress change trajectories.The Logistic regression analysis was used to examine influencing factors.

Results

The psychological stress change trajectories of nurse second victims were classified into three categories:moderate-level slow-decline group(51.7%),high-level rapid-decline group(16.3%),and low-level slow-decline group(32.0%).Logistic regression analysis revealed that department type,whether the adverse event involved a verification error,nurse resilience,and second victim experience and support were significant influencing factors for the trajectory of psychological stress change(all P<0.05).

Conclusions

The psychological stress changes in nurse second victims exhibit three distinct trajectories,indicating population heterogeneity.Targeted interventions can be developed based on the group characteristics and influencing factors of these stress change trajectories,enabling nurses to receive effective psychological and emotional support following adverse events.

, authors=Yunmei WANG, Haiyan LIU, Hui CHEN, Hongying LIU, authorsList=Yunmei WANG, Haiyan LIU, Hui CHEN, Hongying LIU, authorCompany=null, correspAuthors=Haiyan LIU, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322924527566598783, articleId=1322924525146485371, tenantId=1146029695717560320, journalId=1220038315760373764, language=CN, title=护理不良事件中第二受害者护士心理压力变化轨迹及影响因素, columnId=1220689484681761433, journalTitle=护理研究, columnName=科研论著, runingTitle=null, highlight=null, articleAbstract=
目的

探究护理不良事件中护士作为第二受害者心理压力变化轨迹及影响因素，旨在为医疗机构和管理者精准识别重点干预人群、制定更具针对性的干预支持提供参考。

方法

采用目的抽样法，选取山东省某3所三级甲等医院178名发生护理不良事件的护士为研究对象，采用一般资料调查表、压力知觉量表、第二受害者经历及支持量表和心理弹性量表在护理人员接到不良事件报告时（T1）及事件发生后1个月（T2）、2个月（T3）、3个月（T4）4个时间点进行调研，通过潜变量增长模型识别其心理压力变化轨迹的潜在类别，Logistic回归分析其影响因素。

结果

护士第二受害者心理压力变化轨迹分为中水平缓慢下降组（51.7%）、高水平快速下降组（16.3%）、低水平缓慢下降组（32.0%）。Logistic回归分析显示，所在科室、不良事件是否涉及查对失误、心理弹性及第二受害者经历与支持是护士第二受害者心理压力变化轨迹的影响因素（均P<0.05）。

结论

护士第二受害者心理压力变化分为3种不同的变化轨迹，其心理压力变化存在群体异质性；可根据护士经历不良事件后的心理压力变化轨迹的群体特质及影响因素制定针对性的干预措施，使护士在经历不良事件后能够得到有效的心理和情感支持。

, authors=王云梅, 刘海燕*, *, 陈慧, 刘红英, authorsList=王云梅, 刘海燕, 陈慧, 刘红英, authorCompany=null, correspAuthors=刘海燕, authorNote=

王云梅，主管护师，硕士研究生

, correspAuthorsNote=
刘海燕，E-mail：
LIU Haiyan, E-mail:
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journalId=1220038315760373764, articleId=1322924525146485371, companyId=1322924527856005760, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1临沂市人民医院，山东 276000)])], figs=[ArticleFig(id=1322924531685405349, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322924525146485371, language=EN, label=Figure 1, caption=Latent class trajectories of nurses' perceived stress changes, figureFileSmall=36kcqKsQeRORjtRKXY46Tw==, figureFileBig=kJ1K10mWeIL6CZqD6Z3F+w==, tableContent=null), ArticleFig(id=1322924531777680038, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322924525146485371, language=CN, label=图1, caption=护士压力知觉变化潜在类别轨迹图, figureFileSmall=36kcqKsQeRORjtRKXY46Tw==, figureFileBig=kJ1K10mWeIL6CZqD6Z3F+w==, tableContent=null), ArticleFig(id=1322924531949646503, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322924525146485371, language=EN, label=Table 1, caption=

General information of research subjects and relevant information on adverse events(n=178)

, figureFileSmall=null, figureFileBig=null, tableContent=
变量分类人数百分比(%)变量分类人数百分比(%)
性别女17397.191不良事件类型意外事件116.180
男52.809标本事件158.427
年龄<30岁6435.955用药错误63.371
30~40岁10257.303管路滑脱4927.528
>40岁126.742跌倒或坠床4223.596
第一学历中专168.989身份识别错误137.303
专科10558.989输液事件158.427
本科及以上5732.022院内压力性损伤73.933
最高学历专科及以下84.494其他2011.236
本科及以上17095.506以往发生不良事件次数0次4223.596
职称护士2514.0451次8547.753
护师6838.2022次3117.416
主管护师8145.506>2次2011.236
副主任护师及以上42.247本次不良事件级别Ⅱ级或Ⅰ级2413.483
有无配偶有12972.472Ⅲ级12871.910
无4927.528Ⅳ级2614.607
是否育有子女否5530.899病人家属是否理解否31.685
是12369.101是15184.831
每周工作时间<40 h6033.708未告知家属2413.483
40~50 h9050.562责任程度无责任158.427
>50 h2815.730次要责任8748.876
用工形式非正式在编11866.292主要责任6838.202
正式在编6033.708不明确84.494
所在科室妇产科/儿科2514.045科室层级调查分析否1810.112
急危重症科2815.730是16089.888
外科4826.966科片层级调查分析否9653.933
内科6134.270是8246.067
其他168.989护理部层级调查分析否8246.067
事件是否涉及查对失误否14380.337是9653.933
是3519.663医院是否有效调查处理否137.303
病人伤害程度无伤害13475.281是16592.697
轻度伤害2614.607是否经历不同程度处罚否13173.596
中度伤害及以上1810.112是4726.404
), ArticleFig(id=1322924532025143976, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322924525146485371, language=CN, label=表1, caption=

护理人员的一般资料及不良事件的相关资料（n=178）

, figureFileSmall=null, figureFileBig=null, tableContent=
变量分类人数百分比(%)变量分类人数百分比(%)
性别女17397.191不良事件类型意外事件116.180
男52.809标本事件158.427
年龄<30岁6435.955用药错误63.371
30~40岁10257.303管路滑脱4927.528
>40岁126.742跌倒或坠床4223.596
第一学历中专168.989身份识别错误137.303
专科10558.989输液事件158.427
本科及以上5732.022院内压力性损伤73.933
最高学历专科及以下84.494其他2011.236
本科及以上17095.506以往发生不良事件次数0次4223.596
职称护士2514.0451次8547.753
护师6838.2022次3117.416
主管护师8145.506>2次2011.236
副主任护师及以上42.247本次不良事件级别Ⅱ级或Ⅰ级2413.483
有无配偶有12972.472Ⅲ级12871.910
无4927.528Ⅳ级2614.607
是否育有子女否5530.899病人家属是否理解否31.685
是12369.101是15184.831
每周工作时间<40 h6033.708未告知家属2413.483
40~50 h9050.562责任程度无责任158.427
>50 h2815.730次要责任8748.876
用工形式非正式在编11866.292主要责任6838.202
正式在编6033.708不明确84.494
所在科室妇产科/儿科2514.045科室层级调查分析否1810.112
急危重症科2815.730是16089.888
外科4826.966科片层级调查分析否9653.933
内科6134.270是8246.067
其他168.989护理部层级调查分析否8246.067
事件是否涉及查对失误否14380.337是9653.933
是3519.663医院是否有效调查处理否137.303
病人伤害程度无伤害13475.281是16592.697
轻度伤害2614.607是否经历不同程度处罚否13173.596
中度伤害及以上1810.112是4726.404
), ArticleFig(id=1322924532100641449, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322924525146485371, language=EN, label=Table 2, caption=

Scores of PSS，SVEST，CD-RISC at different time points（x±s,n=178）

, figureFileSmall=null, figureFileBig=null, tableContent=
时间压力知觉心理弹性第二受害者经历及支持
T141.657±7.02961.112±14.00364.865±12.374
T239.230±6.68761.820±13.34361.775±11.296
T338.090±6.82965.545±13.42157.994±13.997
T436.770±6.40766.528±13.88355.652±14.197
), ArticleFig(id=1322924532176138922, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322924525146485371, language=CN, label=表2, caption=

护士不同时间点压力知觉、心理弹性、第二受害者经历及支持得分（x±s,n=178）

, figureFileSmall=null, figureFileBig=null, tableContent=
时间压力知觉心理弹性第二受害者经历及支持
T141.657±7.02961.112±14.00364.865±12.374
T239.230±6.68761.820±13.34361.775±11.296
T338.090±6.82965.545±13.42157.994±13.997
T436.770±6.40766.528±13.88355.652±14.197
), ArticleFig(id=1322924532239053483, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322924525146485371, language=EN, label=Table 3, caption=

Correlation between perceived stress and psychological resilience,second victim experience,and support(r value)

, figureFileSmall=null, figureFileBig=null, tableContent=
时间项目压力知觉
T1T2T3T4
T1心理弹性-0.742①
第二受害者经历与支持0.384①
T2心理弹性-0.623①
第二受害者经历与支持0.293①
T3心理弹性-0.236①
第二受害者经历与支持0.655①
T4心理弹性-0.128
第二受害者经历与支持0.679①
), ArticleFig(id=1322924532327133868, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322924525146485371, language=CN, label=表3, caption=

压力知觉与心理弹性、第二受害者经历及支持相关性（r值）

, figureFileSmall=null, figureFileBig=null, tableContent=
时间项目压力知觉
T1T2T3T4
T1心理弹性-0.742①
第二受害者经历与支持0.384①
T2心理弹性-0.623①
第二受害者经历与支持0.293①
T3心理弹性-0.236①
第二受害者经历与支持0.655①
T4心理弹性-0.128
第二受害者经历与支持0.679①
), ArticleFig(id=1322924532402631341, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322924525146485371, language=EN, label=Table 4, caption=

Fit indices of LGCM for nurses' perceived stress scores

, figureFileSmall=null, figureFileBig=null, tableContent=
类别LLRAICBICaBICEntropyP类别概率
LMRTBLMT
1-2 366.9904 745.9704 765.0614 746.060
2-2 202.6604 423.3194 451.9554 423.4530.8180.098<0.0010.483/0.517
3-2 034.7904 093.5764 131.7584 093.7550.972<0.001<0.0010.517/0.163/0.320
4-1 988.0604 006.1154 053.8414 006.3380.9730.116<0.0010.511/0.287/0.039/0.163
5-1 966.9303 969.8584 027.1303 970.1270.8960.116<0.0010.163/0.225/0.315/0.258/ 0.040
), ArticleFig(id=1322924532457157294, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322924525146485371, language=CN, label=表4, caption=

护士压力知觉得分LGCM模型拟合指标

, figureFileSmall=null, figureFileBig=null, tableContent=
类别LLRAICBICaBICEntropyP类别概率
LMRTBLMT
1-2 366.9904 745.9704 765.0614 746.060
2-2 202.6604 423.3194 451.9554 423.4530.8180.098<0.0010.483/0.517
3-2 034.7904 093.5764 131.7584 093.7550.972<0.001<0.0010.517/0.163/0.320
4-1 988.0604 006.1154 053.8414 006.3380.9730.116<0.0010.511/0.287/0.039/0.163
5-1 966.9303 969.8584 027.1303 970.1270.8960.116<0.0010.163/0.225/0.315/0.258/ 0.040
), ArticleFig(id=1322924532528460463, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322924525146485371, language=EN, label=Table 5, caption=

Parameter estimation results of LGCM for nurses' perceived stress

, figureFileSmall=null, figureFileBig=null, tableContent=
类别项目估计值标准误P
类别1截距42.4480.329<0.001
斜率-1.6890.141<0.001
类别2截距52.4290.293<0.001
斜率-2.0030.108<0.001
类别3截距33.7090.519<0.001
斜率-1.2170.285<0.001
), ArticleFig(id=1322924532599763632, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322924525146485371, language=CN, label=表5, caption=

护士压力感知的LGCM模型参数估计

, figureFileSmall=null, figureFileBig=null, tableContent=
类别项目估计值标准误P
类别1截距42.4480.329<0.001
斜率-1.6890.141<0.001
类别2截距52.4290.293<0.001
斜率-2.0030.108<0.001
类别3截距33.7090.519<0.001
斜率-1.2170.285<0.001
), ArticleFig(id=1322924532662678193, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322924525146485371, language=EN, label=Table 6, caption=

Univariate analysis of factors influencing the perceived stress trajectory categories among nurses

, figureFileSmall=null, figureFileBig=null, tableContent=
变量分类中水平缓慢下降组（n=92）高水平快速下降组（n=29）低水平缓慢下降组（n=57）χ2值P
性别女90(97.826)28(96.552)55(96.491)0.2830.710
男2(2.174)1(3.448)2(3.509)
年龄<30岁28(30.435)10(34.483)26(45.614)
30~40岁55(59.783)19(65.517)28(49.123)6.7840.148
>40岁9(9.783)0(0.000)3(5.263)
第一学历中专11(11.957)0(0.000)5(8.772)
专科54(58.696)21(72.414)30(52.632)5.9420.204
本科及以上27(29.348)8(27.586)22(38.596)
最高学历专科及以下3(3.261)1(3.448)4(7.018)1.2450.536
本科及以上89(96.739)28(96.552)53(92.982)
职称护士9(9.783)2(6.897)14(24.561)7.1290.296
护师32(34.783)12(41.379)24(42.105)
主管护师48(52.174)15(51.724)18(31.579)
副主任护师及以上3(3.261)0(0.000)1(1.754)
有无配偶有72（78.261）21（72.414)36(63.158)4.0240.134
无20（21.739）8(27.586)21(36.842)
是否育有子女否22(23.913)9(31.034)24(42.105)5.4560.065
是70(76.087)20(68.966)33(57.895)
每周工作时间<40 h25(27.174)10(34.483)25(43.860)
40~50 h49(53.261)15(51.724)26(45.614)5.2400.264
>50 h18(19.565)4(13.793)6(10.526)
用工形式非正式在编63(68.478)17(58.621)38(66.667)0.9640.618
正式在编29(31.522)12(41.379)19(33.333)
所在科室妇产科/儿科13(14.130)8(27.586)4(7.018)21.5410.006
急危重症科9(9.783)10(34.483)9(15.789)
外科26(28.261)7(24.138)15(26.316)
内科35(38.043)3(10.345)23(40.351)
其他9(9.783)1(3.448)6(10.526)
不良事件类型意外事件5(5.435)1(3.448)5(8.772)21.6840.154
标本事件10(10.870)0(0.000)5(8.772)
用药错误4(4.348)2(6.897)0(0.000)
管路滑脱21(22.826)9(31.034)19(33.333)
跌倒或坠床23(25.000)9(31.034)10(17.544)
身份识别错误7(7.609)4(13.793)2(3.509)
输液事件9(9.783)2(6.897)4(7.018)
院内压力性损伤1(1.087)2(6.897)4(7.018)
其他12(13.043)0(0.000)8(14.035)
是否涉及差对失误否67(72.826)21(72.414)55(96.491)13.854<0.001
是25(27.174)8(27.586)2(3.509)
以往发生不良事件次数0次21(22.826)4(13.793)17(29.825)9.2860.158
1次42(45.652)12(41.379)31(54.386)
2次18(19.565)8(27.586)5(8.772)
>2次11(11.957)5(17.241)4(7.018)
本次不良事件级别Ⅱ级或Ⅰ级10(10.870)9(31.034)5(8.772)
Ⅲ级75(81.522)18(62.069)35(61.404)23.779<0.001
Ⅳ级7(7.609)2(6.897)17(29.825)
病人伤害程度无伤害72(78.261)18(62.069)44(77.193)
轻度伤害14(15.217)2(6.897)10(17.544)17.4010.002
中度伤害及以上6(6.522)9(31.034)3(5.263)
病人家属是否理解否2(2.174)1(3.448)0(0.000)
是78(84.783)24(82.759)49(85.965)1.6770.795
未告知家属12(13.043)4(13.793)8(14.035)
责任程度无责任1(1.087)0(0.000)14(24.561)33.095<0.001
次要责任45(48.913)17(58.621)25(43.860)
主要责任42(45.652)12(41.379)14(24.561)
不明确4(4.348)0(0.000)4(7.018)
科室层级调查分析否12(13.043)2(6.897)4(7.018)1.8000.407
是80(86.957)27(93.103)53(92.982)
科片层级调查分析否49(53.261)18(62.069)29(50.877)1.0040.605
是43(46.739)11(37.931)28(49.123)
护理部层级调查分析否45(48.913)16(55.172)21(36.842)3.2200.200
是47(51.087)13(44.828)36(63.158)
医院是否有效调查处理否9(9.783)1(3.448)3(5.263)1.8220.402
是83(90.217)28(96.552)54(94.737)
是否经历不同程度处罚否65(70.652)23(79.310)43(75.439)0.9970.607
是27(29.348)6(20.690)14(24.561)
), ArticleFig(id=1322924532738175666, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322924525146485371, language=CN, label=表6, caption=

护士压力知觉轨迹类别影响因素的单因素分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量分类中水平缓慢下降组（n=92）高水平快速下降组（n=29）低水平缓慢下降组（n=57）χ2值P
性别女90(97.826)28(96.552)55(96.491)0.2830.710
男2(2.174)1(3.448)2(3.509)
年龄<30岁28(30.435)10(34.483)26(45.614)
30~40岁55(59.783)19(65.517)28(49.123)6.7840.148
>40岁9(9.783)0(0.000)3(5.263)
第一学历中专11(11.957)0(0.000)5(8.772)
专科54(58.696)21(72.414)30(52.632)5.9420.204
本科及以上27(29.348)8(27.586)22(38.596)
最高学历专科及以下3(3.261)1(3.448)4(7.018)1.2450.536
本科及以上89(96.739)28(96.552)53(92.982)
职称护士9(9.783)2(6.897)14(24.561)7.1290.296
护师32(34.783)12(41.379)24(42.105)
主管护师48(52.174)15(51.724)18(31.579)
副主任护师及以上3(3.261)0(0.000)1(1.754)
有无配偶有72（78.261）21（72.414)36(63.158)4.0240.134
无20（21.739）8(27.586)21(36.842)
是否育有子女否22(23.913)9(31.034)24(42.105)5.4560.065
是70(76.087)20(68.966)33(57.895)
每周工作时间<40 h25(27.174)10(34.483)25(43.860)
40~50 h49(53.261)15(51.724)26(45.614)5.2400.264
>50 h18(19.565)4(13.793)6(10.526)
用工形式非正式在编63(68.478)17(58.621)38(66.667)0.9640.618
正式在编29(31.522)12(41.379)19(33.333)
所在科室妇产科/儿科13(14.130)8(27.586)4(7.018)21.5410.006
急危重症科9(9.783)10(34.483)9(15.789)
外科26(28.261)7(24.138)15(26.316)
内科35(38.043)3(10.345)23(40.351)
其他9(9.783)1(3.448)6(10.526)
不良事件类型意外事件5(5.435)1(3.448)5(8.772)21.6840.154
标本事件10(10.870)0(0.000)5(8.772)
用药错误4(4.348)2(6.897)0(0.000)
管路滑脱21(22.826)9(31.034)19(33.333)
跌倒或坠床23(25.000)9(31.034)10(17.544)
身份识别错误7(7.609)4(13.793)2(3.509)
输液事件9(9.783)2(6.897)4(7.018)
院内压力性损伤1(1.087)2(6.897)4(7.018)
其他12(13.043)0(0.000)8(14.035)
是否涉及差对失误否67(72.826)21(72.414)55(96.491)13.854<0.001
是25(27.174)8(27.586)2(3.509)
以往发生不良事件次数0次21(22.826)4(13.793)17(29.825)9.2860.158
1次42(45.652)12(41.379)31(54.386)
2次18(19.565)8(27.586)5(8.772)
>2次11(11.957)5(17.241)4(7.018)
本次不良事件级别Ⅱ级或Ⅰ级10(10.870)9(31.034)5(8.772)
Ⅲ级75(81.522)18(62.069)35(61.404)23.779<0.001
Ⅳ级7(7.609)2(6.897)17(29.825)
病人伤害程度无伤害72(78.261)18(62.069)44(77.193)
轻度伤害14(15.217)2(6.897)10(17.544)17.4010.002
中度伤害及以上6(6.522)9(31.034)3(5.263)
病人家属是否理解否2(2.174)1(3.448)0(0.000)
是78(84.783)24(82.759)49(85.965)1.6770.795
未告知家属12(13.043)4(13.793)8(14.035)
责任程度无责任1(1.087)0(0.000)14(24.561)33.095<0.001
次要责任45(48.913)17(58.621)25(43.860)
主要责任42(45.652)12(41.379)14(24.561)
不明确4(4.348)0(0.000)4(7.018)
科室层级调查分析否12(13.043)2(6.897)4(7.018)1.8000.407
是80(86.957)27(93.103)53(92.982)
科片层级调查分析否49(53.261)18(62.069)29(50.877)1.0040.605
是43(46.739)11(37.931)28(49.123)
护理部层级调查分析否45(48.913)16(55.172)21(36.842)3.2200.200
是47(51.087)13(44.828)36(63.158)
医院是否有效调查处理否9(9.783)1(3.448)3(5.263)1.8220.402
是83(90.217)28(96.552)54(94.737)
是否经历不同程度处罚否65(70.652)23(79.310)43(75.439)0.9970.607
是27(29.348)6(20.690)14(24.561)
), ArticleFig(id=1322924532822061747, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322924525146485371, language=EN, label=Table 7, caption=

Multivariate analysis of factors influencing the perceived stress trajectory categories among nurses

, figureFileSmall=null, figureFileBig=null, tableContent=
分类项目回归系数标准误Z值POR值95%CI
下限上限
中水平缓慢下降组是否涉及查对失误（否）-3.5581.109-3.210<0.0010.0280.0030.250
心理弹性-0.1570.028-5.600<0.0010.8550.8090.903
高水平快速下降组所有科室（妇产科/儿科）4.4691.5002.9800.00387.2694.6111 651.652
是否涉及查对失误（否）-4.2661.398-3.0500.0020.0140.0010.217
心理弹性-0.3560.061-5.840<0.0010.7010.6220.789
第二受害者经历与支持0.1660.0553.0000.0031.1801.0591.315
), ArticleFig(id=1322924532893364916, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322924525146485371, language=CN, label=表7, caption=

护士压力知觉轨迹类别影响因素的多因素分析

, figureFileSmall=null, figureFileBig=null, tableContent=
分类项目回归系数标准误Z值POR值95%CI
下限上限
中水平缓慢下降组是否涉及查对失误（否）-3.5581.109-3.210<0.0010.0280.0030.250
心理弹性-0.1570.028-5.600<0.0010.8550.8090.903
高水平快速下降组所有科室（妇产科/儿科）4.4691.5002.9800.00387.2694.6111 651.652
是否涉及查对失误（否）-4.2661.398-3.0500.0020.0140.0010.217
心理弹性-0.3560.061-5.840<0.0010.7010.6220.789
第二受害者经历与支持0.1660.0553.0000.0031.1801.0591.315
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护理不良事件中第二受害者护士心理压力变化轨迹及影响因素
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王云梅 , 刘海燕 *, * , 陈慧 , 刘红英
护理研究 | 科研论著 2026,40(17): 2990-2998
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护理研究 |科研论著 2026 , 40 (17) : 2990 -2998
护理不良事件中第二受害者护士心理压力变化轨迹及影响因素
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王云梅, 刘海燕*, * , 陈慧, 刘红英
作者信息
  • 1临沂市人民医院，山东 276000
通讯作者:
刘海燕，E-mail：
LIU Haiyan, E-mail:
作者简介:

王云梅，主管护师，硕士研究生

Trajectory of psychological stress changes and influencing factors in nurses as second victims following adverse nursing events
Yunmei WANG, Haiyan LIU , Hui CHEN, Hongying LIU
Affiliations
  • 1Linyi People's Hospital, Shandong 276000 China
出版时间: 2026-09-10 doi: 10.12102/j.issn.1009-6493.2026.17.005
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摘要
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目的

探究护理不良事件中护士作为第二受害者心理压力变化轨迹及影响因素，旨在为医疗机构和管理者精准识别重点干预人群、制定更具针对性的干预支持提供参考。

方法

采用目的抽样法，选取山东省某3所三级甲等医院178名发生护理不良事件的护士为研究对象，采用一般资料调查表、压力知觉量表、第二受害者经历及支持量表和心理弹性量表在护理人员接到不良事件报告时（T1）及事件发生后1个月（T2）、2个月（T3）、3个月（T4）4个时间点进行调研，通过潜变量增长模型识别其心理压力变化轨迹的潜在类别，Logistic回归分析其影响因素。

结果

护士第二受害者心理压力变化轨迹分为中水平缓慢下降组（51.7%）、高水平快速下降组（16.3%）、低水平缓慢下降组（32.0%）。Logistic回归分析显示，所在科室、不良事件是否涉及查对失误、心理弹性及第二受害者经历与支持是护士第二受害者心理压力变化轨迹的影响因素（均P<0.05）。

结论

护士第二受害者心理压力变化分为3种不同的变化轨迹，其心理压力变化存在群体异质性；可根据护士经历不良事件后的心理压力变化轨迹的群体特质及影响因素制定针对性的干预措施，使护士在经历不良事件后能够得到有效的心理和情感支持。

护理不良事件  /  第二受害者  /  心理压力  /  变化轨迹  /  潜类别增长模型  /  影响因素  /  纵向研究
Objective

To explore the trajectory of psychological stress changes and its influencing factors in nurses as second victims following adverse nursing events,aiming to provide references for healthcare institutions and managers to accurately identify key intervention populations and to develop more targeted support strategies.

Methods

A purposive sampling method was used to select 178 nurses who had experienced adverse nursing events from three tertiary first-class hospitals in Shandong province.Surveys were conducted using a general information questionnaire,the Perceived Stress Scale,the Second Victim Experience and Support Scale,and the Connor-Davidson Resilience Scale at four time points:upon reporting the adverse event(T1),and at 1 month(T2),2 months (T3),and 3 months (T4) post-event.Latent class growth modeling was employed to identify latent categories of psychological stress change trajectories.The Logistic regression analysis was used to examine influencing factors.

Results

The psychological stress change trajectories of nurse second victims were classified into three categories:moderate-level slow-decline group(51.7%),high-level rapid-decline group(16.3%),and low-level slow-decline group(32.0%).Logistic regression analysis revealed that department type,whether the adverse event involved a verification error,nurse resilience,and second victim experience and support were significant influencing factors for the trajectory of psychological stress change(all P<0.05).

Conclusions

The psychological stress changes in nurse second victims exhibit three distinct trajectories,indicating population heterogeneity.Targeted interventions can be developed based on the group characteristics and influencing factors of these stress change trajectories,enabling nurses to receive effective psychological and emotional support following adverse events.

nursing adverse event  /  second victim  /  psychological stress  /  change trajectory  /  latent class growth model  /  influencing factor  /  longitudinal study
王云梅, 刘海燕, 陈慧, 刘红英. 护理不良事件中第二受害者护士心理压力变化轨迹及影响因素. 护理研究, 2026 , 40 (17) : 2990 -2998 . DOI: 10.12102/j.issn.1009-6493.2026.17.005
Yunmei WANG, Haiyan LIU, Hui CHEN, Hongying LIU. Trajectory of psychological stress changes and influencing factors in nurses as second victims following adverse nursing events[J]. Chinese Nursing Research, 2026 , 40 (17) : 2990 -2998 . DOI: 10.12102/j.issn.1009-6493.2026.17.005
正文
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护理不良事件是指在护理过程中的发生的、与常规治疗护理所产生的预期结果不相符的，或未预料到的非正常事件[1]。第二受害者是因经历不良事件、医疗错误后而遭受心理或躯体伤害的医务人员[2]。相关研究显示，由于工作任务繁重、人员配备不足以及操作过程中容易受到干扰等原因，护士更容易受到病人安全事件的影响，因此比其他专业人员更容易成为第二受害者[3-4]。在经历护理不良事件后，护士往往会出现一系列复杂的负面情绪困扰，包括自我质疑、内疚感、懊恼、难以释怀等，这些情绪压力可能发展为焦虑、抑郁等心理问题[5]，只要出现1种症状，即可认定为第二受害者;文献显示第二受害者发生率为10.4%~84.3%[6]，这对其身心健康和职业发展易造成长期且深远的影响。目前，我国关于护士第二受害者心理状态的研究多为横断面调查，针对其心理状态的纵向变化及其异质性研究较少。因此,本研究旨在追踪调查第二受害者护士心理压力的变化，并通过潜变量增长模型识别其变化轨迹类别，分析其影响因素，以期为早期识别重点干预人群、制定干预支持体系提供依据和参考。
1　对象与方法
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1.1　对象
采用目的抽样法，在山东省3所三级甲等医院中选择2023年12月—2024年10月发生护理不良事件的在职护士作为研究对象。纳入标准：取得有效执业资格证书的在职在岗护士；亲身经历护理不良事件；对本次调查知情同意且自愿参与。排除标准：进修护士、实习护士、见习护士、规范化培训护士；调研期间工作或生活中发生重大变故；调研期间再次发生护理不良事件。脱落标准：因各种因素导致的失访及退出研究；无法参与相关问卷的填写及数据采集。根据单样本重复设计样本含量估计表[7]，本研究设计对每名护士进行4次重复测量，选用平均相关系数p=0.05，效应值f=0.14，α=0.05，在保证1-β=0.8的条件下，需调查样本量142例，考虑15%失访率，最少需纳入研究对象163人。本研究获得医院科研伦理委员会批准（审批号：202401-H-007），调查对象均签署知情同意书。
1.2　调查工具
1.2.1　一般资料调查表
包括护士一般资料调查表及不良事件相关资料调查表，由研究者自行编制。一般资料包括护士的年龄、性别、职称、学历、专业、有无配偶、用工形式、每周工作时间等；不良事件相关资料包括以往发生护理不良事件的次数、本次发生的不良事件类型、病人伤害程度、病人及家属是否理解、不良事件的级别、责任程度等。
1.2.2　压力知觉量表（Perceived Stress Scale，PSS）
采用杨廷忠等[8]依照我国的文化背景进行汉化形成的量表。此量表有紧张感和失控感2个维度，共14个条目。采用Likert5点计分，其中条目4~条目7、条目9、条目10和条目13为反向计分。1分表示从来没有，2分表示几乎没有，3分表示有时，4分表示经常，5分表示总是，得分越高说明感知到的压力越大。该量表总体及紧张感、失控感维度的Cronbach's α系分别为0.75，0.82，0.88，Spearman-Brown系数为0.78,Guttman折半信度系数为0.78。本研究中Cronbach's α系数为0.793。目前该量表已被广泛应用于青少年[9]、大学生[10]、病人[11]、医护人员[12]等不同群体压力水平的评估，结果均表明其结构效度良好[13]。
1.2.3　第二受害者经历及支持量表(The Second Victim Experience and Support Tool，SVEST)
采用陈娇娇[14]的汉化版量表进行测量，该量表涉及心理困扰、生理困扰、执业困扰3个困扰维度及同事支持、管理支持、亲友支持3个支持维度，共24个条目。采用Likert 5级计分，非常不同意计1分，非常同意计5分，其中困扰维度为正向计分，支持维度为反向计分，总分120分，得分越高表示护士经历医疗不良事件后得到的支持越不足，量表Cronbach's α系数为0.805。本研究中Cronbach's α系数为0.865。
1.2.4　心理弹性量表（Connor-Davidson Resilience Scale，CD-RISC）
采用Yu等[15]修订版的量表，此量表有力量性、坚韧性和乐观性3个维度、25个条目。采用Likert5级计分，“从来不”计0分，“一直如此”计4分，条目得分相加为量表总分，总分为0~100分，分值越大说明心理弹性水平越高，量表Cronbach's α系数为0.945。本研究中Cronbach's α系数为0.943。
1.3　资料收集方法
本研究4个调查时间点分别为在接到不良事件上报时(T1)、事件发生后1个月(T2)、2个月(T3)、3个月(T4)。由研究者本人进行问卷调查和随访，调查前向研究对象解释本研究目的及意义，获取研究对象知情同意，并对研究对象进行登记编号，记录事件发生日间、调研时间，为后续调研提供提醒。T1时间点通过问卷星收集一般资料、第二受害者经历及支持量表、心理弹性量表和压力知觉量表。T2~T4时间点通过问卷星追踪调查第二受害者经历及支持量表、心理弹性量表和压力知觉量表。
1.4　质量控制
1.4.1　研究设计阶段
阅读国内外第二受害者相关文献制定研究方案草稿；咨询统计学专家样本量计算与统计方法可行性，征询护理管理专家及临床护理专家意见形成初稿；开展预试验，梳理需调整项目汇总表并再次征集专家意见；综合预试验结果与专家建议修改完善方案，形成终稿。
1.4.2　实施阶段
数据调研前，调研人员熟悉研究内容与工具；调研时向研究对象说明研究目的、意义及配合过程，获得研究对象同意后添加微信并备注编号与初次调研时间；研究对象填写问卷有疑问时调研人员随时解答。
1.4.3　数据处理阶段
调查者编码问卷后用Excel汇总整理，数据核对录入由2人负责以确保准确完整，数据收集完成后请统计学专家指导数据处理与统计分析。
1.5　统计学方法
使用SPSS 29.0及Mplus 8.3软件进行统计学分析，定性资料采用频数、百分比（%）描述；正态分布的定量资料采用均数±标准差（x±s）描述。采用重复测量方差分析T1~T4时间点的压力知觉得分、第二受害者经历及支持得分以及心理弹性得分。采用Pearson相关分析法对T1~T4时间点的压力知觉得分与第二受害者经历及支持得分、心理弹性得分进行相关性分析。选择潜变量增长模型（latent growth curve models，LGCM）探究护理人员发生不良事件后T1~T4时间点心理压力变化轨迹的异质性亚组。采用卡方检验和单因素方差分析，对压力知觉亚组群影响因素进行单因素分析。采用多分类Logistics回归分析，对PSS亚组群影响因素进行多因素分析。检验标准为α=0.05。
2　结果
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2.1　护理人员一般资料及不良事件相关资料
本研究共纳入209名护士，其中失访31人，失访率为14.8%，其中T1调查时失访5人，T2失访7人，T3失访13人、T4失访6人；失访原因为主动退出、失联及再次发生护理不良事件，比较完成随访者与失访者的基线心理压力评分差异无统计学意义（P>0.05）。本研究共178名护士全程参与4次随访调查，护理人员一般资料及不良事件相关资料见表1。
2.2　护士不同时间点压力知觉、心理弹性、第二受害者经历及支持得分及相关性
本研究采用Pearson分析法分析变量间的相关性。结果显示，压力知觉在T1、T2、T3时间点与心理弹性呈负相关（P<0.05），在T4时间点相关性无统计学意义（P>0.05）；压力知觉与第二受害者经历及支持在T1、T2、T3、T4呈正相关（P<0.05），详见表2和表3。
2.3　护士压力知觉变化轨迹类别的识别
为了进一步识别护士压力知觉水平变化的群体异质性，采用LGCM对护士4个时间点压力知觉水平进行分析，依次提取1~5个类别；结果显示，3个类别为最佳模型，见表4和图1。根据LGCM模型参数估计结果的截距和斜率（见表5），对3个潜类别进行命名。类别1：初始得分42.448分，属于中等水平，随时间变化呈缓慢下降趋势（斜率估计值为-1.689，P<0.01），命名为“中水平缓慢下降组”；类别2：初始得分52.429分，处于最高水平，随时间变化下降明显（斜率估计值为-2.003，P<0.01），命名为“高水平快速下降组”；类别3：初始得分33.709分，3个类别中最低，随时间变化下降缓慢（斜率估计值为-1.217，P<0.01），命名为“低水平缓慢下降组”。
2.4　护士压力知觉轨迹类别的影响因素
2.4.1　单因素分析
根据LGCM确定的压力知觉亚组群，对护理人员压力知觉亚组群的一般资料和不良事件相关资料因素进行差异性检验，结果显示，所在科室、不良事件是否涉及查对失误、不良事件级别、病人伤害程度、责任程度方面在3个类别间差异有统计学意义（P<0.05），见表6。
2.4.2　多因素分析
将单因素分析中有统计学意义且不存在多重共线性的变量纳入多分类Logistic回归模型，以“低水平缓慢下降组”为参照，Logistic回归分析结果显示，非查对错误护士相较于涉及查对失误的护士，进入中水平缓慢下降组的风险更低（P<0.001）。心理弹性越高，护理人员进入中水平缓慢下降组的风险越低（P<0.001）。妇产儿科护士进入高水平快速下降组的风险高于低水平缓慢下降组护士（P=0.003）。非查对错误护士相较于涉及查对失误的护士，进入高水平快速下降组的风险更低（P=0.002）。第二受害者经历与支持得分越高，护理人员进入高水平快速下降组的风险越高（P=0.003）。心理弹性得分越高，护理人员进入高水平快速下降组的风险越低（P<0.001）。见表7。本研究Entropy=0.972，最小类别平均后验概率=0.976，两步法的分类不确定性偏倚已降至最低，结果可靠性较高。
3　讨论
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3.1　护士作为第二受害者心理压力变化存在群体异质性
本研究结果显示，护士经历护理不良事件后T1~T4时间点压力知觉变化有中水平缓慢下降组、高水平快速下降组、低水平缓慢下降组3种轨迹，反映了护士心理压力的不同变化趋势。其中，中水平缓慢下降组初始得分介于其他2个类别之间，随时间推移下降，占比较高（51.7%），说明护士在经历不良事件后心理压力增加，但随着时间推移，加上个人情绪宣泄、认知重构和自我接纳等心理适应过程后，会逐渐减轻自责感，心理压力水平缓慢降低，这与曹娜等[16]的研究结果相似。高水平快速下降组初始得分最高，虽下降速度较其他2个类别快，但各时间段得分均高于其他2个类别，占16.3%（29人）。从创伤后成长理论看，护士在经历不良事件后，可能在事件处理过程中实现积极心理改变，如专业能力增强、经验更加丰富、人际关系深化等[17]。护士初始压力最高，随后的快速下降可能部分反映了其对不良事件的初步适应与认知整合，以及通过事件处置、同事支持等途径启动了成长过程。积极变化虽已发生，但其压力水平在后续调研中仍维持在较高水平。根据二次应激和创伤模型，不良事件本身即可能构成直接创伤，而事后对事件的回顾复盘、讨论、分析以及后续整改措施落实及跟进，均可能使护士反复暴露于创伤情境中，从而引发或延续二次创伤[18]。高水平快速下降组护士初始高分提示其直接创伤反应强烈，虽经干预快速缓解，但若其工作环境中持续存在创伤性刺激（如处理类似事件、担心复发、面对病人后续状况），或内心持续进行责任归因与反刍，则可能导致压力反应的慢性化。护士压力水平长期高于其他组的表现，可能正是直接创伤与后续职业环境中潜在二次创伤源共同作用的结果，反映出其心理负荷并未随时间彻底消散，而是转化为一种持续较高的背景压力。因此，针对高水平快速下降组护士，建议建立“直接创伤干预+二次创伤防控”双轨支持机制，除即时心理疏导外，优化复盘流程以减少创伤暴露，定期监测压力水平并提供持续心理支持，阻断压力慢性化。护士自身亦需强化心理调适、主动寻求支持、提升专业能力并深化对安全事件的认知，以协同应对心理压力挑战。
3.2　护士作为第二受害者心理压力变化轨迹的影响因素
3.2.1　所在科室
本研究结果显示，妇产科/儿科护士进入高水平快速下降组的风险高于低水平缓慢下降组护士，说明妇产儿科的护理人员压力感知相对要高，本研究结果与张虹等[19]的一项质性研究结果一致，这与妇产儿科工作特性有关。产妇分娩过程不确定性大，从产程不顺到产后出血等紧急状况频发，要求护士迅速精准应对，使其长期精神紧绷。儿科护理对象多为儿童，难以准确表达不适，护士需细致观察判断，且儿童病情变化快、难预测，进一步加重心理负担，致使妇产儿科护士压力感知高，更易进入高水平快速下降组。另有研究指出，不同科室的护理人员面临的工作压力和挑战不同，发生不良事件后其压力表现会有差异。例如，精神科护士在经历不良事件后，因病人失控或存在攻击性行为，该科室护士的心理困扰程度较高[20]。另外，急危重症科室护士因日常工作中频繁处理紧急且复杂的病人，如果发生不良事件可能面临更为严峻的压力环境[21-22]。提示护理管理者在不良事件发生后应充分考虑各科室的工作特点，制定个性化的压力管理和支持措施。
3.2.2　事件类型因素
以往相关研究多聚焦于护理不良事件的常规分类对护士心理压力的影响[23-24]，而本研究则进一步深入探究了“是否涉及查对失误”这一特定因素的作用。研究结果显示，涉及查对失误的护理人员压力感知较高，可能与护士作为查对环节的直接执行者，在责任划分上往往承担着重要责任，一旦发生查对失误，不仅容易引发病人及家属的质疑和投诉[25]，还可能进一步发展为医疗纠纷。这不仅影响了护士的职业形象，对医疗机构的声誉也可能造成损害有关[26]。因此，查对相关的护理不良事件可能对护理人员的心理压力和自信心产生更为显著的负面影响。鉴于此，建议医院管理者强化各环节查对培训及考核管理，引入信息化与智能化技术手段以提供支持，完善事件应对与纠纷处理机制，同时推行非惩罚性安全文化，聚焦系统改进而非个人追责；护士自身需提高安全意识和慎独精神，同时增强心理调适，化失误为成长动力。
3.2.3　心理弹性
本研究结果显示，心理弹性越高，护理人员的压力感知水平越低，对中水平缓慢下降组及高水平快速下降组具有预测效应，表明护士心理弹性水平越低，应对压力的能力越弱，压力感知越显著。刘思含等[27]的研究指出，充分的支持体系能够增强护士的心理弹性，而心理弹性的提升则有助于护士克服护理不良事件所带来的心理困扰，这一观点与本研究结果相契合。彭莉等[28]的研究也发现，护士在经历不良事件后，若其心理弹性水平较高，其创伤后的成长水平也相应较高。这些研究结果与本研究相互印证，共同强调了提升护士心理弹性对于增强其压力应对能力及促进个人成长的重要意义。因此，建议医疗机构开展正念、积极心理学等专项培训，培育鼓励分享、共情互助以及从逆境中汲取成长力量的团队文化，通过定期组织复盘会、心理韧性工作坊及同伴支持小组活动等形式，系统提升护士心理弹性，形成“经历-反思-成长”的良性循环。
3.2.4　支持因素
本研究显示，第二受害者经历与支持水平越高，护理人员的压力感知越低，对中水平缓慢下降组及高水平快速下降组具有预测效应。杨紫燕[29]的研究指出，对第二受害者实施积极的支持干预，包括提供危机应对指导和心理支持，能够有效改善其心理困扰状况。此外，Khansa等[30]的研究也表明，绝大多数受访者（85.1%）认为来自同伴的支持对他们产生了积极影响，有助于减轻身心方面的困扰。这些研究结果与本研究相互印证，强调了支持干预对于缓解护士压力的重要性。因此，针对支持因素对护士压力感知的影响，建议管理者构建多层次支持干预体系，比如制定差异化危机应对手册，提供适配性指导；系统培训与赋能一线医护人员，形成可持续互助生态；设立分级心理支持通道，如建立科室同伴支持小组，以提供及时支持，设幸福力咨询工作室，由专业咨询师提供心理调适等深度咨询，在医院心理门诊由资深精神心理科医生针对严重心理困扰给予疏导治疗，满足多样化需求等。将支持干预纳入医院人文建设范畴，营造多维度支持文化，有助于有效降低第二受害者心理压力感知水平。
4　小结
收起
本研究通过纵向追踪揭示了护士作为第二受害者经历不良事件后心理压力变化的3种异质性轨迹，其中高水平快速下降组虽呈现快速缓解趋势，但其压力水平在3个月内持续高于其他2个类别，提示该群体存在压力慢性化的潜在风险。研究进一步表明，科室类别、涉及查对失误的护士进入高压力轨迹的风险增加，而心理弹性和有效的第二受害者支持则是重要的保护性因素。这些发现不仅深化了对第二受害者心理动态过程的理解，也为实施精准、分层的心理支持干预提供了实证依据。建议未来开展历时更久、更具延续性的纵向追踪研究，以进一步揭示压力的长期演变机制，并在实践中构建整合科室特点、事件性质、个体韧性培育与系统性支持于一体的综合干预体系。

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2026年第40卷第17期
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doi: 10.12102/j.issn.1009-6493.2026.17.005
  • 接收时间：2025-10-14
  • 首发时间：2026-10-30
  • 出版时间：2026-09-10
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  • 收稿日期：2025-10-14
  • 修回日期：2026-05-19
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    1临沂市人民医院，山东 276000

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Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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