سامانه همایش های دانشگاه آزاد اسلامی واحد نجف آباد

صفحه اصلی / اولین همایش بین المللی تحول خدمات سلامت: تلفیق مراقبت، درمان، بازتوانی و امیدبخشی

Second Victim Experiences and Support Systems Among Nurses in Low- and Middle-Income Countries: A Scoping Review

نویسندگان :

Ali Safdari¹ Mohsen Soleimani² Ali Asghar Ghods Ali Asghar Ghods³

1- دانشگاه علوم پزشکی سمنان 2- دانشگاه علوم پزشکی سمنان 3- دانشگاه علوم پزشکی سمنان

کلمات کلیدی :

Psychological Trauma،Nurses،Developing Countries،Scoping review

چکیده :

Background: The second victim phenomenon captures the psychological trauma, compromised clinical self-efficacy, and professional disruption experienced by healthcare providers following inadvertent involvement in adverse clinical events. While extensively mapped across high-resource health systems, the scope, depth, and institutional response to this phenomenon remain poorly synthesized in low- and middle-income countries (LMICs), settings perpetually burdened by chronic staffing shortages, overwhelming workloads, and fragile safety climates. This scoping review aimed to systematically chart existing evidence on second victim experiences, associated psychological and occupational sequelae, and available support systems among nurses in low- and middle-income countries. Method: Guided by Arksey and O’Malley’s five-stage methodological framework, we systematically searched international (PubMed/MEDLINE, Scopus, Web of Science) and Iranian national databases (SID, Magiran, IranDoc) from inception to September 2026, alongside forward and backward citation tracing. Applying the Population, Concept, and Context (PCC) framework, quantitative, qualitative, and mixed-methods empirical studies focusing on clinical nurses across LMIC settings were eligible. Data concerning epidemiological parameters, psychometric properties of assessment instruments, and organizational interventions were charted and synthesized narratively. Finding: Evidence demonstrates a substantial yet heterogeneous prevalence of second victim experiences across LMIC nursing cohorts, with estimates varying widely from approximately 10% to over 80% depending on clinical acuity, measurement criteria, and reporting thresholds, peaking consistently in critical care and emergency departments. Major psychological and professional ramifications included profound guilt, pervasive anxiety, secondary traumatic stress, clinical burnout, absenteeism, and heightened turnover intentions. The Second Victim Experience and Support Tool (SVEST) predominated quantitative assessments, while qualitative studies captured profound experiences of professional isolation and distress. Regarding organizational support, formal multi-tiered crisis intervention programs and structured peer-support protocols were scarcely identified across the reviewed literature; nurses predominantly relied on informal colleague support within work environments frequently characterized by punitive administrative practices and individual-blame cultures. Conclusion: The current evidence base is constrained by a predominance of cross-sectional designs and a critical deficit of longitudinal or interventional trials. Mitigating this hidden crisis in low- and middle-income countries demands transitioning away from punitive, individual-blame paradigms toward institutionalizing “Just Culture” principles. Establishing culturally tailored, multi-tiered organizational support structures is an urgent prerequisite for safeguarding nursing workforce resilience and sustaining patient safety across resource-constrained healthcare environments.