THE SECOND VICTIM SYNDROME

This is a research held in Dow University Of Health Sciences, Karachi.

SECOND VICTIM SYNDROME IN SURGEONS AND PHYSICIAN – A COMPARATIVE CROSS-SECTIONAL STUDY

 

INTRODUCTION:

Albert Wu in March 2000 used the term second victim for the first time which was to bring the need to provide emotional support to medical practitioners who are involved in medical errors under consideration. (1) Most frequent cases related to medical errors occur in the ICU , leading to a high risk of physiological burden and mental stress on doctors. This burden and guilt lead to second victim syndrome (2). Improving the quality of our health care and medical practitioners involves checking up on their duty readiness and well-being of them  (3). Medical errors by medical professionals are the third leading cause of death, first two being heart attack and cancer. Every day doctors meet unexpected patient outcomes that cause serious issues in their future lives (4). Peer support plays an important role in consoling the health care professionals who are affected due to such cases (5).

It is estimated that about half of the healthcare providers would encounter Second Victim Syndrome (SVS) at least once during their careers (6). Despite the fact that the surgeon’s line of work frequently puts them in demanding and stressful circumstances, which can make them more susceptible to SVS (7). Healthcare organizations bear the responsibility of identifying high-risk events and reducing the impacts of second victim experiences by implementing programs and providing appropriate support, as SV phenomena are a direct consequence of work expectations (8). By making deliberate attempts to enhance the culture of healthcare and create personal support networks, surgeons can increase their resilience, deliver better patient care, and enjoy longer and more fruitful careers (9). Our aim therefore is to find the frequency of SVS in medical and surgical departments, and the possible risk factors leading to this phenomenon.

 

AIMS AND OBJECTIVES:

The aim of this research is to investigate the frequency of Second Victim Syndrome (SVS) among surgeons and physicians.

The objectives include:

1.      To compare the frequency of second victim syndrome between surgeons and physician.

2.      To compare the risk factors leading to second victim syndrome among surgeons and physician.

 

HYPOTHESIS:

-Null Hypothesis:

There is no difference in the frequency of second victim syndrome between general physicians and surgeons.

 

- Alternative Hypothesis:

There is significant difference in the frequency of second victim syndrome between general physicians and surgeons.

 

METHODOLOGY:

This is a cross-sectional study, that will be conducted among the surgeons and physician of Dow University of Health Sciences.

Study design:

Cross sectional

Study Duration

3 months

Study Population:

The research will be conducted among doctors including consultants, Senior medical Officer and post-graduate trainees working in surgical and medical wards of Dow University of Health Sciences.

Sample size:

Openepi version 3.0 online sample size calculator was used for sample size estimation. Using the anticipated frequency of 50%, sample size was calculated as 132¹¹ subjects. Power of the study was kept at 80%, with margin of error 5%.

Sampling Technique:

Non-probability convenience sampling.

Research Tool:

A preformed questionnaire will be used for data collection.

Selection Criteria:

Ø Inclusion Criteria

o   Consultants, Senior medical Officer and post-graduate trainees working in surgical and medical wards of Dow University of Health Sciences

Ø Exclusion Criteria

o   Doctors who don’t consent to participate will be excluded from the study.

o   Doctors currently on anti-depressants and anti-psychotics will not be included.

 

Data Collection: Data will be collected from doctors of Dow University of Health Sciences. After the consent, the responses will be collected through a questionnaire.

Data Analysis:Data would be analyzed using SPSS version 26.0. Significance will be set at ≤.05.

 

REFERENCES:

 

1.      ClarksonMD,HaskellH,HemmelgarnC,SkolnikPJ.Abandontheterm“secondvictim”.BMJ.2019Mar 27;364.

2.      Naya K, Aikawa G, Ouchi A, Ikeda M, Fukushima A, Yamada S, Kamogawa M,Yoshihara S,SakuramotoH.Secondvictimsyndromeinintensivecareunithealthcareworkers:Asystematicreviewand meta-analysis on types, prevalence, risk factors, and recovery time. Plos one. 2023 Oct3;18(10):e0292108.

3.      MarmonLM,HeissK.Improvingsurgeonwellness:thesecondvictim syndromeandqualityofcare.InSeminarsinpediatricsurgery2015Dec1(Vol. 24,No.6,pp.315-318).WBSaunders.

4.      OzekeO,OzekeV,CoskunO,BudakogluII.Secondvictimsinhealthcare:currentperspectives.AdvancesinMedicalEducationandPractice.2019 Aug12:593-603.

5.      Heiss K, Clifton M. The unmeasured quality metric: Burn out and the second victim syndrome inhealthcare.InSeminarsinPediatricSurgery2019Jun 1(Vol.28,No.3,pp.189-194).WBSaunders.

6,7: . Chong RIH, Yaow CYL, Chong NZ, Yap NLX, Hong ASY, Ng QX, Tan HK. Scoping review of the second victim syndrome among surgeons: Understanding the impact, responses, and support systems. Am J Surg. 2024 Mar;229:5-14. doi: 10.1016/j.amjsurg.2023.09.045. Epub 2023 Oct 7. PMID: 37838505..

    

---

RESULTS 

1. Overall Prevalence of SVS: 56.5% of participants reported experiencing Second Victim Syndrome (SVS) .

 2. SVS Among Specialties: The prevalence of SVS was similar among specialties, with 28.7% of physicians and 27.8% of surgeons facing SVS. 

3. Support and Coping: Those who experienced SVS reported high levels of support, with 98.4% receiving supervisor support, 95.1% benefiting from colleague support, and 82% from institutional support, all of which contributed to improving their experience.

 4. Impact of Designation: The prevalence of SVS varied by designation, with 21.7% of postgraduate trainees experiencing SVS, compared to just 5.6% of medical officers.

CONCLUSION 

In conclusion, Second Victim Syndrome (SVS) affects more than half of healthcare professionals, with similar rates observed among physicians and surgeons. Support from colleagues, supervisors, and institutions played a significant role in helping those affected manage the challenges of SVS. Additionally, designation impacted its prevalence too with postgraduate trainees experiencing higher rates of SVS compared to other designations. These results highlight the importance of providing strong support systems to healthcare workers to reduce the impact of SV