关键词: 不良事件；护士；第二受害者痛苦；反刍性沉思；职业倦怠

Abstract: Objective: To explore the relationships among second victim distress, ruminative contemplation, and job burnout in nurses, and to examine the mediating role of ruminative contemplation in the relationship between second victim distress and job burnout in nurses. Methods: A total of 535 nurses who had experienced adverse events were recruited by convenience sampling method from 7 tertiary grade A hospitals in Beijing, Anhui, and Shanxi provinces from December 2023 to March 2024. A survey was conducted by the general information questionnaire, the Second Victim Experience and Support Tool, the Event-Related Rumination Inventory and the Maslach Burnout Inventory, and the data was analyzed by structural equation model. Results: The scores for second victim distress, intrusive ruminative contemplation, deliberate ruminative contemplation, and job burnout among nurses were (42.05±8.56), (14.64±7.70), (15.67±7.32), and (54.09±16.41) points, respectively. Ruminative contemplation, with both intrusive and deliberate ruminative contemplation as independent intermediary variables, had an effect on job burnout. Specifically, the total effect of second victim distress on job burnout was 0.398 (P<0.001), and the total indirect effect was 0.162 (P<0.001), with the mediating effect accounting for 40.70% of the total effect. Conclusion: The level of job burnout among nurses experiencing second victimization is relatively high and requires further improvement. Nursing administrators should take measures to alleviate the distress of nurses as second victims, guide them to transform intrusive rumination into purposeful rumination, and thereby reduce their levels of job burnout.

Key words: adverse event; nurse; second victim distress; ruminative contemplation; job burnout