目的 系统总结医疗不良事件中护士作为第二受害者的心理体验,全面了解其内心真实需求,为更好地开展针对护士第二受害者的干预措施提供依据。方法 计算机检索Cochrane Library、PubMed、Web of Science、EBSCO数据库、Embase数据库、中国知网、万方数据库、中国生物医学文献数据库、维普数据库、台湾学术文献数据库,收集有关医疗不良事件中护士作为第二受害者的质性研究,检索年限为建库至2019年12月。采用澳大利亚JBI循证卫生保健中心质性研究质量评价标准评价文献质量,采用汇集性整合的方法对结果进行整合分析。结果 共纳入9篇研究,提炼出24个完好明确的研究结果,将相似的研究结果归纳形成9个新类别,得出4个整合结果：护士应对不良事件的方式因时不同;不良事件的发生使护士承担巨大压力;不良事件的发生一定程度上促进了护理行为的正向改变;不良事件中所感知到的社会支持至关重要。 结论 医疗组织机构在着重提高公众对于第二受害者的认知度与容忍度、倡导非惩罚文化的同时,应建立明确清晰的不良事件调查程序,给予第二受害者精神支持,促使第二受害者早日重返工作岗位,促进我国护理事业的不断发展。

Objective To systematically summarize the psychological experience of nurses as the second victim in medical adverse events,and to fully understand their real needs,so as to inform a basis for better intervention measures. Methods Cochrane Library,PubMed,Web of Science,EBSCO,Embase,CNKI,Wanfang Database,CBM,VIP Database and Taiwan Airiti Library Database were searched. These qualitative research on nurses’ experience as the second victim in medical adverse events was collected. The retrieval period was up to December 2019. The quality of the literature was evaluated by the quality evaluation criteria of the Australian JBI evidence-based Health Care Center and the results were analyzed by the method of collective integration. Results A total of 9 studies were included,24 intact and clear research results were extracted,similar research results were summarized into 9 new categories and 4 integrated results were obtained including nurses’ ways of dealing with adverse events were different from time to time;the occurrence of adverse events made nurses bear great pressure;the occurrence of adverse events promoted the positive development of nursing to a certain extent;the perceived social support in adverse events was very important. Conclusion While medical organizations focus on improving public awareness and tolerance of the second victim and advocating the culture of non-punishment,they should establish a clear procedure for investigating adverse events and give spiritual support to the second victim,urge the second victim to return to work as soon as possible and promote the continuous development of nursing in our country.