Background Second victims, defined as healthcare team members being traumatised by an unanticipated clinical event or outcome, are frequent in healthcare. Evidence of this phenomenon in Germany, however, is sparse. Recently, we reported the first construction and validation of a German questionnaire. This study aimed to understand this phenomenon better in a sample of young (<= 35 years) German physicians. Methods The electronic questionnaire (SeViD-I survey) was administered for 6 weeks to a sample of young physicians in training for internal medicine or a subspecialty. All physicians were members of the German Society of Internal Medicine. The questionnaire had three domains - general experience, symptoms, and support strategies - comprising 46 items. Binary logistic regression models were applied to study the influence of various independent factors on the risk of becoming a second victim, the magnitude of symptoms and the time to self-perceived recovery. Results The response rate was 18% (555/3047). 65% of the participants were female, the mean age was 32 years. 59% experienced second victim incidents in their career so far and 35% during the past 12 months. Events with patient harm and unexpected patient deaths or suicides were the most frequent key incidents. 12% of the participants reported that their self-perceived time to full recovery was more than 1 year or have never recovered. Being female was a risk factor for being a second victim (odds ratio (OR) 2.5) and experiencing a high symptom load (OR 2). Working in acute care was promoting a shorter duration to self-perceived recovery (OR 0.5). Support measures with an exceptionally high approval among second victims were the possibility to discuss emotional and ethical issues, prompt debriefing/crisis intervention after the incident and a safe opportunity to contribute insights to prevent similar events in the future. Conclusion The second victim phenomenon is frequent among young German physicians in internal medicine. In general, these traumatic events have a potentially high impact on physician health and the care they deliver. A better understanding of second victim traumatisations in Germany and broad implementation of effective support programs are warranted.
German hospitals are now confronted with major challenges from both shortages and fluctuations in the numbers of physicians and nurses. This makes it even more important that physicians and nurses do not prematurely leave patient care. The objective of the present study was to improve our understanding of the factors that trigger intentions to leave the profession. For this purpose, data from 1060 young physicians and nurses in hospital care were analysed. Intentions to leave the profession was assessed with the Copenhagen Psychosocial Questionnaire (COPSOQ). In the first step, the association was determined between intention to leave the profession and the factors of perceived quality of care and job satisfaction. In a second step, a mediation analysis was performed to determine the effect of perceived quality of care after correction for the possible mediator of job satisfaction. There were statistically significant negative associations between perceived quality of care and intention to leave the profession (beta: −2.9, 95% CI: −4.48-−1.39) and job satisfaction and intention to leave the profession (beta: −0.5, 95% CI: −0.64-−0.44). The effect of perceived quality of care on intention to leave the profession was partially mediated by job satisfaction. Thus, high perceived quality of care and high job satisfaction are both important factors that tend to prevent young physicians and nurses from leaving their professions.for this include overtime, psychosocial stress, burnout, career aspects and particularly, a low level of job satisfaction [2][3][4][5][6]. In order to improve their balance between work and family, some physicians switch to nontherapeutic work or emigrate, in the hope of finding better working conditions in other countries [7].Although the absolute number of all physicians in Germany has been constantly increasing over the years [8], it is still justified to discuss a "relative lack of physicians" or a "lack of medical working hours". The reasons for this include the relatively high number of hospital beds (in comparison with other European countries), the imbalanced distribution between conurbations and rural areas, the fact that many physicians are very highly specialized, and finally the entry of more women into medicine [9]. At the end of 2018, it was found that women made up 47% of physicians registered at the German Medical Association [10]. This proportion is increasing, as is the proportion of female physicians who work part-time.The position was similar for nursing staff. Even during training, 20-30% of trainees were considering not remaining in the profession for more than 5 years [11]. Systematic reviews have proposed a wide variety of reasons that trained nursing staff may consider leaving the profession. These include inadequate earnings, lack of personnel, lack of autonomy and high stress at work [12][13][14]. At the individual level, these factors lead to low job satisfaction, which is also empirically associated with thoughts of leaving the profession [15][16][17][18][19][20][21]....
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