The second victim phenomenon in medical practitioners, nurses, and pharmacists : the SeViMa study for Malta

Abstract

Aim: To determine the prevalence, distribution, symptom burden, and recovery patterns of the second victim phenomenon (SVP) among healthcare professionals in Malta and to assess demographic, workplace, cultural, and personality-related correlates of SVP risk and symptom severity. Subject and methods: This was a cross-sectional study. Data were collected using a questionnaire that incorporated the English translation of the Second Victims in German-speaking countries (SeViD) instrument, the Big Five Inventory-10, and open-ended questions. The questionnaire was sent to all registered medical practitioners, nurses, and pharmacists in Malta. Analyses examined associations between SVP status/symptom load and professional group, demographic variables, workplace characteristics, and personality traits. Results: The prevalence of SVP was 77.7% among medical practitioners, 69.8% among nurses, and 42.3% among pharmacists. Triggers included patient death, patient harm, and aggression. Emotional and cognitive symptoms predominated, particularly intrusive recollections, self-doubt, and concentration difficulties. Prolonged symptoms were reported by 18.9% of medical practitioners, 14.7% of nurses, and 11.0% of pharmacists. Risk factors differed by profession: fewer years of experience predicted a higher symptom load in medical practitioners; older age increased risk in nurses while experience was protective; and female gender, non-Maltese nationality, and community pharmacy setting were associated with higher symptom severity among pharmacists. Personality traits did not predict SVP status but were associated with symptom severity. Conclusion: SVP is significant in Malta, with profession-specific risk profiles and a substantial symptom burden. Informal support predominates, highlighting the need for structured, targeted measures to reduce SVP impacts across professional groups.