Keywords: second victim; mental well-being; health care professionals

Background:

The term second victim refers to any healthcare professional who has been directly or indirectly involved in an adverse event or medical error that resulted in patient harm or death and who is negatively affected by the experience. The second victim phenomenon can lead to significant mental and physical health problems, reducing overall well-being and work performance.

Research questions:

This study aimed to assess the prevalence and impact of the second victim phenomenon among primary health care professionals in Estonia.

Method:

A cross-sectional study was conducted using an online survey in 2025. Participants were recruited through professional associations, social media platforms, and press releases. We used Estonian version of the second victim questionnaire (SeVID). Quantitative methods were applied for data analysis.

Results:

A total of 134 primary health care workers completed the questionnaire, of whom 71% (n=95) were physicians. Among respondents, 61% (n = 82) reported experiencing the second victim phenomenon, and 40% of them had encountered it more than once. The leading causes were patient death (37%), preventable harm (29%), aggression from patients or relatives (20%), and non-hazardous event (11%). Common reactions among professionals included guilt (87%), self-doubt (83%), depressive mood (78%), concentration difficulties (66%), and sleep disturbances (57%). Primary health care professionals expressed a strong preference for support measures, including trained peer support offered by the workplace (97%), emotional support from colleagues (96%), forum for discussion of emotional and ethical values (95%), open and blame-free conversations (96%), legal counseling (95%) and 91% expressed the need for psychiatrist care. However, only 41% of professionals reported receiving any support following such incidents.

Conclusions:

There is an urgent need for systemic changes, including the development of clear organizational protocols, peer-support programs, and access to legal counseling and care for primary health care professionals affected by the second victim phenomenon.

Points for discussion:

Best practices from other countries for supporting second victims in primary care.