# The second victim phenomenon in Japan: prevalence, impact, and associated factors— the JaSeVic study

## TL;DR

This study explores how often healthcare professionals in Japan experience distress after patient safety incidents and what factors help them recover.

## Contribution

The study identifies the prevalence and impact of the second victim phenomenon in Japan and highlights the role of organizational and cultural factors in mitigating distress.

## Key findings

- 78.1% of healthcare professionals in Japan reported experiencing the second victim phenomenon.
- Organizational support and a nonpunitive safety culture significantly reduce distress and turnover intentions.
- Only 15.7% of participants reported receiving organizational support after a patient safety incident.

## Abstract

Patient safety incidents (PSIs) not only affect patients but also cause psychological and physical distress in healthcare professionals, known as the second victim phenomenon (SVP). Understanding the prevalence, characteristics, and support needs related to SVP is essential to promote healthcare worker well-being and patient safety in Japan.

The study conducted a web-based, cross-sectional survey in Japan that targeted experienced healthcare professionals on the mailing lists of academic societies or organizations. The survey assessed the types, prevalence, recovery time, impacts, and desired support related to SVP. Structural equation modeling (SEM) and mediation analysis were used to examine associations among organizational support, patient safety culture, second victim (SV) distress, and outcomes (turnover intentions, absenteeism, and resilience). Multiple regression analysis examined factors associated with SV distress.

A total of 884 participants responded, and 78.1% reported experiencing SVP. Individuals directly involved in PSIs reported higher levels of distress and perceived less institutional support than observers. Only 15.7% reported the presence of organizational support. Recovery exceeded one year in 13.9% of cases, and 9.7% reported persistent symptoms. Organizational support and a positive patient safety culture were associated with lower SV distress, turnover intentions, and absenteeism, and with higher resilience (all p < 0.05). Mediation analysis indicated indirect associations through reduced SV distress. The most significant factors associated with lower SV distress were nonpunitive responses to errors (B = − 0.132, 95% CI [− 0.195, − 0.070]) and colleague support (B = − 0.582, 95% CI [− 0.659, − 0.505]).

The findings indicate that SVP is common and often prolonged among healthcare professionals and that those directly involved in PSIs report greater vulnerability. Organizational support, including colleague support, and a nonpunitive patient safety culture were associated with lower SV distress and lower turnover intentions.

The online version contains supplementary material available at 10.1186/s12913-026-14251-5.