Psychological Distress and Support Profiles among Healthcare Second Victims: A Latent Profile Analysis

Background Nurses involved in patient safety incidents (PSIs) often become "second victims," suffering significant psychological and professional distress. Rather than being a homogeneous group, these nurses exhibit diverse experiences, suggesting the need for a person-centered approach to better understand their distinct support needs. This study employed Latent Profile Analysis (LPA)—a person-centered method ideal for identifying hidden subgroups—to classify second victim nurses based on their distress and support patterns, with the aim of informing tailored intervention strategies. Methods A stratified cluster sampling technique was employed in May 2024 among clinical nurses from 16 tertiary hospitals and 21 secondary hospitals in Shanxi Province, China, who had experienced PSIs. Participants completed a socio-demographic questionnaire, the Chinese version of the SVEST, and the Simplified Coping Style Questionnaire (SCSQ). Latent Profile Analysis (LPA) was performed on the 24 SVEST items to identify homogeneous subgroups. Multinomial logistic regression was used to examine associations between subgroup membership and demographic, work-related, and coping strategy variables. Results Among 21,519 nurses analyzed, a two-profile model best fit the data. Profile 1 (52.5%, n = 11,295), labeled the ‘high-distress, low-support’ group, reported higher psychological distress (e.g., guilt, self-blame) and lower perceived support. Profile 2 (47.5%, n = 10,224), labeled the ‘low-distress, high-support’ group, reported lower distress and higher support. Multivariate analysis revealed that nurses in the ‘low-distress, high-support’ group were significantly more likely to be older (OR = 1.02, 95%CI: 1.01–1.02), use positive coping strategies (OR = 1.19, 95%CI: 1.18–1.20), and perceive higher levels of leadership support ('always' supported: OR = 8.65, 95%CI: 7.43–10.09). Conversely, nurses with longer work experience (> 10 years vs. <3 years: OR = 0.70, 95%CI: 0.61–0.79) and those using negative coping strategies (OR = 0.89, 95%CI: 0.89–0.90) were more likely to belong to the ‘high-distress, low-support’ group. Conclusion This study is the first to identify distinct profiles of second victim nurses using LPA, revealing significant heterogeneity in their experiences of distress and support. The findings underscore the critical influence of leadership support, coping strategies, age, and work experience. Developing targeted, hierarchical support systems is essential—providing intensive psychological and institutional support for the high-distress group, and reinforcing psychological capital and professional value for the low-distress group. Integrating proactive leadership and systemic support into hospital management is recommended to create a comprehensive support loop.