The Relationship Between Second Victim Experiences and Compassion Fatigue Among ICU Nurses: The Chain-Mediating Role of Ego-resiliency and Emotional Contagion

The Relationship Between Second Victim Experiences and Compassion Fatigue Among ICU Nurses: The Chain-Mediating Role of Ego-resiliency and Emotional Contagion | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The Relationship Between Second Victim Experiences and Compassion Fatigue Among ICU Nurses: The Chain-Mediating Role of Ego-resiliency and Emotional Contagion hao liu, xiaoqing wang, yan mao, haiying liu, yang liu, chengfei xu, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8487452/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract Background ICU nurses are prone to becoming "second victims" after experiencing patient safety incidents, and the mechanism of its relationship with compassion fatigue remains unclear. Based on the Conservation of Resources Theory, this study explores the mediating roles of ego-resiliency and emotional contagion. Methods A cross-sectional design was adopted. A convenience sample of 221 ICU nurses from three tertiary hospitals in Tianjin was surveyed from February to April 2025. The Second Victim Experience and Support Tool, the Ego-Resiliency Scale, the Compassion Fatigue Short Scale, and the Emotional Contagion Scale were used. Structural equation modeling was employed to analyze the chain mediation effects. Results The second victim experience was significantly positively correlated with compassion fatigue (r = 0.476). It not only directly and positively predicted compassion fatigue (β = 0.23), but also exerted indirect effects through the independent mediation of ego-resiliency (β = 0.80), the independent mediation of emotional contagion (β = 0.93), and the chain mediation path of "ego-resiliency → emotional contagion" (β = 0.53). Conclusions The second victim experience leads to compassion fatigue through both the depletion of individual psychological resources and team-level emotional contagion. Interventions should systematically integrate enhancing individual resilience, optimizing team emotional climate, and strengthening organizational support to block the resource depletion pathway and protect nurses' psychological health. Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 08 Feb, 2026 Reviewers agreed at journal 30 Jan, 2026 Reviewers invited by journal 29 Jan, 2026 Editor invited by journal 06 Jan, 2026 Editor assigned by journal 05 Jan, 2026 Submission checks completed at journal 05 Jan, 2026 First submitted to journal 31 Dec, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8487452","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":583604666,"identity":"7feca2d4-0239-47b4-82ee-fc396eaba2c3","order_by":0,"name":"hao liu","email":"","orcid":"","institution":"Tianjin Union Medical Center, The First Affiliated Hospital of Nankai University","correspondingAuthor":false,"prefix":"","firstName":"hao","middleName":"","lastName":"liu","suffix":""},{"id":583604667,"identity":"cc71b94b-2c4f-457e-acb2-8f768cdf8c42","order_by":1,"name":"xiaoqing wang","email":"","orcid":"","institution":"Tianjin Union Medical 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Emotional Contagion","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-8487452/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8487452/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eICU nurses are prone to becoming \"second victims\" after experiencing patient safety incidents, and the mechanism of its relationship with compassion fatigue remains unclear. Based on the Conservation of Resources Theory, this study explores the mediating roles of ego-resiliency and emotional contagion.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA cross-sectional design was adopted. A convenience sample of 221 ICU nurses from three tertiary hospitals in Tianjin was surveyed from February to April 2025. The Second Victim Experience and Support Tool, the Ego-Resiliency Scale, the Compassion Fatigue Short Scale, and the Emotional Contagion Scale were used. Structural equation modeling was employed to analyze the chain mediation effects.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe second victim experience was significantly positively correlated with compassion fatigue (r\u0026thinsp;=\u0026thinsp;0.476). It not only directly and positively predicted compassion fatigue (β\u0026thinsp;=\u0026thinsp;0.23), but also exerted indirect effects through the independent mediation of ego-resiliency (β\u0026thinsp;=\u0026thinsp;0.80), the independent mediation of emotional contagion (β\u0026thinsp;=\u0026thinsp;0.93), and the chain mediation path of \"ego-resiliency \u0026rarr; emotional contagion\" (β\u0026thinsp;=\u0026thinsp;0.53).\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eThe second victim experience leads to compassion fatigue through both the depletion of individual psychological resources and team-level emotional contagion. Interventions should systematically integrate enhancing individual resilience, optimizing team emotional climate, and strengthening organizational support to block the resource depletion pathway and protect nurses' psychological health.\u003c/p\u003e","manuscriptTitle":"The Relationship Between Second Victim Experiences and Compassion Fatigue Among ICU Nurses: The Chain-Mediating Role of Ego-resiliency and Emotional Contagion","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-02 17:16:11","doi":"10.21203/rs.3.rs-8487452/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-02-08T05:37:06+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"24370604737596614350231857584266503178","date":"2026-01-30T11:49:31+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-01-29T16:42:41+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-01-06T10:29:29+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-01-05T12:55:39+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-01-05T12:55:10+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Nursing","date":"2025-12-31T07:45:26+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"305d269b-1c44-42e7-9ddd-d47f1e248724","owner":[],"postedDate":"February 2nd, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-02-02T17:16:11+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-02 17:16:11","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8487452","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8487452","identity":"rs-8487452","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}