The Second Victim Experience and Support Tool: a cross-cultural adaptation, validation and psychometric evaluation of the Serbian version for pharmacy professionals (SR-SVEST-R)

The Second Victim Experience and Support Tool: a cross-cultural adaptation, validation and psychometric evaluation of the Serbian version for pharmacy professionals (SR-SVEST-R) | 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 Second Victim Experience and Support Tool: a cross-cultural adaptation, validation and psychometric evaluation of the Serbian version for pharmacy professionals (SR-SVEST-R) Ivana Zimonjić, Valentina Marinković, José Joaquín Mira, Bojana Knežević, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5293950/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 13 Feb, 2025 Read the published version in International Journal of Clinical Pharmacy → Version 1 posted 6 You are reading this latest preprint version Abstract Background : The second victim phenomenon, involving emotional and psychological distress after adverse events, is underexplored among pharmacy professionals. The validated Second Victim Experience and Support Tool measures these experiences and support options, with the improved version also assessing resilience. Aim : This study aimed to validate the Second Victim Experience and Support Tool-Revised, measure the second victim phenomenon, and present results among pharmacy professionals in Serbia. Method : This cross-sectional study included 350 pharmacy professionals (MPharm and technicians). The questionnaire, with 9 factors and 35 statements, was translated and adapted following guidelines, and the content was validated by five experts. A pre-test with 30 participants ensured clarity, followed by Confirmatory Factor Analysis for construct validity and Cronbach's Alpha for reliability. Results : Content validity was confirmed with item scores from 0.8 to 1 and an average scale score of 0.83. Factor analysis identified 9 factors and 30 items (Chi-square = 545.571, degrees of freedom = 366, p < 0.001). The model fit was supported by a Root Mean Square Error of Approximation of 0.037, a Comparative Fit Index of 0.958, a Tucker-Lewis Index of 0.950, and a Standardised Root Mean Square Residual of 0.040. Reliability analysis showed a Cronbach's alpha of 0.88, with factor values from 0.60 to 0.90. Among participants, 49.5% feared future events, 47.4% felt exhausted, 22.6% considered quitting, 72.6% valued peer support, and 28.9% improved work quality. Conclusion : The Serbian resilience measuring version effectively evaluates the second victim experience and support options among pharmacy professionals, showing good validity and reliability. Second Victims SVEST Patient Safety Medication Errors Survey Figures Figure 1 IMPACT STATEMENTS This study presents a validated and reliable culturally adapted tool for pharmacy professionals, enhancing understanding of the second victim phenomenon. Results of the study emphasise pharmacy professionals' experiences and support preferences after adverse incidents, highlighting a strong need for colleague support alongside reported distress and intentions to leave their positions, with some enhancing their resilience. The tool's reliability supports its use in assessing and improving support programs for pharmacy professionals affected by patient care outcomes. INTRODUCTION The "second victim" phenomenon describes healthcare professionals, including pharmacy professionals, who experience emotional and psychological distress following adverse patient events or unintended errors [1-3]. Common consequences reported in the literature include anxiety, self-directed anger, fear of future errors, diminished self-confidence, and adverse effects on job performance [4-6]. These can lead to increased absenteeism, defensive practices affecting care quality, higher turnover intentions, and the organisation becoming a tertiary victim due to lower staff morale and productivity [7, 8]. Despite their critical role in optimising medication use and ensuring patient safety [9], pharmacists often face significant stress from accepting responsibility for therapy outcomes [10, 11]. Second victim experiences may also affect their willingness to provide advanced services, like medication review [12, 13] and impact the quality and safety of future clinical practice [14]. Effective support programs, like peer support and leadership initiatives, are vital and should be tailored to the healthcare environment's cultural and organisational context [15, 16]. The Second Victim Experience and Support Tool (SVEST) is designed to evaluate the experiences of second victims and the desirability of support for healthcare professionals [17]. The original version includes 29 statements classified into 7 factors and 2 outcome variables, followed by 7 support options. An extended version incorporates resilience as a positive outcome dimension (SVEST-R) with 4 statements, resulting in 9 factors and 35 items [18]. The SVEST has been culturally adapted and validated in various countries and is available in multiple languages, including Chinese, Danish, Italian, Korean, Persian, Portuguese, Spanish and Turkish [19-25]. The SVEST-R is available in German and Malay [26, 27]. Previous studies on the second victim phenomenon mostly included doctors and nurses, with pharmacists representing under 10% in few studies [28]. Currently, there is no validated version available in Serbian, nor is there a specific validated version for pharmacy professionals. AIM This study aimed to validate the SVEST-R for pharmacy professionals, assess the second victim phenomenon, and present findings among pharmacy professionals in Serbia, evaluating its effectiveness in capturing support needs, potentially applicable in Serbian-speaking countries. ETHICS APPROVAL The University of Belgrade – Faculty of Pharmacy's Medical Ethics Committee approved this study (Reference number: 1340/2, dated June 12th, 2023). METHOD Study design The study used a cross-sectional design in two phases. In Phase 1, the SVEST-R was translated and culturally adapted from English to Serbian. In Phase 2, the Serbian SR-SVEST-R was pre-tested with 30 pharmacy professionals (following recommendations [ 29 ]) and psychometrically validated for assessing the second victim phenomenon among pharmacy professionals. The process involved evaluating its validity and reliability following general guideline steps [ 30 ] and comparing with other SVEST validation studies. The SVEST-R [ 18 ] includes 9 factors: 6 for the second victim phenomenon (i) psychological distress, (ii) physiological distress, (iii) colleague support, (iv) supervisor support, (v) institutional support, (vi) professional self-efficacy, and 3 outcomes (vii) turnover intentions, (viii) absenteeism, (ix) resilience. It also covers 7 support options: (a) immediate time away from the unit, (b) peaceful recovery location, (c) discussion with a respected peer, (d) employee assistance program for free counselling, (e) discussion with a manager or supervisor, (f) scheduled time with a counsellor, (g) confidential 24-hour support contact. Items are rated from 1 (strongly disagree) to 5 (strongly agree), with reverse-coded items marked by asterisks. Support options are rated from 1 (extremely undesirable) to 5 (extremely desirable). Validation on 316 participants [ 18 ] (primarily nurses, 2.5% pharmacists) showed χ2 = 1555, DOF = 524, RMSEA = 0.079, CFI = 0.821, SRMR = 0.091, factor loadings 0.42–0.92, and Cronbach’s alpha 0.66–0.86. Setting, sampling, and recruitment The study included 350 pharmacy professionals (MPharm and pharmacy technicians) from Serbia, adhering to the recommended sample size of 10 participants per item [ 31 ]. Convenience sampling was used for recruitment [ 32 ], focusing solely on community pharmacy professionals and excluding those from other settings. The SR-SVEST-R questionnaire was administered in paper form at two continuing education events in Serbia in October 2023, with all participants consenting and completing it in its entirety, with no withdrawals. Data collection Data collection was conducted by three researchers: PhD student Ivana Zimonjić (I.Z., MPharm) and professors Valentina Marinković (V.M., PhD) and Marina Odalović (M.O., PhD). They distributed and collected paper questionnaires during accredited educational sessions, adhering to a structured protocol to ensure consistency and reliability. Translation and Cultural Adaptation The process began with obtaining permission from the original authors of the SVEST-R in March 2023 to translate and adapt the tool. Following the Malaysian SVEST-R study, the translation adhered to Wild’s guidelines [ 27 , 33 ]. Two bilingual healthcare professionals performed the forward translation from English to Serbian, ensuring each item's meaning was preserved. A panel of five experts, comprising healthcare professionals and researchers experienced in patient safety, reviewed the translated items for cultural relevance and clarity, adjusting the language for the Serbian context. Two additional bilingual professionals conducted a backward translation from Serbian to English, unaware of the original questionnaire, to verify accuracy. Some terms were modified for cultural alignment: "miserable" in question 3 was changed to "less valued," "fair" in question 15 was adjusted to "appropriate," "supervisor" was replaced with "manager/chief," and "organisation" with "healthcare institution." Finally, the expert panel reviewed the backward translation for conceptual and cultural equivalence. Content Validation An expert panel of five rated each item's relevance and clarity on a 4-point scale (1 = not relevant, 4 = highly relevant), leading to final adjustments. Content validity was measured by the Item-level Content Validity Index (I-CVI) and Scale-level Content Validity Index (S-CVI/Ave), with values > 0.8 considered acceptable [ 34 ]. A pre-test with 30 pharmacists followed cognitive evaluation, resulting in the final SR-SVEST-R version (Supplementary material). Data analysis, interpretation and storage All raw data were stored in Microsoft Word and Excel anonymised and sequentially numbered for identification. The lead researcher ensured secure electronic storage with restricted access. Descriptive statistics were conducted using SPSS software (SPSS 29.0 for Windows, SPSS Inc., Chicago, IL, USA) to summarise demographic characteristics and questionnaire responses. Mean scores were calculated for each item, dimension, and outcome, while agreement percentages (score ≥ 4) were also calculated for each item and support option, following the original study's methodology [ 17 , 18 ]. Psychometric Evaluation Construct validity was assessed using Confirmatory Factor Analysis (CFA) with AMOS software package (IBM SPSS Amos 26.0 for Windows, IBM Corp., Armonk, NY, USA). The assessment of the factor structure of the SR-SVEST-R involved calculating various fit indices to evaluate the model fit. The cut-off values for assessing model fit in CFA were: a non-significant Chi-square (χ²) (p > 0.05) for a good fit, Root Mean Square Error of Approximation (RMSEA) < 0.08 for acceptable and 0.90 for acceptable and > 0.95 for excellent, Tucker-Lewis Index (TLI) > 0.90 for acceptable and > 0.95 for excellent, and Standardised Root Mean Square Residual (SRMR) < 0.08 for good and < 0.05 for excellent [ 35 ]. The ratio of Parameter Change in the Minimum to Degrees of Freedom (PCMIN/DF), known as χ²/df values less than 3 indicates a good model fit. Items with factor loadings ≤ 0.40 were eliminated and error covariances were added only in the same construct [ 36 ]. Reliability was assessed using Cronbach's Alpha, with values of 0.70 or higher deemed acceptable for the overall scale and its subdimensions [ 37 , 38 ]. RESULTS Demographic characteristics of the participants In the study group (n = 350), the mean age was 43 years (SD = 11.6), and the mean work experience was 17 years (SD = 11.9). Most participants were female (91.4%). Education levels included master's (48.3%), secondary school (26.0%), specialised studies (13.1%), bachelor's (6.3%), and doctorate (5.1%). Job positions included pharmacists (64.3%) and pharmacy technicians (33.7%), with most working in private pharmacies (86.9%). Awareness of the second victim phenomenon was 45.1%. Demographic details are in Table 1 . Table 1 Demographic characteristics of the study participants (n = 350) Sociodemographic Variables (n = 350) Categories N (%) Mean (Min-Max) (SD) Age 43 (20–74) (11.6) Years of work experience 17 (1–65) (11.9) Gender Female 320 (91.4) Male 30 (8.6) Level of education Secondary School 91 (26.0) College - Bachelor's Degree 22 (6.3) University - Master's Degree 169 (48.3) Specialised Academic Studies 46 (13.1) Health Specialisation 4 (1.1) Master's or Doctorate 18 (5.1) Job position Pharmacy technician in a community pharmacy 112 (32.0) Pharmacy technician in an emergency pharmacy 6 (1.7) Pharmacist in a community pharmacy 225 (64.3) Pharmacist in an emergency pharmacy 7 (2.0) Type of institution Private Pharmacy 305 (87.2) State Pharmacy 45 (12.8) Size of the city Rural area 34 (9.7) Smaller town (up to 100,000 inhabitants) 141 (40.3) Medium-sized city (100–200,000 inhabitants) 47 (13.4) Large city (over 200,000 inhabitants) 128 (36.6) Have you ever heard of the phenomenon known as the Second Victim? Yes 158 (45.1) No 192 (54.9) Please insert Table 1 here. Demographic characteristics of the study participants (n = 350) Content Validation The Item-level Content Validity Index (I-CVI) ranged from 0.8 to 1 (6 items with 1 – Q1, Q2, Q11, Q32, Q33, Q35 and others with 0.8), and the Scale-level Content Validity Index (S-CVI/Ave) was 0.83, indicating acceptable content validity (for specific questions - Q, see Table 2 and Supplementary material). Descriptive statistics – mean scores, agreements Table 2 presents the domain-specific findings for the SR-SVEST-R. The data reveal varied levels of agreement across different domains. Psychological distress had a 37.2% agreement (Mean = 2.94, SD = 1.51). Physical distress was agreed upon by 24.8% (Mean = 2.42, SD = 1.40). Colleague support showed 20.5% agreement (Mean = 2.17, SD = 1.35). Supervisor support was reported by 28.8% (Mean = 2.57, SD = 1.57), while institutional support was noted by 28.2% (Mean = 2.73, SD = 1.48). Professional self-efficacy and turnover intentions had 14.8% and 15.5% agreement levels, respectively (Means = 2.13 and 2.04, SDs = 1.30 for both). Absenteeism had the lowest agreement at 13.6% (Mean = 1.91, SD = 1.44), while resilience was agreed upon by 25.4% (Mean = 2.45, SD = 1.55). Table 2 Domain descriptive findings of the SR-SVEST-R (n = 350) Domain Item Agreement (%) Mean SD Psychological distress 37.2 2.94 1.51 Q1. I have experienced embarrassment from these instances. 46.3 3.33 1.54 Q2. My involvement in these types of instances has made me fearful of future occurrences. 49.5 3.39 1.54 Q3. My experiences have made me feel less valued. 20.9 2.37 1.42 Q4. I feel deep remorse/guilt for my past involvements in these types of events. 32.0 2.71 1.53 Physical distress 24.8 2.42 1.40 Q5. The mental weight of my experience is exhausting. 47.4 3.30 1.53 Q6. My experience with these occurrences can make it hard to sleep regularly. 26.5 2.47 1.44 Q7. The stress from such situations causes me nausea or disgust. 17.7 2.19 1.38 Q8. Thinking about these situations reduces my appetite. 14.6 2.00 1.30 Q9. I have had bad dreams as a result of these situations. 17.8 2.13 1.37 Colleague support 20.5 2.17 1.35 Q10. My colleagues can be indifferent to the impact these situations have had on me. 21.1 2.28 1.41 Q11. My colleagues help me feel that I am still a good healthcare professional despite any mistakes I have made. ᵃ 41.5 2.95 1.65 Q12. My colleagues no longer trust me. 10.2 1.67 1.19 Q13. My professional reputation has been damaged because of these situations. 9.1 1.76 1.15 Supervisor support 28.8 2.57 1.57 Q14. I feel that my manager/chief treats me appropriately after these occasions. ᵃ 37.2 2.81 1.65 Q15. My manager/chief's reactions are appropriate. ᵃ 32.0 2.62 1.65 Q16. My manager/chief blames individuals. 18.0 2.21 1.51 Q17. I feel my manager/chief considers the complexity of pharmaceutical care in these situations. ᵃ 28.0 2.62 1.47 Institution support 28.2 2.73 1.48 Q18. My healthcare institution understands that those involved may need help to process and resolve any effects they may have on care professionals. ᵃ 28.6 2.73 1.48 Q19. My healthcare institution offers a variety of resources to help get me over the effects of involvement with these instances. ᵃ 29.1 2.77 1.48 Q20. Concern for the well-being of those involved in these situations is not strong at my institution. 26.9 2.68 1.48 Professional self-efficacy 14.8 2.13 1.30 Q21. After such events, I felt incompetent regarding my ability to provide pharmaceutical care. 16.5 2.30 1.32 Q22. My experience makes me question whether I am still a good healthcare professional. 13.8 2.07 1.28 Q23. Following my experience, I became afraid to undertake challenging or high-risk services. 16.3 2.16 1.31 Q24. These situations have negatively impacted my job performance. 12.6 2.00 1.27 Turnover intentions 15.5 2.04 1.30 Q25. Experiences with such events have led me to consider seeking a job outside of pharmaceutical care. 15.4 2.03 1.32 Q26. Sometimes the stress of potentially being involved in such events makes me want to quit my job. 22.6 2.37 1.41 Q27. I have started to inquire about other job opportunities. 15.7 2.09 1.34 Q28. I plan to leave my job within the next 6 months due to these experiences. 8.3 1.66 1.14 Absenteeism 13.6 1.91 1.44 Q29. My experiences with adverse events or errors in providing pharmaceutical care have led me to take time off work. 12.0 1.85 1.29 Q30. I was absent from work following one of these events. 13.1 1.81 1.72 Q31. When at work, I am distracted and not fully present because of these experiences. 15.8 2.07 1.32 Resilience 25.4 2.45 1.55 Q32. Due to these situations, I have become much more cautious at work. ᵃ 27.2 2.50 1.59 Q33. These events have led me to improve the quality of pharmaceutical care. ᵃ 28.9 2.49 1.62 Q34. My experiences with adverse events or errors in pharmaceutical care have resulted in positive changes in procedures or processes within my healthcare institution. ᵃ 22.6 2.42 1.49 Q35. After participating in adverse events and/or a professional error, I have developed as a healthcare professional. ᵃ 22.8 2.37 1.49 Agreement = mean score of ≥ 4.0, negative impact of Second Victim experience ᵃ Reverse-scored item (1 = strongly agree, 5 = strongly disagree) Please insert Table 2 here. Domain descriptive findings of the SR-SVEST-R (n = 350) Support options The most desirable support was having a respected peer to discuss the event, with 72.6% of participants finding it desirable and a mean score of 4.17 (SD = 1.25). Similarly, an employee assistance program offering free counselling was highly valued, with 62.6% of participants indicating it as desirable and a mean score of 4.01 (SD = 1.28). In contrast, immediate time away from the unit and a designated peaceful location for recovery were less preferred, with 45.1% and 50.5% of participants finding these options desirable, and mean scores of 3.29 (SD = 1.55) and 3.49 (SD = 1.47), respectively (Table 3 ). Table 3 The desirability for the Second Victim support options (n = 350) Support option Desired, % Not desired, % Mean SD 1. The opportunity to immediately step away from work for a short period. 45.1 29.7 3.29 1.55 2. A specified peaceful location that is available to recover and re- compose after one of these types of events. 50.5 26.0 3.49 1.47 3. A respected peer to discuss the details of what happened. 72.6 11.2 4.17 1.25 4. An employee assistance program that can provide free counselling to employees outside of work. 62.6 12.9 4.01 1.28 5. A discussion with my manager/chief about the incident. 61.8 16.6 3.87 1.35 6. The opportunity to schedule a time with a counsellor at my healthcare institution to discuss the event. 56.8 20.0 3.75 1.38 7. A confidential way to get in touch with someone 24 hours a day to discuss how my experience may be affecting me. 53.5 17.7 3.67 1.34 Agreement = mean score of ≥ 4.0, negative impact of Second Victim experience Please insert Table 3 here. The desirability for the Second Victim support options (n = 350) Confirmatory Factor Analysis (CFA) Table 4 presents the results of the CFA for the SR-SVEST-R across four models. In Model 1, which includes all original items, factor loadings range from 0.19 to 0.88. Model 2, which excluded items Q11, Q14, Q16, and Q20 (factor loadings were as follows: 0.26, 0.31, 0.25 and 0.19), showed loadings between 0.39 and 0.88. Model 3 removed item Q10 (factor loading 0.39), resulting in loadings from 0.55 to 0.88. Model 4, which included additional error covariances (e5→e8, e29→e30, and e34→e35), demonstrates loadings ranging from 0.56 to 0.92. Table 4 Confirmatory Factor Analysis (CFA) (IBM AMOS 26) with standardised factor loadings for the SR-SVEST-R (n = 350) Domain Item Model 1 Model 2 Model 3 Model4 Psychological distress Q1. I have experienced embarrassment from these instances. 0.58 0.58 0.58 0.58 Q2. My involvement in these types of instances has made me fearful of future occurrences. 0.61 0.61 0.61 0.62 Q3. My experiences have made me feel less valued. 0.74 0.74 0.74 0.74 Q4. I feel deep remorse/guilt for my past involvements in these types of events. 0.69 0.69 0.69 0.69 Physical distress Q5. The mental weight of my experience is exhausting. 0.61 0.61 0.61 0.66 Q6. My experience with these occurrences can make it hard to sleep regularly. 0.73 0.73 0.73 0.73 Q7. The stress from such situations causes me nausea or disgust. 0.73 0.73 0.73 0.72 Q8. Thinking about these situations reduces my appetite. 0.70 0.70 0.70 0.73 Q9. I have had bad dreams as a result of these situations. 0.80 0.79 0.79 0.77 Colleague support Q10. My colleagues can be indifferent to the impact these situations have had on me. 0.43 0.39 Deleted Deleted Q11. My colleagues help me feel that I am still a good healthcare professional despite any mistakes I have made. ᵃ 0.26 Deleted Deleted Deleted Q12. My colleagues no longer trust me. 0.52 0.55 0.55 0.56 Q13. My professional reputation has been damaged because of these situations. 0.70 0.75 0.78 0.78 Supervisor support Q14. I feel that my manager/chief treats me appropriately after these occasions. ᵃ 0.31 Deleted Deleted Deleted Q15. My manager/chief's reactions are appropriate. ᵃ 0.69 0.71 0.71 0.71 Q16. My manager/chief blames individuals. 0.25 Deleted Deleted Deleted Q17. I feel my manager/chief considers the complexity of pharmaceutical care in these situations. ᵃ 0.64 0.64 0.64 0.63 Institution support Q18. My healthcare institution understands that those involved may need help to process and resolve any effects they may have on care professionals. ᵃ 0.83 0.84 0.84 0.85 Q19. My healthcare institution offers a variety of resources to help get me over the effects of involvement with these instances. ᵃ 0.73 0.72 0.72 0.72 Q20. Concern for the well-being of those involved in these situations is not strong at my institution. 0.19 Deleted Deleted Deleted Professional self-efficacy Q21. After such events, I felt incompetent regarding my ability to provide pharmaceutical care. 0.70 0.70 0.70 0.70 Q22. My experience makes me question whether I am still a good healthcare professional. 0.75 0.75 0.75 0.75 Q23. Following my experience, I became afraid to undertake challenging or high-risk services. 0.77 0.77 0.77 0.77 Q24. These situations have negatively impacted my job performance. 0.75 0.75 0.75 0.76 Turnover intentions Q25. Experiences with such events have led me to consider seeking a job outside of pharmaceutical care. 0.78 0.78 0.78 0.78 Q26. Sometimes the stress of potentially being involved in such events makes me want to quit my job. 0.76 0.76 0.76 0.77 Q27. I have started to inquire about other job opportunities. 0.73 0.73 0.73 0.73 Q28. I plan to leave my job within the next 6 months due to these experiences. 0.61 0.61 0.61 0.61 Absenteeism Q29. My experiences with adverse events or errors in providing pharmaceutical care have led me to take time off work. 0.74 0.74 0.74 0.61 Q30. I was absent from work following one of these events. 0.63 0.63 0.63 0.48 Q31. When at work, I am distracted and not fully present because of these experiences. 0.67 0.67 0.67 0.74 Resilience Q32. Due to these situations, I have become much more cautious at work. ᵃ 0.82 0.82 0.82 0.84 Q33. These events have led me to improve the quality of pharmaceutical care. ᵃ 0.88 0.88 0.88 0.92 Q34. My experiences with adverse events or errors in pharmaceutical care have resulted in positive changes in procedures or processes within my healthcare institution. ᵃ 0.80 0.80 0.80 0.73 Q35. After participating in adverse events and/or a professional error, I have developed as a healthcare professional. ᵃ 0.81 0.81 0.81 0.75 Model 1 = all original items, Model 2 = removed items Q11, Q14, Q16 and Q20, Model 3 = removed item Q10, Model 4 = added covariances e5→e8, e29→e30, and e34→e35. ᵃ Reverse-scored item (1 = strongly agree, 5 = strongly disagree) Please insert Table 4 here. Confirmatory Factor Analysis (CFA) (IBM AMOS 26) with standardised factor loadings for the SR-SVEST-R (n = 350) Table 5 details the model fit indices for the SR-SVEST-R. In Model 1, the key fit indices were as follows: χ²/df = 1.905, RMSEA = 0.051, CFI = 0.895 and SRMR = 0.065. For Model 4, after adding error covariances, the indices improved: χ²/df = 1.491, RMSEA = 0.037, CFI = 0.958 and SRMR = 0.040. Table 5 Model fit indices of the SR-SVEST-R compared to the original SVEST-R and Malaysian M-SVEST-R Testing Parameters Model 1 Model 2 Model 3 Model 4 (e5→e8, e29→e30, e34→e35) Original SVEST-R M-SVEST-R Chi-square 998.323 729.819 656.891 545.571 1555.60 797.00 Df 524 398 369 366 524 418 p-value 0.000 0.000 0.000 0.000 < 0.0001 < 0.0001 χ²/df 1.905 1.834 1.780 1.491 - - RMSEA 0.051 0.049 0.047 0.037 0.079 0.05 (95% CI) (0.045, 0.057) (0.043, 0.055) (0.041, 0.053) (0.031, 0.043) - (0.044, 0.055) CFI 0.895 0.923 0.932 0.958 0.821 0.946 GFI 0.862 0.881 0.888 0.907 - - AGFI 0.834 0.852 0.859 0.882 - - TLI 0.881 0.910 0.920 0.950 - 0.935 SRMR 0.065 0.048 0.044 0.040 0.091 0.055 AIC 1210.323 925.819 848.891 743.571 - 28,120 BIC 1619.234 1303.896 1219.253 1125.507 - 28,200 χ²: Chi-square; Df: Degrees of Freedom; χ²/df: Chi-square/Degrees of Freedom Ratio; RMSEA: Root Mean Square Error of Approximation; CFI: Comparative Fit Index; GFI: Goodness of Fit Index; AGFI: Adjusted Goodness of Fit Index; TLI: Tucker-Lewis Index; SRMR: Standardized Root Mean Square Residual; AIC: Akaike Information Criterion; BIC: Bayesian Information Criterion. Model 1 = all original items, Model 2 = removed items Q11, Q14, Q16 and Q20, Model 3 = removed item Q10, Model 4 = added covariances e5→e8, e29→e30, and e34→e35. Please insert Table 5 here. Model fit indices of the SR-SVEST-R compared to the original SVEST-R and Malaysian M-SVEST-R The final Model 4 with factor loadings, error estimates and covariances is presented in Fig. 1 . Please insert Fig. 1 here. Confirmatory factor analysis of the SR-SVEST-R, final model (Model 4) The Cronbach's alpha coefficients for the SR-SVEST-R across all models were consistent, with the total scale maintaining a reliability of 0.88. Psychological distress and physical distress consistently scored 0.75 and 0.83, respectively. Colleague support improved from 0.47 in Model 1 to 0.60 in Models 3 and 4. Supervisor support and institutional support increased slightly across models, stabilising at 0.62 and 0.77, respectively, in Models 2, 3, and 4. Professional self-efficacy, turnover intentions, absenteeism, and resilience remained steady at 0.83, 0.81, 0.70, and 0.90, respectively, across all models. DISCUSSION Statement of key findings Participants identified several notable impacts from their second victim experiences: 49.5% expressed fear of future events, 47.4% reported mental exhaustion, and 22.6% contemplated quitting. Crucial supportive measures included peer discussions (72.6%), employee assistance programs (62.6%), and conversations with managers (61.8%). Additionally, 28.9% observed improvements in the quality of care. Overall, our study indicates a higher level of distress, and negative outcomes compared to other healthcare professionals described in previous studies [ 17 – 19 , 25 – 27 , 39 – 41 ], highlighting the distinct challenges in community pharmacies [ 42 ] which may compromise the standards of pharmacy practice [ 43 ] and impact patient outcomes. The SR-SVEST-R exhibited better fit indices and reliability compared to other versions [ 17 , 18 , 27 ], confirming its robustness. Context-specific adaptations were essential, as demonstrated by the removal of several items to improve precision and reliability. Strengths and Weaknesses The study's strength lies in its rigorous methodology and statistical testing, ensuring robust validation of the SR-SVEST-R for community pharmacy professionals. The tool was meticulously translated and culturally adapted, with expert input enhancing content validity. CFA confirmed internal consistency and construct validity, making it suitable for Serbian-speaking Western Balkan countries. A limitation of the study is its reliance on self-reported data, which may introduce recall bias and socially desirable responses. While the SR-SVEST-R was adapted for the Serbian context, its applicability in other cultural settings, including other Western Balkan countries, may require further adaptation. However, existing literature suggests minimal cultural differences within the former Yugoslavia, supporting the tool's broader applicability in these regions [ 44 , 45 ]. Interpretation Our study uniquely focuses on pharmacy professionals, contrasting with previous research showing lower pharmacist representation [ 28 ], such as 8.5% in Burlison et al. [ 17 ] and 10% in De Sordi et al. [ 46 ]. This emphasises the distinctiveness of our research on the second victim phenomenon within the pharmacy field. The SR-SVEST-R's S-CVI/Ave of 0.84, with six items at 1.0 and 29 items at 0.8, is acceptable per Polit and Beck [ 34 ]. This aligns with studies on the original SVEST, which showed similar or slightly lower values in Spain and Malaysia [ 28 ], indicating satisfactory content validity. Our study shows higher agreement across several domains compared to the original SVEST [ 17 ] and SVEST-R [ 18 ]. Psychological and physical distress levels exceed those in SVEST [ 17 ], SVEST-R [ 18 ], Malaysia [ 27 ], Denmark [ 24 ], and Turkey [ 23 ]. Colleague support is higher than in SVEST [ 17 ], SVEST-R [ 18 ], and Malaysia [ 27 ] but lower than in Denmark [ 24 ] and Turkey [ 23 ]. Supervisor and institutional support surpass SVEST [ 17 ], SVEST-R [ 18 ], Malaysia [ 27 ], and Turkey [ 23 ] but are below Denmark [ 24 ]. Professional self-efficacy aligns with Turkey [ 17 ], SVEST-R [ 18 ], and Malaysia [ 27 ] but lower than in Denmark [ 24 ]. Turnover intentions and absenteeism are higher than in SVEST [ 17 ], SVEST-R [ 18 ], Denmark [ 24 ], and Malaysia [ 27 ] but lower than in Turkey [ 23 ]. Resilience significantly exceeds SVEST-R [ 18 ] and Malaysia [ 27 ]. The differences may arise from the specific nature of pharmacy practice, staff preparedness, and personality traits, with colleague support equally seen as vital. The CFA of the SR-SVEST-R demonstrates improved performance in assessing the second victim phenomenon compared to the original SVEST [ 17 ], SVEST-R [ 18 ] and other national versions. The SR-SVEST-R, with 9 factors, has fit indices of RMSEA 0.037 and CFI 0.958, while the original SVEST-R reports RMSEA 0.079 and CFI 0.821 [ 18 ]. In comparison to other versions [ 28 ], the SR-SVEST-R shows more favourable indices, including the G-SVEST (11 factors, indices not available) [ 25 ], C-SVEST (6 factors, RMSEA 0.051, CFI 0.946) [ 39 ], D-SVEST (7 factors, RMSEA 0.069, CFI 0.884) [ 24 ], T-SVEST (9 factors, RMSEA 0.071, CFI 0.931) [ 23 ], I-SVEST (7 factors, RMSEA 0.075, CFI 0.91) [ 39 ] and K-SVEST (8 factors, RMSEA 0.05, CFI 0.92) [ 18 ]. The decision to remove items during CFA was based on theoretical background, factor loadings, and fit indices. We initially refined the model by analysing factor correlations and high modification indices (MI) for covariances. However, removing links between highly correlated factors and adding correlations for high MI variables worsened performance. Thus, we removed items: Q10 (My colleagues can be indifferent to the impact these situations have had on me.), Q11 (My colleagues help me feel that I am still a good healthcare provider despite any mistakes I have made.), Q14 (I feel that my manager/chief treats me appropriately after these occasions.), Q16 (My manager/chief blames individuals.), and Q20 (Concern for the well-being of those involved in these situations is not strong at my institution.) due to low factor loadings to improve overall fit. Afterwards, adding error covariances resulted in the best fit in Model 4. Similar adjustments were noted in other versions: Q11 was excluded in the Turkish [ 23 ] and Malaysian [ 27 ] versions, Q16 and Q20 in the Malaysian version [ 27 ], and Q16 in the Argentine [ 40 ] version. Q10 was problematic, but retained in the Danish version for its relevance to colleague support [ 24 ]. These enhanced the precision and reliability of the SR-SVEST-R, resulting in improved Cronbach’s alpha for individual factors and providing a more accurate assessment of psychological distress and support. The SR-SVEST-R exhibited strong reliability, with a Cronbach’s alpha of 0.88. Psychological distress (0.75) and Physical distress (0.83) scores were higher than in the SVEST-R (0.70 and 0.79) [ 18 ] and comparable to the Danish version (0.81 and 0.87) [ 24 ]. Colleague support improved from 0.47 to 0.60, surpassing the SVEST-R’s 0.34 [ 18 ] and aligning with the Malaysian version (0.66) [ 27 ] but higher than the Danish version (0.40) [ 24 ]. Supervisor and institutional support stabilised at 0.62 and 0.77, similar to the SVEST-R (0.58 and 0.73) [ 18 ] and Danish version (0.73 and 0.68) [ 24 ], and higher than the Turkish version (0.61 and 0.63) [ 23 ]. Other dimensions showed high reliability (0.81–0.90), consistent with the Malaysian [ 27 ], Danish [ 24 ], and Turkish versions [ 23 ]. Relevance for clinical practice Our study validated the first tool for assessing the second victim phenomenon among pharmacy professionals. This tool enables real-time assessments, informs targeted interventions, and promotes a just culture. It supports changes aligned with the European Researchers’ Network Working on Second Victims (ERNST) model [ 47 ] and enhances clinical practice by informing training curricula and fostering ongoing professional development. Further research Future research should explore pharmacy professionals' second victim experiences and support needs in Serbian-speaking Western Balkans countries, using the SR-SVEST-R with a larger sample, providing insights to improve accountability, advanced service participation, and attitudes toward tailored education. CONCLUSION The SR-SVEST-R questionnaire is a valid and reliable tool for measuring second victim experiences and support needs among pharmacy professionals. Additionally, it can be used to evaluate existing support programs designed for this population. Declarations ACKNOWLEDGMENTS: The authors would like to thank Svetlana Pintar Vukosavljević, Jelena Stefanović Vojinović, Tatjana Milošević, Sonja Stojiljković and Milan Rakić, for the practical pharmacy practice aspect and contribution to content validation. AI language models (ChatGPT4, OpenAI, San Francisco, CA, USA; Grammarly, Inc., San Francisco, CA, USA) assisted in refining the language in this manuscript. They were used for the improvement of grammar and sentence reformulation but did not contribute to authorship or content creation. This article/publication is based on work from COST Action CA19113, supported by COST (European Cooperation in Science and Technology). FUNDING: This research was supported by the Ministry of Science, Technological Development and Innovation, Republic of Serbia, through two Grant Agreements with the University of Belgrade-Faculty of Pharmacy No 451-03-65/2024-03/ 200161 and No 451-03-66/2024-03/ 200161. No funding was received to assist with the preparation of this manuscript. CONFLICTS OF INTEREST: None of the authors have any competing interests to declare. References Wu AW. Medical error: the second victim. West J Med. 2000;172(6):358-9. Edrees HH, Paine LA, Feroli ER, et al. Health care workers as second victims of medical errors. Pol Arch Med Wewn. 2011;121(4):101-8. Vanhaecht K, Seys D, Russotto S, et al. An Evidence and Consensus-Based Definition of Second Victim: A Strategic Topic in Healthcare Quality, Patient Safety, Person-Centeredness and Human Resource Management. Int J Environ Res Public Health. 2022;19(24). Busch IM, Moretti F, Purgato M, et al. 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Scand J Public Health. 2022;50(4):497-506. Santana-Domínguez I, González-de la Torre H, Martín-Martínez A. Cross-cultural adaptation to the Spanish context and evaluation of the content validity of the Second Victim Experience and Support Tool (SVEST-E) questionnaire. Enferm Clin (Engl Ed). 2021;31(6):334-43. Strametz R, Siebold B, Heistermann P, et al. Validation of the German Version of the Second Victim Experience and Support Tool-Revised. J Patient Saf. 2022;18(3):182-92. Mohd Kamaruzaman AZ, Ibrahim MI, Mokhtar AM, et al. Translation and Validation of the Malay Revised Second Victim Experience and Support Tool (M-SVEST-R) among Healthcare Workers in Kelantan, Malaysia. Int J Environ Res Public Health. 2022;19(4). Dato Md Yusof YJ, Ng QX, Teoh SE, et al. Validation and use of the Second Victim Experience and Support Tool questionnaire: a scoping review. Public Health. 2023;223:183-92. Sousa VD, Rojjanasrirat W. 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The content validity index: are you sure you know what's being reported? Critique and recommendations. Res Nurs Health. 2006;29(5):489-97. Xia Y, Yang Y. RMSEA, CFI, and TLI in structural equation modeling with ordered categorical data: The story they tell depends on the estimation methods. Behav Res Methods. 2019;51(1):409-28. Bryant FB, Yarnold PR, Michelson EA. Statistical methodology: VIII. Using confirmatory factor analysis (CFA) in emergency medicine research. Acad Emerg Med. 1999;6(1):54-66. Bland JM, Altman DG. Cronbach's alpha. BMJ. 1997;314(7080):572. Tavakol M, Dennick R. Making sense of Cronbach's alpha. Int J Med Educ. 2011;2:53-5. Chen J, Yang Q, Zhao Q, et al. Psychometric validation of the Chinese version of the Second Victim Experience and Support Tool (C-SVEST). J Nurs Manag. 2019;27(7):1416-22. Brunelli MV, Estrada S, Celano C. Cross-Cultural Adaptation and Psychometric Evaluation of a Second Victim Experience and Support Tool (SVEST). 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ISBN: 978-0-07-177015-6 Sordi LP, Lourenção DCA, Gallasch CH, et al. The second victim experience: cross-cultural adaptation of an instrument for the Brazilian context. Rev Gaucha Enferm. 2022;43:e20210010. Mira J, Carillo I, Tella S, et al. The European Researchers’ Network Working on Second Victim (ERNST) Policy Statement on the Second Victim Phenomenon for Increasing Patient Safety. Public Health Reviews. 2024;45:1607175. Supplementary Files SupplementaryMaterialTranslatedSRSVESTR.docx Cite Share Download PDF Status: Published Journal Publication published 13 Feb, 2025 Read the published version in International Journal of Clinical Pharmacy → Version 1 posted Editorial decision: Minor revisions 14 Jan, 2025 Reviewers agreed at journal 07 Nov, 2024 Reviewers invited by journal 27 Oct, 2024 Editor invited by journal 25 Oct, 2024 First submitted to journal 25 Oct, 2024 Editor assigned by journal 21 Oct, 2024 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. 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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-5293950","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":370820916,"identity":"cde63763-9596-4947-a4fb-392a89ade41a","order_by":0,"name":"Ivana Zimonjić","email":"data:image/png;base64,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","orcid":"https://orcid.org/0000-0002-1795-3487","institution":"University of Belgrade Faculty of Pharmacy: Univerzitet u Beogradu Farmaceutski fakultet","correspondingAuthor":true,"prefix":"","firstName":"Ivana","middleName":"","lastName":"Zimonjić","suffix":""},{"id":370820917,"identity":"4072305c-1037-4ee3-b2ba-0a8fc4ff9104","order_by":1,"name":"Valentina Marinković","email":"","orcid":"","institution":"University of Belgrade Faculty of Pharmacy: Univerzitet u Beogradu Farmaceutski fakultet","correspondingAuthor":false,"prefix":"","firstName":"Valentina","middleName":"","lastName":"Marinković","suffix":""},{"id":370820918,"identity":"237945ec-da93-4af6-a8a5-6990edd1fe20","order_by":2,"name":"José Joaquín Mira","email":"","orcid":"","institution":"Miguel Hernandez University of Elche: Universidad Miguel Hernandez de Elche","correspondingAuthor":false,"prefix":"","firstName":"José","middleName":"Joaquín","lastName":"Mira","suffix":""},{"id":370820919,"identity":"059fdc92-1d4e-42b0-ad10-61fbefc23288","order_by":3,"name":"Bojana Knežević","email":"","orcid":"","institution":"University Hospital Centre Zagreb: Klinicki Bolnicki Centar Zagreb","correspondingAuthor":false,"prefix":"","firstName":"Bojana","middleName":"","lastName":"Knežević","suffix":""},{"id":370820920,"identity":"df715c72-30bf-41c4-9697-5b1d331bf1ea","order_by":4,"name":"Borivoje-Boris Djokic","email":"","orcid":"","institution":"Keiser University - 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Common consequences reported in the literature include\u0026nbsp;anxiety, self-directed anger, fear of future errors, diminished self-confidence, and adverse effects on job performance\u0026nbsp;[4-6]. These can lead to increased absenteeism, defensive practices affecting care quality, higher turnover intentions, and the organisation becoming a tertiary victim due to lower staff morale and productivity\u0026nbsp;[7, 8]. Despite their critical role in optimising medication use and ensuring patient safety\u0026nbsp;[9], pharmacists often face significant stress from accepting responsibility for therapy outcomes\u0026nbsp;[10, 11]. Second victim experiences may also affect their willingness to provide advanced services, like medication review\u0026nbsp;[12, 13]\u0026nbsp;and impact the quality and safety of future clinical practice\u0026nbsp;[14]. Effective support programs, like peer support and leadership initiatives, are vital and should be tailored to the healthcare environment's cultural and organisational context\u0026nbsp;[15, 16].\u003c/p\u003e\n\u003cp\u003eThe Second Victim Experience and Support Tool (SVEST) is designed to evaluate the experiences of second victims and the desirability of support for healthcare professionals\u0026nbsp;[17]. The original version includes 29 statements classified into 7 factors and 2 outcome variables, followed by 7 support options. An extended version incorporates resilience as a positive outcome dimension (SVEST-R) with 4 statements, resulting in 9 factors and 35 items\u0026nbsp;[18]. The SVEST has been culturally adapted and validated in various countries and is available in multiple languages, including Chinese, Danish, Italian, Korean, Persian, Portuguese, Spanish and Turkish\u0026nbsp;[19-25]. The SVEST-R is available in German and Malay\u0026nbsp;[26, 27]. Previous studies on the second victim phenomenon mostly included doctors and nurses, with pharmacists representing under 10% in few studies\u0026nbsp;[28]. Currently, there is no validated version available in Serbian, nor is there a specific validated version for pharmacy professionals.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAIM\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study aimed to validate the SVEST-R for pharmacy professionals, assess the second victim phenomenon, and present findings among pharmacy professionals in Serbia, evaluating its effectiveness in capturing support needs, potentially applicable in Serbian-speaking countries.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eETHICS APPROVAL\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe University of Belgrade – Faculty of Pharmacy's Medical Ethics Committee approved this study (Reference number: 1340/2, dated June 12th, 2023).\u0026nbsp;\u003c/p\u003e"},{"header":"METHOD","content":"\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eStudy design\u003c/h2\u003e \u003cp\u003eThe study used a cross-sectional design in two phases. In Phase 1, the SVEST-R was translated and culturally adapted from English to Serbian. In Phase 2, the Serbian SR-SVEST-R was pre-tested with 30 pharmacy professionals (following recommendations [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]) and psychometrically validated for assessing the second victim phenomenon among pharmacy professionals. The process involved evaluating its validity and reliability following general guideline steps [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e] and comparing with other SVEST validation studies.\u003c/p\u003e \u003cp\u003eThe SVEST-R [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e] includes 9 factors: 6 for the second victim phenomenon (i) psychological distress, (ii) physiological distress, (iii) colleague support, (iv) supervisor support, (v) institutional support, (vi) professional self-efficacy, and 3 outcomes (vii) turnover intentions, (viii) absenteeism, (ix) resilience. It also covers 7 support options: (a) immediate time away from the unit, (b) peaceful recovery location, (c) discussion with a respected peer, (d) employee assistance program for free counselling, (e) discussion with a manager or supervisor, (f) scheduled time with a counsellor, (g) confidential 24-hour support contact. Items are rated from 1 (strongly disagree) to 5 (strongly agree), with reverse-coded items marked by asterisks. Support options are rated from 1 (extremely undesirable) to 5 (extremely desirable). Validation on 316 participants [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e] (primarily nurses, 2.5% pharmacists) showed χ2\u0026thinsp;=\u0026thinsp;1555, DOF\u0026thinsp;=\u0026thinsp;524, RMSEA\u0026thinsp;=\u0026thinsp;0.079, CFI\u0026thinsp;=\u0026thinsp;0.821, SRMR\u0026thinsp;=\u0026thinsp;0.091, factor loadings 0.42\u0026ndash;0.92, and Cronbach\u0026rsquo;s alpha 0.66\u0026ndash;0.86.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eSetting, sampling, and recruitment\u003c/h3\u003e\n\u003cp\u003eThe study included 350 pharmacy professionals (MPharm and pharmacy technicians) from Serbia, adhering to the recommended sample size of 10 participants per item [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. Convenience sampling was used for recruitment [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e], focusing solely on community pharmacy professionals and excluding those from other settings. The SR-SVEST-R questionnaire was administered in paper form at two continuing education events in Serbia in October 2023, with all participants consenting and completing it in its entirety, with no withdrawals.\u003c/p\u003e\n\u003ch3\u003eData collection\u003c/h3\u003e\n\u003cp\u003eData collection was conducted by three researchers: PhD student Ivana Zimonjić (I.Z., MPharm) and professors Valentina Marinković (V.M., PhD) and Marina Odalović (M.O., PhD). They distributed and collected paper questionnaires during accredited educational sessions, adhering to a structured protocol to ensure consistency and reliability.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eTranslation and Cultural Adaptation\u003c/h2\u003e \u003cp\u003eThe process began with obtaining permission from the original authors of the SVEST-R in March 2023 to translate and adapt the tool. Following the Malaysian SVEST-R study, the translation adhered to Wild\u0026rsquo;s guidelines [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. Two bilingual healthcare professionals performed the forward translation from English to Serbian, ensuring each item's meaning was preserved. A panel of five experts, comprising healthcare professionals and researchers experienced in patient safety, reviewed the translated items for cultural relevance and clarity, adjusting the language for the Serbian context. Two additional bilingual professionals conducted a backward translation from Serbian to English, unaware of the original questionnaire, to verify accuracy. Some terms were modified for cultural alignment: \"miserable\" in question 3 was changed to \"less valued,\" \"fair\" in question 15 was adjusted to \"appropriate,\" \"supervisor\" was replaced with \"manager/chief,\" and \"organisation\" with \"healthcare institution.\" Finally, the expert panel reviewed the backward translation for conceptual and cultural equivalence.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eContent Validation\u003c/h3\u003e\n\u003cp\u003eAn expert panel of five rated each item's relevance and clarity on a 4-point scale (1\u0026thinsp;=\u0026thinsp;not relevant, 4\u0026thinsp;=\u0026thinsp;highly relevant), leading to final adjustments. Content validity was measured by the Item-level Content Validity Index (I-CVI) and Scale-level Content Validity Index (S-CVI/Ave), with values\u0026thinsp;\u0026gt;\u0026thinsp;0.8 considered acceptable [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. A pre-test with 30 pharmacists followed cognitive evaluation, resulting in the final SR-SVEST-R version (Supplementary material).\u003c/p\u003e\n\u003ch3\u003eData analysis, interpretation and storage\u003c/h3\u003e\n\u003cp\u003eAll raw data were stored in Microsoft Word and Excel anonymised and sequentially numbered for identification. The lead researcher ensured secure electronic storage with restricted access. Descriptive statistics were conducted using SPSS software (SPSS 29.0 for Windows, SPSS Inc., Chicago, IL, USA) to summarise demographic characteristics and questionnaire responses. Mean scores were calculated for each item, dimension, and outcome, while agreement percentages (score\u0026thinsp;\u0026ge;\u0026thinsp;4) were also calculated for each item and support option, following the original study's methodology [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e].\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003ePsychometric Evaluation\u003c/h2\u003e \u003cp\u003eConstruct validity was assessed using Confirmatory Factor Analysis (CFA) with AMOS software package (IBM SPSS Amos 26.0 for Windows, IBM Corp., Armonk, NY, USA). The assessment of the factor structure of the SR-SVEST-R involved calculating various fit indices to evaluate the model fit. The cut-off values for assessing model fit in CFA were: a non-significant Chi-square (χ\u0026sup2;) (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05) for a good fit, Root Mean Square Error of Approximation (RMSEA)\u0026thinsp;\u0026lt;\u0026thinsp;0.08 for acceptable and \u0026lt;\u0026thinsp;0.05 for excellent, Comparative Fit Index (CFI)\u0026thinsp;\u0026gt;\u0026thinsp;0.90 for acceptable and \u0026gt;\u0026thinsp;0.95 for excellent, Tucker-Lewis Index (TLI)\u0026thinsp;\u0026gt;\u0026thinsp;0.90 for acceptable and \u0026gt;\u0026thinsp;0.95 for excellent, and Standardised Root Mean Square Residual (SRMR)\u0026thinsp;\u0026lt;\u0026thinsp;0.08 for good and \u0026lt;\u0026thinsp;0.05 for excellent [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. The ratio of Parameter Change in the Minimum to Degrees of Freedom (PCMIN/DF), known as χ\u0026sup2;/df values less than 3 indicates a good model fit. Items with factor loadings\u0026thinsp;\u0026le;\u0026thinsp;0.40 were eliminated and error covariances were added only in the same construct [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]. Reliability was assessed using Cronbach's Alpha, with values of 0.70 or higher deemed acceptable for the overall scale and its subdimensions [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e"},{"header":"RESULTS","content":"\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\n \u003ch2\u003eDemographic characteristics of the participants\u003c/h2\u003e\n \u003cp\u003eIn the study group (n\u0026thinsp;=\u0026thinsp;350), the mean age was 43 years (SD\u0026thinsp;=\u0026thinsp;11.6), and the mean work experience was 17 years (SD\u0026thinsp;=\u0026thinsp;11.9). Most participants were female (91.4%). Education levels included master\u0026apos;s (48.3%), secondary school (26.0%), specialised studies (13.1%), bachelor\u0026apos;s (6.3%), and doctorate (5.1%). Job positions included pharmacists (64.3%) and pharmacy technicians (33.7%), with most working in private pharmacies (86.9%). Awareness of the second victim phenomenon was 45.1%. Demographic details are in Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e\n \u003cdiv class=\"gridtable\"\u003e\u0026nbsp;\u003ctable id=\"Tab1\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eDemographic characteristics of the study participants (n\u0026thinsp;=\u0026thinsp;350)\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"4\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eSociodemographic Variables (n\u0026thinsp;=\u0026thinsp;350)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eCategories\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eN (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eMean (Min-Max) (SD)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e43 (20\u0026ndash;74) (11.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYears of work experience\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e17 (1\u0026ndash;65) (11.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e320 (91.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e30 (8.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLevel of education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSecondary School\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e91 (26.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCollege - Bachelor\u0026apos;s Degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e22 (6.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUniversity - Master\u0026apos;s Degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e169 (48.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSpecialised Academic Studies\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e46 (13.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHealth Specialisation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e4 (1.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMaster\u0026apos;s or Doctorate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e18 (5.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eJob position\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePharmacy technician in a community pharmacy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e112 (32.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePharmacy technician in an emergency pharmacy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e6 (1.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePharmacist in a community pharmacy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e225 (64.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePharmacist in an emergency pharmacy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e7 (2.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eType of institution\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePrivate Pharmacy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e305 (87.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eState Pharmacy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e45 (12.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSize of the city\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRural area\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e34 (9.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSmaller town (up to 100,000 inhabitants)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e141 (40.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMedium-sized city (100\u0026ndash;200,000 inhabitants)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e47 (13.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLarge city (over 200,000 inhabitants)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e128 (36.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHave you ever heard of the phenomenon known as the Second Victim?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e158 (45.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e192 (54.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cp\u003ePlease insert Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e here. Demographic characteristics of the study participants (n\u0026thinsp;=\u0026thinsp;350)\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e\n \u003ch2\u003eContent Validation\u003c/h2\u003e\n \u003cp\u003eThe Item-level Content Validity Index (I-CVI) ranged from 0.8 to 1 (6 items with 1 \u0026ndash; Q1, Q2, Q11, Q32, Q33, Q35 and others with 0.8), and the Scale-level Content Validity Index (S-CVI/Ave) was 0.83, indicating acceptable content validity (for specific questions - Q, see Table \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e and Supplementary material).\u003c/p\u003e\n \u003ch2\u003eDescriptive statistics \u0026ndash; mean scores, agreements\u003c/h2\u003e\n \u003cp\u003eTable 2 presents the domain-specific findings for the SR-SVEST-R. The data reveal varied levels of agreement across different domains. Psychological distress had a 37.2% agreement (Mean\u0026thinsp;=\u0026thinsp;2.94, SD\u0026thinsp;=\u0026thinsp;1.51). Physical distress was agreed upon by 24.8% (Mean\u0026thinsp;=\u0026thinsp;2.42, SD\u0026thinsp;=\u0026thinsp;1.40). Colleague support showed 20.5% agreement (Mean\u0026thinsp;=\u0026thinsp;2.17, SD\u0026thinsp;=\u0026thinsp;1.35). Supervisor support was reported by 28.8% (Mean\u0026thinsp;=\u0026thinsp;2.57, SD\u0026thinsp;=\u0026thinsp;1.57), while institutional support was noted by 28.2% (Mean\u0026thinsp;=\u0026thinsp;2.73, SD\u0026thinsp;=\u0026thinsp;1.48). Professional self-efficacy and turnover intentions had 14.8% and 15.5% agreement levels, respectively (Means\u0026thinsp;=\u0026thinsp;2.13 and 2.04, SDs\u0026thinsp;=\u0026thinsp;1.30 for both). Absenteeism had the lowest agreement at 13.6% (Mean\u0026thinsp;=\u0026thinsp;1.91, SD\u0026thinsp;=\u0026thinsp;1.44), while resilience was agreed upon by 25.4% (Mean\u0026thinsp;=\u0026thinsp;2.45, SD\u0026thinsp;=\u0026thinsp;1.55).\u003c/p\u003e\n \u003cdiv class=\"gridtable\"\u003e\u0026nbsp;\u003ctable id=\"Tab2\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eDomain descriptive findings of the SR-SVEST-R (n\u0026thinsp;=\u0026thinsp;350)\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"5\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eDomain\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eItem\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eAgreement (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eSD\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePsychological distress\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e37.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.51\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ1. I have experienced embarrassment from these instances.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e46.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.54\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ2. My involvement in these types of instances has made me fearful of future occurrences.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e49.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.54\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ3. My experiences have made me feel less valued.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e20.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.42\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ4. I feel deep remorse/guilt for my past involvements in these types of events.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e32.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.53\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePhysical distress\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e24.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.40\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ5. The mental weight of my experience is exhausting.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e47.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.53\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ6. My experience with these occurrences can make it hard to sleep regularly.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e26.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.44\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ7. The stress from such situations causes me nausea or disgust.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e17.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.38\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ8. Thinking about these situations reduces my appetite.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e14.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ9. I have had bad dreams as a result of these situations.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e17.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.37\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eColleague support\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e20.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.35\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ10. My colleagues can be indifferent to the impact these situations have had on me.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e21.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.41\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ11. My colleagues help me feel that I am still a good healthcare professional despite any mistakes I have made. ᵃ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e41.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.65\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ12. My colleagues no longer trust me.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.19\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ13. My professional reputation has been damaged because of these situations.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e9.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.15\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSupervisor support\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e28.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.57\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ14. I feel that my manager/chief treats me appropriately after these occasions. ᵃ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e37.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.65\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ15. My manager/chief\u0026apos;s reactions are appropriate. ᵃ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e32.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.65\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ16. My manager/chief blames individuals.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e18.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.51\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ17. I feel my manager/chief considers the complexity of pharmaceutical care in these situations. ᵃ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e28.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.47\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eInstitution support\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e28.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.48\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ18. My healthcare institution understands that those involved may need help to process and resolve any effects they may have on care professionals. ᵃ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e28.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.48\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ19. My healthcare institution offers a variety of resources to help get me over the effects of involvement with these instances. ᵃ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e29.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.48\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ20. Concern for the well-being of those involved in these situations is not strong at my institution.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e26.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.48\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eProfessional self-efficacy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e14.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ21. After such events, I felt incompetent regarding my ability to provide pharmaceutical care.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e16.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.32\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ22. My experience makes me question whether I am still a good healthcare professional.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e13.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.28\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ23. Following my experience, I became afraid to undertake challenging or high-risk services.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e16.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.31\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ24. These situations have negatively impacted my job performance.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e12.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.27\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTurnover intentions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e15.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ25. Experiences with such events have led me to consider seeking a job outside of pharmaceutical care.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e15.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.32\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ26. Sometimes the stress of potentially being involved in such events makes me want to quit my job.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e22.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.41\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ27. I have started to inquire about other job opportunities.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e15.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.34\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ28. I plan to leave my job within the next 6 months due to these experiences.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e8.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAbsenteeism\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e13.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.44\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ29. My experiences with adverse events or errors in providing pharmaceutical care have led me to take time off work.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e12.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.29\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ30. I was absent from work following one of these events.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e13.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.72\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ31. When at work, I am distracted and not fully present because of these experiences.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e15.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.32\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eResilience\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e25.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.55\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ32. Due to these situations, I have become much more cautious at work. ᵃ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e27.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.59\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ33. These events have led me to improve the quality of pharmaceutical care. ᵃ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e28.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.62\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ34. My experiences with adverse events or errors in pharmaceutical care have resulted in positive changes in procedures or processes within my healthcare institution. ᵃ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e22.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.49\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ35. After participating in adverse events and/or a professional error, I have developed as a healthcare professional. ᵃ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e22.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.49\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\"\u003eAgreement\u0026thinsp;=\u0026thinsp;mean score of \u0026ge;\u0026thinsp;4.0, negative impact of Second Victim experience\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\"\u003eᵃ Reverse-scored item (1\u0026thinsp;=\u0026thinsp;strongly agree, 5\u0026thinsp;=\u0026thinsp;strongly disagree)\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec15\" class=\"Section2\"\u003e\n \u003cp\u003ePlease insert Table \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e here. Domain descriptive findings of the SR-SVEST-R (n\u0026thinsp;=\u0026thinsp;350)\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec16\" class=\"Section2\"\u003e\n \u003ch2\u003eSupport options\u003c/h2\u003e\n \u003cp\u003eThe most desirable support was having a respected peer to discuss the event, with 72.6% of participants finding it desirable and a mean score of 4.17 (SD\u0026thinsp;=\u0026thinsp;1.25). Similarly, an employee assistance program offering free counselling was highly valued, with 62.6% of participants indicating it as desirable and a mean score of 4.01 (SD\u0026thinsp;=\u0026thinsp;1.28). In contrast, immediate time away from the unit and a designated peaceful location for recovery were less preferred, with 45.1% and 50.5% of participants finding these options desirable, and mean scores of 3.29 (SD\u0026thinsp;=\u0026thinsp;1.55) and 3.49 (SD\u0026thinsp;=\u0026thinsp;1.47), respectively (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\n \u003cdiv class=\"gridtable\"\u003e\u0026nbsp;\u003ctable id=\"Tab3\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eThe desirability for the Second Victim support options (n\u0026thinsp;=\u0026thinsp;350)\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"5\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eSupport option\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eDesired, %\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNot desired, %\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eSD\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1. The opportunity to immediately step away from work for a short period.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e45.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e29.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.55\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2. A specified peaceful location that is available to recover and re- compose after one of these types of events.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e50.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e26.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.47\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3. A respected peer to discuss the details of what happened.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e72.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e11.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e4.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.25\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4. An employee assistance program that can provide free counselling to employees outside of work.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e62.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e12.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e4.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.28\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5. A discussion with my manager/chief about the incident.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e61.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e16.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.35\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6. The opportunity to schedule a time with a counsellor at my healthcare institution to discuss the event.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e56.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e20.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.38\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7. A confidential way to get in touch with someone 24 hours a day to discuss how my experience may be affecting me.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e53.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e17.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.34\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\"\u003eAgreement\u0026thinsp;=\u0026thinsp;mean score of \u0026ge;\u0026thinsp;4.0, negative impact of Second Victim experience\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cp\u003ePlease insert Table \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e here. The desirability for the Second Victim support options (n\u0026thinsp;=\u0026thinsp;350)\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec17\" class=\"Section2\"\u003e\n \u003ch2\u003eConfirmatory Factor Analysis (CFA)\u003c/h2\u003e\n \u003cp\u003eTable\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e presents the results of the CFA for the SR-SVEST-R across four models. In Model 1, which includes all original items, factor loadings range from 0.19 to 0.88. Model 2, which excluded items Q11, Q14, Q16, and Q20 (factor loadings were as follows: 0.26, 0.31, 0.25 and 0.19), showed loadings between 0.39 and 0.88. Model 3 removed item Q10 (factor loading 0.39), resulting in loadings from 0.55 to 0.88. Model 4, which included additional error covariances (e5\u0026rarr;e8, e29\u0026rarr;e30, and e34\u0026rarr;e35), demonstrates loadings ranging from 0.56 to 0.92.\u003c/p\u003e\n \u003cdiv class=\"gridtable\"\u003e\u0026nbsp;\u003ctable id=\"Tab4\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eConfirmatory Factor Analysis (CFA) (IBM AMOS 26) with standardised factor loadings for the SR-SVEST-R (n\u0026thinsp;=\u0026thinsp;350)\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"6\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eDomain\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eItem\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eModel 1\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eModel 2\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eModel 3\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eModel4\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePsychological distress\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ1. I have experienced embarrassment from these instances.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.58\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ2. My involvement in these types of instances has made me fearful of future occurrences.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.62\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ3. My experiences have made me feel less valued.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.74\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ4. I feel deep remorse/guilt for my past involvements in these types of events.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.69\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePhysical distress\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ5. The mental weight of my experience is exhausting.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.66\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ6. My experience with these occurrences can make it hard to sleep regularly.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.73\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ7. The stress from such situations causes me nausea or disgust.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.72\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ8. Thinking about these situations reduces my appetite.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.73\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ9. I have had bad dreams as a result of these situations.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.77\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eColleague support\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ10. My colleagues can be indifferent to the impact these situations have had on me.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDeleted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDeleted\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ11. My colleagues help me feel that I am still a good healthcare professional despite any mistakes I have made. ᵃ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDeleted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDeleted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDeleted\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ12. My colleagues no longer trust me.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.56\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ13. My professional reputation has been damaged because of these situations.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.78\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSupervisor support\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ14. I feel that my manager/chief treats me appropriately after these occasions. ᵃ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDeleted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDeleted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDeleted\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ15. My manager/chief\u0026apos;s reactions are appropriate. ᵃ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.71\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ16. My manager/chief blames individuals.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDeleted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDeleted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDeleted\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ17. I feel my manager/chief considers the complexity of pharmaceutical care in these situations. ᵃ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.63\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eInstitution support\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ18. My healthcare institution understands that those involved may need help to process and resolve any effects they may have on care professionals. ᵃ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.85\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ19. My healthcare institution offers a variety of resources to help get me over the effects of involvement with these instances. ᵃ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.72\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ20. Concern for the well-being of those involved in these situations is not strong at my institution.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDeleted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDeleted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDeleted\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eProfessional self-efficacy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ21. After such events, I felt incompetent regarding my ability to provide pharmaceutical care.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.70\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ22. My experience makes me question whether I am still a good healthcare professional.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.75\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ23. Following my experience, I became afraid to undertake challenging or high-risk services.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.77\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ24. These situations have negatively impacted my job performance.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.76\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTurnover intentions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ25. Experiences with such events have led me to consider seeking a job outside of pharmaceutical care.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.78\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ26. Sometimes the stress of potentially being involved in such events makes me want to quit my job.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.77\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ27. I have started to inquire about other job opportunities.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.73\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ28. I plan to leave my job within the next 6 months due to these experiences.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.61\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAbsenteeism\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ29. My experiences with adverse events or errors in providing pharmaceutical care have led me to take time off work.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.61\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ30. I was absent from work following one of these events.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.48\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ31. When at work, I am distracted and not fully present because of these experiences.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.74\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eResilience\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ32. Due to these situations, I have become much more cautious at work. ᵃ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.84\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ33. These events have led me to improve the quality of pharmaceutical care. ᵃ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.92\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ34. My experiences with adverse events or errors in pharmaceutical care have resulted in positive changes in procedures or processes within my healthcare institution. ᵃ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.73\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ35. After participating in adverse events and/or a professional error, I have developed as a healthcare professional. ᵃ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.75\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\"\u003eModel 1\u0026thinsp;=\u0026thinsp;all original items, Model 2\u0026thinsp;=\u0026thinsp;removed items Q11, Q14, Q16 and Q20, Model 3\u0026thinsp;=\u0026thinsp;removed item Q10, Model 4\u0026thinsp;=\u0026thinsp;added covariances e5\u0026rarr;e8, e29\u0026rarr;e30, and e34\u0026rarr;e35.\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\"\u003eᵃ Reverse-scored item (1\u0026thinsp;=\u0026thinsp;strongly agree, 5\u0026thinsp;=\u0026thinsp;strongly disagree)\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cp\u003ePlease insert Table \u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e here. Confirmatory Factor Analysis (CFA) (IBM AMOS 26) with standardised factor loadings for the SR-SVEST-R (n\u0026thinsp;=\u0026thinsp;350)\u003c/p\u003e\n \u003cp\u003eTable \u003cspan class=\"InternalRef\"\u003e5\u003c/span\u003e details the model fit indices for the SR-SVEST-R. In Model 1, the key fit indices were as follows: \u0026chi;\u0026sup2;/df\u0026thinsp;=\u0026thinsp;1.905, RMSEA\u0026thinsp;=\u0026thinsp;0.051, CFI\u0026thinsp;=\u0026thinsp;0.895 and SRMR\u0026thinsp;=\u0026thinsp;0.065. For Model 4, after adding error covariances, the indices improved: \u0026chi;\u0026sup2;/df\u0026thinsp;=\u0026thinsp;1.491, RMSEA\u0026thinsp;=\u0026thinsp;0.037, CFI\u0026thinsp;=\u0026thinsp;0.958 and SRMR\u0026thinsp;=\u0026thinsp;0.040.\u003c/p\u003e\n \u003cdiv class=\"gridtable\"\u003e\u0026nbsp;\u003ctable id=\"Tab5\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eModel fit indices of the SR-SVEST-R compared to the original SVEST-R and Malaysian M-SVEST-R\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"7\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eTesting Parameters\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eModel 1\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eModel 2\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eModel 3\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eModel 4 (e5\u0026rarr;e8, e29\u0026rarr;e30, e34\u0026rarr;e35)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eOriginal SVEST-R\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eM-SVEST-R\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eChi-square\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e998.323\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e729.819\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e656.891\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e545.571\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1555.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e797.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDf\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e524\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e398\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e369\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e366\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e524\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e418\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026chi;\u0026sup2;/df\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.905\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.834\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.780\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.491\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRMSEA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.051\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.049\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.047\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.037\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.079\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(95% CI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(0.045, 0.057)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(0.043, 0.055)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(0.041, 0.053)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(0.031, 0.043)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(0.044, 0.055)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCFI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.895\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.923\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.932\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.958\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.821\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.946\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGFI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.862\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.881\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.888\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.907\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAGFI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.834\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.852\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.859\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.882\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTLI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.881\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.910\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.920\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.950\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.935\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSRMR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.065\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.048\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.044\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.040\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.091\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.055\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAIC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1210.323\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e925.819\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e848.891\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e743.571\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e28,120\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBIC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1619.234\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1303.896\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1219.253\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1125.507\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e28,200\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\"\u003e\u0026chi;\u0026sup2;: Chi-square; Df: Degrees of Freedom; \u0026chi;\u0026sup2;/df: Chi-square/Degrees of Freedom Ratio; RMSEA: Root Mean Square Error of Approximation; CFI: Comparative Fit Index; GFI: Goodness of Fit Index; AGFI: Adjusted Goodness of Fit Index; TLI: Tucker-Lewis Index; SRMR: Standardized Root Mean Square Residual; AIC: Akaike Information Criterion; BIC: Bayesian Information Criterion.\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\"\u003eModel 1\u0026thinsp;=\u0026thinsp;all original items, Model 2\u0026thinsp;=\u0026thinsp;removed items Q11, Q14, Q16 and Q20, Model 3\u0026thinsp;=\u0026thinsp;removed item Q10, Model 4\u0026thinsp;=\u0026thinsp;added covariances e5\u0026rarr;e8, e29\u0026rarr;e30, and e34\u0026rarr;e35.\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cp\u003ePlease insert Table \u003cspan class=\"InternalRef\"\u003e5\u003c/span\u003e here. Model fit indices of the SR-SVEST-R compared to the original SVEST-R and Malaysian M-SVEST-R\u003c/p\u003e\n \u003cp\u003eThe final Model 4 with factor loadings, error estimates and covariances is presented in Fig. \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e\n \u003cp\u003ePlease insert Fig. \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e here. Confirmatory factor analysis of the SR-SVEST-R, final model (Model 4)\u003c/p\u003e\n \u003cp\u003eThe Cronbach\u0026apos;s alpha coefficients for the SR-SVEST-R across all models were consistent, with the total scale maintaining a reliability of 0.88. Psychological distress and physical distress consistently scored 0.75 and 0.83, respectively. Colleague support improved from 0.47 in Model 1 to 0.60 in Models 3 and 4. Supervisor support and institutional support increased slightly across models, stabilising at 0.62 and 0.77, respectively, in Models 2, 3, and 4. Professional self-efficacy, turnover intentions, absenteeism, and resilience remained steady at 0.83, 0.81, 0.70, and 0.90, respectively, across all models.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"DISCUSSION","content":"\u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003eStatement of key findings\u003c/h2\u003e \u003cp\u003eParticipants identified several notable impacts from their second victim experiences: 49.5% expressed fear of future events, 47.4% reported mental exhaustion, and 22.6% contemplated quitting. Crucial supportive measures included peer discussions (72.6%), employee assistance programs (62.6%), and conversations with managers (61.8%). Additionally, 28.9% observed improvements in the quality of care. Overall, our study indicates a higher level of distress, and negative outcomes compared to other healthcare professionals described in previous studies [\u003cspan additionalcitationids=\"CR18\" citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan additionalcitationids=\"CR26\" citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan additionalcitationids=\"CR40\" citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e], highlighting the distinct challenges in community pharmacies [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e] which may compromise the standards of pharmacy practice [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e] and impact patient outcomes. The SR-SVEST-R exhibited better fit indices and reliability compared to other versions [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e], confirming its robustness. Context-specific adaptations were essential, as demonstrated by the removal of several items to improve precision and reliability.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003eStrengths and Weaknesses\u003c/h2\u003e \u003cp\u003eThe study's strength lies in its rigorous methodology and statistical testing, ensuring robust validation of the SR-SVEST-R for community pharmacy professionals. The tool was meticulously translated and culturally adapted, with expert input enhancing content validity. CFA confirmed internal consistency and construct validity, making it suitable for Serbian-speaking Western Balkan countries.\u003c/p\u003e \u003cp\u003eA limitation of the study is its reliance on self-reported data, which may introduce recall bias and socially desirable responses. While the SR-SVEST-R was adapted for the Serbian context, its applicability in other cultural settings, including other Western Balkan countries, may require further adaptation. However, existing literature suggests minimal cultural differences within the former Yugoslavia, supporting the tool's broader applicability in these regions [\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e, \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec21\" class=\"Section2\"\u003e \u003ch2\u003eInterpretation\u003c/h2\u003e \u003cp\u003eOur study uniquely focuses on pharmacy professionals, contrasting with previous research showing lower pharmacist representation [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e], such as 8.5% in Burlison et al. [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e] and 10% in De Sordi et al. [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e]. This emphasises the distinctiveness of our research on the second victim phenomenon within the pharmacy field.\u003c/p\u003e \u003cp\u003eThe SR-SVEST-R's S-CVI/Ave of 0.84, with six items at 1.0 and 29 items at 0.8, is acceptable per Polit and Beck [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. This aligns with studies on the original SVEST, which showed similar or slightly lower values in Spain and Malaysia [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e], indicating satisfactory content validity.\u003c/p\u003e \u003cp\u003eOur study shows higher agreement across several domains compared to the original SVEST [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e] and SVEST-R [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Psychological and physical distress levels exceed those in SVEST [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e], SVEST-R [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e], Malaysia [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e], Denmark [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e], and Turkey [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Colleague support is higher than in SVEST [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e], SVEST-R [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e], and Malaysia [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e] but lower than in Denmark [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e] and Turkey [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Supervisor and institutional support surpass SVEST [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e], SVEST-R [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e], Malaysia [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e], and Turkey [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e] but are below Denmark [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Professional self-efficacy aligns with Turkey [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e], SVEST-R [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e], and Malaysia [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e] but lower than in Denmark [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Turnover intentions and absenteeism are higher than in SVEST [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e], SVEST-R [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e], Denmark [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e], and Malaysia [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e] but lower than in Turkey [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Resilience significantly exceeds SVEST-R [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e] and Malaysia [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. The differences may arise from the specific nature of pharmacy practice, staff preparedness, and personality traits, with colleague support equally seen as vital.\u003c/p\u003e \u003cp\u003eThe CFA of the SR-SVEST-R demonstrates improved performance in assessing the second victim phenomenon compared to the original SVEST [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e], SVEST-R [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e] and other national versions. The SR-SVEST-R, with 9 factors, has fit indices of RMSEA 0.037 and CFI 0.958, while the original SVEST-R reports RMSEA 0.079 and CFI 0.821 [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. In comparison to other versions [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e], the SR-SVEST-R shows more favourable indices, including the G-SVEST (11 factors, indices not available) [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e], C-SVEST (6 factors, RMSEA 0.051, CFI 0.946) [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e], D-SVEST (7 factors, RMSEA 0.069, CFI 0.884) [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e], T-SVEST (9 factors, RMSEA 0.071, CFI 0.931) [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e], I-SVEST (7 factors, RMSEA 0.075, CFI 0.91) [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e] and K-SVEST (8 factors, RMSEA 0.05, CFI 0.92) [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe decision to remove items during CFA was based on theoretical background, factor loadings, and fit indices. We initially refined the model by analysing factor correlations and high modification indices (MI) for covariances. However, removing links between highly correlated factors and adding correlations for high MI variables worsened performance. Thus, we removed items: Q10 (My colleagues can be indifferent to the impact these situations have had on me.), Q11 (My colleagues help me feel that I am still a good healthcare provider despite any mistakes I have made.), Q14 (I feel that my manager/chief treats me appropriately after these occasions.), Q16 (My manager/chief blames individuals.), and Q20 (Concern for the well-being of those involved in these situations is not strong at my institution.) due to low factor loadings to improve overall fit. Afterwards, adding error covariances resulted in the best fit in Model 4. Similar adjustments were noted in other versions: Q11 was excluded in the Turkish [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e] and Malaysian [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e] versions, Q16 and Q20 in the Malaysian version [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e], and Q16 in the Argentine [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e] version. Q10 was problematic, but retained in the Danish version for its relevance to colleague support [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. These enhanced the precision and reliability of the SR-SVEST-R, resulting in improved Cronbach\u0026rsquo;s alpha for individual factors and providing a more accurate assessment of psychological distress and support.\u003c/p\u003e \u003cp\u003eThe SR-SVEST-R exhibited strong reliability, with a Cronbach\u0026rsquo;s alpha of 0.88. Psychological distress (0.75) and Physical distress (0.83) scores were higher than in the SVEST-R (0.70 and 0.79) [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e] and comparable to the Danish version (0.81 and 0.87) [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Colleague support improved from 0.47 to 0.60, surpassing the SVEST-R\u0026rsquo;s 0.34 [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e] and aligning with the Malaysian version (0.66) [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e] but higher than the Danish version (0.40) [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Supervisor and institutional support stabilised at 0.62 and 0.77, similar to the SVEST-R (0.58 and 0.73) [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e] and Danish version (0.73 and 0.68) [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e], and higher than the Turkish version (0.61 and 0.63) [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Other dimensions showed high reliability (0.81\u0026ndash;0.90), consistent with the Malaysian [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e], Danish [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e], and Turkish versions [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec22\" class=\"Section2\"\u003e \u003ch2\u003eRelevance for clinical practice\u003c/h2\u003e \u003cp\u003eOur study validated the first tool for assessing the second victim phenomenon among pharmacy professionals. This tool enables real-time assessments, informs targeted interventions, and promotes a just culture. It supports changes aligned with the European Researchers\u0026rsquo; Network Working on Second Victims (ERNST) model [\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e] and enhances clinical practice by informing training curricula and fostering ongoing professional development.\u003c/p\u003e \u003cdiv id=\"Sec23\" class=\"Section3\"\u003e \u003ch2\u003eFurther research\u003c/h2\u003e \u003cp\u003eFuture research should explore pharmacy professionals' second victim experiences and support needs in Serbian-speaking Western Balkans countries, using the SR-SVEST-R with a larger sample, providing insights to improve accountability, advanced service participation, and attitudes toward tailored education.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eThe SR-SVEST-R questionnaire is a valid and reliable tool for measuring second victim experiences and support needs among pharmacy professionals. Additionally, it can be used to evaluate existing support programs designed for this population.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eACKNOWLEDGMENTS:\u0026nbsp;\u003c/strong\u003eThe authors would like to thank Svetlana Pintar Vukosavljević, Jelena Stefanović Vojinović, Tatjana Milo\u0026scaron;ević, Sonja Stojiljković and Milan Rakić, for the practical pharmacy practice aspect and contribution to content validation. AI language models (ChatGPT4, OpenAI, San Francisco, CA, USA; Grammarly, Inc., San Francisco, CA, USA) assisted in refining the language in this manuscript. They were used for the improvement of grammar and sentence reformulation but did not contribute to authorship or content creation. This article/publication is based on work from COST Action CA19113, supported by COST (European Cooperation in Science and Technology).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFUNDING:\u0026nbsp;\u003c/strong\u003eThis research was supported by the Ministry of Science, Technological Development and Innovation, Republic of Serbia, through two Grant Agreements with the University of Belgrade-Faculty of Pharmacy No 451-03-65/2024-03/ 200161 and No 451-03-66/2024-03/ 200161. No funding was received to assist with the preparation of this manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCONFLICTS OF INTEREST:\u0026nbsp;\u003c/strong\u003eNone of the authors have any competing interests to declare.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eWu AW. Medical error: the second victim. West J Med. 2000;172(6):358-9.\u003c/li\u003e\n\u003cli\u003eEdrees HH, Paine LA, Feroli ER, et al. Health care workers as second victims of medical errors. 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Behav Res Methods. 2019;51(1):409-28.\u003c/li\u003e\n\u003cli\u003eBryant FB, Yarnold PR, Michelson EA. Statistical methodology: VIII. Using confirmatory factor analysis (CFA) in emergency medicine research. Acad Emerg Med. 1999;6(1):54-66.\u003c/li\u003e\n\u003cli\u003eBland JM, Altman DG. Cronbach\u0026apos;s alpha. BMJ. 1997;314(7080):572.\u003c/li\u003e\n\u003cli\u003eTavakol M, Dennick R. Making sense of Cronbach\u0026apos;s alpha. Int J Med Educ. 2011;2:53-5.\u003c/li\u003e\n\u003cli\u003eChen J, Yang Q, Zhao Q, et al. Psychometric validation of the Chinese version of the Second Victim Experience and Support Tool (C-SVEST). J Nurs Manag. 2019;27(7):1416-22.\u003c/li\u003e\n\u003cli\u003eBrunelli MV, Estrada S, Celano C. Cross-Cultural Adaptation and Psychometric Evaluation of a Second Victim Experience and Support Tool (SVEST). J Patient Saf. 2021;17(8):e1401-e5.\u003c/li\u003e\n\u003cli\u003ePieretti A, Bastiani L, Bellandi T, et al. Second Victim Experience and Support Tool: An Assessment of Psychometric Properties of Italian Version. J Patient Saf. 2021.\u003c/li\u003e\n\u003cli\u003eAstbury JL, Gallagher CT. Development and validation of a questionnaire to measure moral distress in community pharmacists. Int J Clin Pharm. 2017;39(1):156-64.\u003c/li\u003e\n\u003cli\u003eEarle-Payne K, Forsyth P, Johnson CF, et al. The standards of practice for delivery of polypharmacy and chronic disease medication reviews by general practice clinical pharmacists: a consensus study. Int J Clin Pharm. 2022;44(3):663-72.\u003c/li\u003e\n\u003cli\u003eMinkov M, Hofstede, G. Clustering of 316 European Regions on Measures of Values: Do Europe\u0026rsquo;s Countries Have National Cultures? Cross-Cultural Research. 2013;48(2):144-76.\u003c/li\u003e\n\u003cli\u003eHofstede G, Hofstede GJ, Minkov M. Cultures and Organizations: Software of the Mind: Intercultural Cooperation and Its Importance for Survival. 2nd Edition ed. London: McGraw-Hill; 2010. ISBN: 978-0-07-177015-6\u003c/li\u003e\n\u003cli\u003eSordi LP, Louren\u0026ccedil;\u0026atilde;o DCA, Gallasch CH, et al. The second victim experience: cross-cultural adaptation of an instrument for the Brazilian context. Rev Gaucha Enferm. 2022;43:e20210010.\u003c/li\u003e\n\u003cli\u003eMira J, Carillo I, Tella S, et al. The European Researchers\u0026rsquo; Network Working on Second Victim (ERNST) Policy Statement on the Second Victim Phenomenon for Increasing Patient Safety. Public Health Reviews. 2024;45:1607175.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"international-journal-of-clinical-pharmacy","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ijcp","sideBox":"Learn more about [International Journal of Clinical Pharmacy](https://www.springer.com/journal/11096)","snPcode":"11096","submissionUrl":"https://submission.nature.com/new-submission/11096/3","title":"International Journal of Clinical Pharmacy","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"Second Victims, SVEST, Patient Safety, Medication Errors, Survey","lastPublishedDoi":"10.21203/rs.3.rs-5293950/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5293950/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e: The second victim phenomenon, involving emotional and psychological distress after adverse events, is underexplored among pharmacy professionals. The validated Second Victim Experience and Support Tool measures these experiences and support options, with the improved version also assessing resilience.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAim\u003c/strong\u003e: This study aimed to validate the Second Victim Experience and Support Tool-Revised, measure the second victim phenomenon, and present results among pharmacy professionals in Serbia.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethod\u003c/strong\u003e: This cross-sectional study included 350 pharmacy professionals (MPharm and technicians). The questionnaire, with 9 factors and 35 statements, was translated and adapted following guidelines, and the content was validated by five experts. A pre-test with 30 participants ensured clarity, followed by Confirmatory Factor Analysis for construct validity and Cronbach's Alpha for reliability.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: Content validity was confirmed with item scores from 0.8 to 1 and an average scale score of 0.83. Factor analysis identified 9 factors and 30 items (Chi-square = 545.571, degrees of freedom = 366, p \u0026lt; 0.001). The model fit was supported by a Root Mean Square Error of Approximation of 0.037, a Comparative Fit Index of 0.958, a Tucker-Lewis Index of 0.950, and a Standardised Root Mean Square Residual of 0.040. Reliability analysis showed a Cronbach's alpha of 0.88, with factor values from 0.60 to 0.90. Among participants, 49.5% feared future events, 47.4% felt exhausted, 22.6% considered quitting, 72.6% valued peer support, and 28.9% improved work quality.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e: The Serbian resilience measuring version effectively evaluates the second victim experience and support options among pharmacy professionals, showing good validity and reliability.\u003c/p\u003e","manuscriptTitle":"The Second Victim Experience and Support Tool: a cross-cultural adaptation, validation and psychometric evaluation of the Serbian version for pharmacy professionals (SR-SVEST-R)","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-11-15 12:28:26","doi":"10.21203/rs.3.rs-5293950/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Minor revisions","date":"2025-01-14T11:43:28+00:00","index":"","fulltext":""},{"type":"reviewerAgreed","content":"","date":"2024-11-07T07:36:19+00:00","index":0,"fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-10-27T08:38:32+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"International Journal of Clinical Pharmacy","date":"2024-10-25T11:54:44+00:00","index":"","fulltext":""},{"type":"submitted","content":"International Journal of Clinical Pharmacy","date":"2024-10-25T04:04:08+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-10-21T13:21:16+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"international-journal-of-clinical-pharmacy","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ijcp","sideBox":"Learn more about [International Journal of Clinical Pharmacy](https://www.springer.com/journal/11096)","snPcode":"11096","submissionUrl":"https://submission.nature.com/new-submission/11096/3","title":"International Journal of Clinical Pharmacy","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"1776863f-a4fc-40fb-a7eb-f13d18119fba","owner":[],"postedDate":"November 15th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-02-17T16:07:14+00:00","versionOfRecord":{"articleIdentity":"rs-5293950","link":"https://doi.org/10.1007/s11096-025-01875-6","journal":{"identity":"international-journal-of-clinical-pharmacy","isVorOnly":false,"title":"International Journal of Clinical Pharmacy"},"publishedOn":"2025-02-13 15:57:56","publishedOnDateReadable":"February 13th, 2025"},"versionCreatedAt":"2024-11-15 12:28:26","video":"","vorDoi":"10.1007/s11096-025-01875-6","vorDoiUrl":"https://doi.org/10.1007/s11096-025-01875-6","workflowStages":[]},"version":"v1","identity":"rs-5293950","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5293950","identity":"rs-5293950","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}