Support-system engagement personas among junior nurses as second victims of patient safety incidents: a qualitative descriptive study

Institutional provision of support resources does not necessarily translate into junior nurses’ actual use of these resources after patient safety incidents. This study aimed to identify support-system engagement personas among junior nurses as second victims and to examine the principal differences across personas. A multicentre qualitative descriptive design was used. Between March and June 2026, 29 nurses who volunteered for an interview were purposively recruited from three hospitals in Jilin Province, China; all had ≤ 3 years of clinical experience, had been directly involved in a patient safety incident within the preceding 18 months, and reported incident-related effects at eligibility screening. Face-to-face semi-structured interviews were conducted. Data collection and analysis proceeded concurrently; core codes, analytic dimensions, and feature combinations in the combined dataset had largely stabilised by the 26th interview, after which three further confirmatory interviews were conducted and recruitment ceased at the 29th participant. Data were managed in NVivo 20.0. Literature-informed qualitative content analysis, with inductive coding and category development, was combined with case profiling and cross-case comparison to construct empirical types presented as personas. Four personas were identified through comparison across six common case-profile dimensions: the Self-Suppression Persona ( n = 10), the Blocked Help-Seeking Persona ( n = 5), the Relational Collaboration Persona ( n = 8), and the Guarded Disclosure Persona ( n = 6). They described, respectively, private management of distress under evaluative concerns; desired support constrained by access or response difficulties; engagement through trusted and responsive relationships; and formal participation accompanied by selective disclosure of personal distress. Each persona summarised the dominant configuration of support engagement in the participant’s account following the selected incident. The personas summarise recurring configurations of support engagement in junior nurses’ accounts following patient safety incidents. They may inform the recognition of different support needs and the development of locally appropriate support arrangements. Transferability should be assessed in light of possible under-representation of nurses least willing to disclose and exclusion where interviewing could interfere with an ongoing incident-related disciplinary investigation; practical utility requires further evaluation.