Effectiveness of support programs for second victims in healthcare: systematic review

The effectiveness of support programs for healthcare professionals identified as second victims after adverse events was evaluated through a systematic review conducted in accordance with PRISMA 2020. Searches were performed in PubMed, Scopus, SciELO, Elsevier, and Google Scholar, yielding 16 empirical studies on structured interventions such as RISE, forYOU, HELP, internal models, and peer support. Methodological quality was assessed using ROBINS-I and CASP. The programs demonstrated reductions in acute psychological symptoms (anxiety, post-traumatic stress), high satisfaction and improved perceptions of institutional support; some studies also reported organizational benefits such as decreased absenteeism, lower turnover, and economic feasibility through cost-benefit analyses. The use of validated instruments (SVEST, IES-R) allowed the measurement of both individual and organizational changes. Identified barriers included stigma, workload, limited resources, and the absence of standardized indicators, while facilitators comprised visible leadership, peer training, and institutional protocols. Evidence gaps remain due to the predominance of high-income contexts, heterogeneous outcomes, and limited longitudinal follow-up. Support programs for second victims are feasible and effective; however, multicenter and context-specific studies in Latin America are needed to consolidate the evidence and promote implementation