AB091. Psychosocial impacts of surgical complications on surgeons: evidence and structural modelling considerations

Background: Surgical complications not only endanger patient outcomes but also traumatize the involved surgeon emotionally, psychologically, and socially. These “second victims” often endure lasting stress that may impair their well-being (WB) and follow-up clinical performance. The psychosocial impacts of this problem, however, remain under-explored in low- and middle-income settings. The research seeks to investigate the emotional and behavioral impact of surgical complications on practicing surgeons, pinpoint contributory psychosocial risk factors, and examine how coping mechanism (CM) usage influences outcomes. It also determines the interrelationship among the primary variables using structural equation modeling (SEM).

Methods: Guided by evidence from 19 relevant studies, the study assessed emotional responses such as guilt, worry, and withdrawal, and behavioral adaptations such as hyper-cautious practice and avoidance. Utilizing the application of SmartPLS, a structural model was developed for assessing the effect of complication severity, institutional support, emotional resilience (ER), and CMs on surgeons’ WB.

Results: The research identified that younger, less experienced, and work-life balance- compromised surgeons were most vulnerable to adverse emotional responses. Severe complications significantly predicted depressive symptoms and behavioral changes. The structural model confirmed that institutional support and adaptive coping significantly enhanced ER (P<0.001), while repressive behaviors indicated poorer outcomes.

Conclusions: Surgical complications place a major psychosocial load on surgeons that is underestimated in policy and training materials. Solutions aimed at emotional preparedness, peer support networks, and organizational compassion are the key. These findings offer a blueprint for international surgical systems to improve their safeguarding and empowerment of their surgical staff, thus improving provider WB and patient safety.

Keywords: Emotional resilience; global surgery; second victim; surgeon; mental health