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Experiences of family‐witnessed cardiopulmonary resuscitation in hospital and its impact on life: An interview study with cardiac arrest survivors and their family members

检查表 心肺复苏术 感觉 定性研究 医学 苦恼 悲伤 家庭成员 心理学 解释现象学分析 复苏 家庭医学 护理部 医疗急救 精神科 临床心理学 急诊医学 社会心理学 认知心理学 社会学 社会科学
作者
Annette Waldemar,Anna Strömberg,Ingela Thylén,Anders Bremer
出处
期刊:Journal of Clinical Nursing [Wiley]
卷期号:32 (19-20): 7412-7424 被引量:2
标识
DOI:10.1111/jocn.16788
摘要

Abstract Aim To explore experiences of cardiac arrest in‐hospital and the impact on life for the patient who suffered the arrest and the family member who witnessed the resuscitation. Background Guidelines advocate that the family should be offered the option to be present during resuscitation, but little is known about family‐witnessed cardiopulmonary resuscitation in hospital and the impact on the patient and their family. Design A qualitative design consisting of joint in‐depth interviews with patients and family members. Methods Family interviews were conducted with seven patients and their eight corresponding family members (aged 19–85 years) 4–10 months after a family‐witnessed in‐hospital cardiac arrest. Data were analysed using interpretative phenomenological analysis. The study followed the guidelines outlined in the consolidated criteria for reporting qualitative research (COREQ) checklist. Results The participants felt insignificant and abandoned following the in‐hospital cardiac arrest. Surviving patients and their close family members felt excluded, alone and abandoned throughout the care process; relationships, emotions and daily life were affected and gave rise to existential distress. Three themes and eight subordinate themes were identified: (1) the intrusion of death—powerless in the face of the fragility of life, highlights what it is like to suffer a cardiac arrest and to cope with an immediate threat to life; (2) being totally exposed—feeling vulnerable in the care relationship, describes how a lack of care from healthcare staff damaged trust; (3) learning to live again—making sense of an existential threat, pertaining to the family's reactions to a difficult event that impacts relationships but also leads to a greater appreciation of life and a positive view of the future. Conclusion Surviving and witnessing a cardiac arrest in‐hospital is a critical event for everyone involved. Patients and family members are vulnerable in this situation and need to be seen and heard, both in the hospital and after hospital discharge. Consequently, healthcare staff need to show compassion and attend to the needs of the family, which involves continually assessing how family members are coping during the process, and providing support and information during and after resuscitation. Relevance to clinical practice It is important to provide support to family members who witness the resuscitation of a loved one in‐hospital. Structured follow‐up care is crucial for cardiac arrest survivors and their families. To promote person‐centred care, nurses need interprofessional training on how to support family members during resuscitation, and follow‐up care focusing on providing resources for multiple challenges faced by survivors (emotional, cognitive, physical) and families (emotional) is needed. Patient or public contribution In‐hospital cardiac arrest patients and family members were involved when designing the study.
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