“Application of Transitions Nursing Theory among Patients with Cardiac Arrests to Assess the Impact of Cardiopulmonary Resuscitation Duration on Functional Outcome—A Conceptual Framework”

Abstract

Background: Change is the only constant in life, and humans continuously strive to cope and adapt based on the changes in their health (physical and mental) status. Cardiovascular diseases (CVD’s) are the leading cause of cardiac emergencies that cause enormous impact on patients, families, and health systems prompting processes and strategies for coping with their health status changes and their aftermath effect. Aim: A discussion of the conceptual framework of transition theory applicable to the study to assess the impact of the cardiopulmonary resuscitation (CPR) duration on the functional outcome among patients with in-hospital cardiac arrest (IHCA). Methodology: The transition theory, a middle-range and situation specific theory is applied to the prospective study conducted at a tertiary care hospital in South India. The outcomes were measured using the cerebral performance category (CPC). Results: The theory identifies that cardiac arrest is a situational transition affected by the chronicity of the disease as described with unfavorable outcome with CPC score of 3–5. The fear of death, dependency state of the patient in an unfavorable outcome based on CPC, and caregiver burden on family due to the prolonged duration of acuity of the disease or death of the patient are identified as properties in this theory. Based on the study, the personal meaning includes lifestyle modifications, the impact of spiritualism, financial stability, and the educational qualifications of the patient and family identified as personal meanings that play a major role as facilitators and inhibitors. The patterns and responses in this study identified with follow-up appointments, confidence in caring for themselves, and coping for themselves among the survived cardiac arrest patients. The nursing therapeutics identified from the study are risks identified from the comprehensive assessment, readiness to intervene and implement nursing actions, educating the patient and family based on the transition, and enhancing the creation of a healthy environment. Conclusions: The transition theory is holistically applicable for patients with cardiac arrest, identifying the process and changes adapted by the patient and family with the progression of the disease and the roles adapted by the family members in the event of the patient’s death.