亲属在院外心肺复苏失败后的经历:定性分析。

IF 2.3 3区 医学 Q1 EMERGENCY MEDICINE
Caroline Huxley, Eleanor Reeves, Justin Kearney, Galina Gardiner, Karin Eli, Rachael Fothergill, Gavin D Perkins, Michael Smyth, Anne-Marie Slowther, Frances Griffiths
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引用次数: 0

摘要

目的:院外心脏骤停(OHCA)患者的亲属在复苏过程中会感到困惑和痛苦。救护车临床医生提供的清晰信息和亲眼目睹复苏过程的机会有助于他们在混乱的现场中游刃有余。然而,英国缺乏有关亲属在复苏失败后的经历以及与救护车临床医生互动的证据。本定性研究探讨了这些经历,以便为救护车临床医生的实践提供参考:方法:英国的两家救护车服务机构确定了其临床医生在过去两周内参加的 OHCA 事件。至少三个月后,这些事件的非幸存者的亲属被邀请参加远程或面对面访谈。访谈的重点是他们尝试复苏的经历、与救护车临床医生的互动、当时的感受以及事后的反思。采用反思性主题分析法对数据进行分析:对 14 名非幸存者的亲属进行了半结构式访谈。主题分析确定了四个主题。心脏骤停对亲属来说是一个创伤性事件,混乱嘈杂的场景增加了他们的痛苦。许多人描述了事件发生后创伤后应激障碍的症状。在复苏过程中,参与者需要从临床医生那里了解发生了什么,并提供有关其亲属意愿的信息。参与者需要得到临床医生的保证,即他们已经尽了一切可能来抢救他们的亲属,当他们能够目睹部分抢救过程时,他们就会感到安心。参与者对抢救持续时间之长感到惊讶;一些人对抢救持续如此之久感到痛心:亲属的经历凸显了救护车临床医生所面临的两大挑战:(1)要意识到亲属在需要得到医护人员尽全力抢救病人的保证与希望避免长时间抢救最终徒劳无功之间所感受到的矛盾;(2)与在场人员进行持续对话,以便在管理抢救尝试的同时为临床决策提供信息。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Relatives' experiences of unsuccessful out-of-hospital cardiopulmonary resuscitation attempts: a qualitative analysis.

Aim: Relatives of patients who have experienced an out of hospital cardiac arrest (OHCA) experience confusion and distress during resuscitation. Clear information from ambulance clinicians and the opportunity to witness the resuscitation helps them navigate the chaotic scene. However, UK-based evidence concerning relatives' experiences of unsuccessful resuscitation attempts and interactions with ambulance clinicians is lacking. This qualitative study explores those experiences to inform ambulance clinician practice.

Methods: Two ambulance services in the UK identified OHCA events attended by their clinicians within the previous two weeks. After a minimum of three months relatives of non-survivors of these events were invited to participate in either a remote or face-to-face interview. Interviews focussed on their experiences of the resuscitation attempt and interactions with ambulance clinicians, their feelings at the time, and their reflections on the event afterwards. Data were analysed using reflexive thematic analysis.

Results: Semi-structured interviews were conducted with 14 relatives of OHCA non-survivors. Thematic analysis identified four themes. Cardiac arrest is a traumatic event for relatives, with chaotic noisy scenes increasing their distress. Many described feelings symptomatic of Post-Traumatic Stress Disorder since the event. During resuscitation, participants needed information from clinicians about what was happening, and provided information about their relatives' wishes. Participants needed reassurance from clinicians that everything possible was done to save their relative and were reassured when they could witness some of the resuscitation. Participants were surprised how long resuscitation seemed to last; some were distressed that it lasted so long.

Conclusion: Relatives' experiences highlight two key challenges for ambulance clinicians: (1) being aware of the tension relatives feel between needing reassurance that the crew is doing everything to save the patient and wanting to avoid prolonged and ultimately futile resuscitation attempts; and (2) having ongoing conversations with those present to inform clinical decision-making whilst managing the resuscitation attempt.

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来源期刊
BMC Emergency Medicine
BMC Emergency Medicine Medicine-Emergency Medicine
CiteScore
3.50
自引率
8.00%
发文量
178
审稿时长
29 weeks
期刊介绍: BMC Emergency Medicine is an open access, peer-reviewed journal that considers articles on all urgent and emergency aspects of medicine, in both practice and basic research. In addition, the journal covers aspects of disaster medicine and medicine in special locations, such as conflict areas and military medicine, together with articles concerning healthcare services in the emergency departments.
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