Aim: To explore and gain in-depth understanding of how out-of-hospital cardiac arrest survivors experience the short- and long-term consequences on daily life.
Design: A qualitative exploratory design.
Methods: A purposive sample of 32 survivors of out-of-hospital cardiac arrest. Data from six audiotaped focus group interviews were collected in either November 2018 or in March 2019. Analysis and interpretation of the transcribed texts was performed using a phenomenological-hermeneutic approach guided by Ricoeur for unfolding lived experiences.
Results: Three narratives were identified. The survivors narrated how they in the early phase after the cardiac arrest experienced: (a) 'a fragmented memory at the mercy of the system'. The analysis further showed how the participants were: (b) 'living in the shadow of anxiety and mixed feelings' and with the: (c) 'lost sense of self' up to several years after survival.
Conclusion: The participants in our study experienced distinct bodily impairments, suffering, and the lost sense of self in the return to daily life from early on to several years after resuscitation. There seem to be an urgent need for an early initiated post-arrest transitional care program led by an expert cardiac arrest nurse. In particular, the healthcare professionals need to pay attention to survivors in employment and with children living at home. Facilitated cardiac arrest peer support groups might minimize the long-term suffering, heighten the self-image, and install a new hope for the future.
Impact: To ease the post-arrest return to daily life for out-of-hospital cardiac arrest survivors it seems important that a transitional care program from the inhospital setting to the community consist of: (a) screening for and education on bodily losses at an early stage, (b) provision of support on the often prolonged emotional reactions, and (c) referring for further individual and targeted psychological and neurological follow-up and rehabilitation if needed.
目的: 探索并深入对医院外心脏骤停幸存者在日常生活中如何经历短期和长期后果的了解。 设计: 定性探索性设计。 方法: 32名医院外心脏骤停幸存者的目的性样本。2018年11月或2019年3月收集了六份焦点小组访谈录音数据。在Ricoeur的指导下, 采用现象学--解释学方法对转录文本进行分析和解释, 以展现生活经验。 结果: 确定了三种讲述: 幸存者讲述了他们在心脏骤停后早期阶段的经历: (a) ‘由系统支配的零碎记忆’。分析进一步显示了参与者的情况为: (b) ‘生活在焦虑和复杂情绪的阴影下’以及 (c) 在生存数年后‘失去自我意识’。 结论: 在我们的研究中, 参与者在从早期复苏到几年后恢复日常生活的过程中经历了明显的身体损伤、痛苦和自我意识的丧失。目前似乎迫切需要一个由心脏骤停专家护士领导的骤停后早期过渡护理项目。特别是, 医疗保健专业人员需要关注就业中的幸存者和家中有儿童的人。促进心脏骤停同伴支持小组可能会减少长期的痛苦, 提高自我形象, 并为未来树立新的希望。 影响: 为了缓解医院外心脏骤停幸存者骤停后恢复日常生活的困难, 从住院到社区的过渡护理计划似乎很重要, 其中包括: (a) 在早期阶段对身体损失进行筛查和教育, (b) 提供对经常性长时间的情绪反应的支持, (c) 如有需要, 可接受进一步的个人和针对性心理和神经方面的随访和康复。.
Keywords: cardiac arrest; daily life; focus groups; interview; lived experiences; nurse; out-of-hospital cardiac arrest; phenomenological hermeneutic.
© 2020 John Wiley & Sons Ltd.