Psychological effects on patient’s relatives regarding their presence during resuscitation (original) (raw)
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Family presence during resuscitation: A randomised controlled trial of the impact of family presence
Australasian Emergency Nursing Journal, 2006
Introduction: This study was undertaken to determine effects on relatives of family presence in an emergency resuscitation room during resuscitation. Methods: This study was undertaken using a randomised controlled trial using survey methodology. The setting of the study was the emergency department of a major tertiary referral teaching hospital in Queensland. Participants were relatives over 18 years of age, related to patients meeting the inclusion criteria. Relatives were randomly assigned to the experimental or control group. The control group followed the established procedure of placement in the relatives' waiting room, while the experimental group was given the option to be present during the resuscitation with a supportive officer for assistance. Results: An association was found between those who were present (and their relative survived) and their belief that their presence was beneficial to the patient. Demographic data identified characteristics of the relatives. Conclusions: This work has identified that relatives find it beneficial to be present in the resuscitation room. Their presence helped with communication between staff and family, and helped relatives to cope with the situation.
Family Presence During Cardiopulmonary Resuscitation
Survey of Anesthesiology, 2014
Background The effect of family presence during cardiopulmonary resuscitation (CPR) on the family members themselves and the medical team remains controversial. Methods We enrolled 570 relatives of patients who were in cardiac arrest and were given CPR by 15 prehospital emergency medical service units. The units were randomly assigned either to systematically offer the family member the opportunity to observe CPR (intervention group) or to follow standard practice regarding family presence (control group). The primary end point was the proportion of relatives with posttraumatic stress disorder (PTSD)-related symptoms on day 90. Secondary end points included the presence of anxiety and depression symptoms and the effect of family presence on medical efforts at resuscitation, the well-being of the health care team, and the occurrence of medicolegal claims. Results In the intervention group, 211 of 266 relatives (79%) witnessed CPR, as compared with 131 of 304 relatives (43%) in the control group. In the intention-to-treat analysis, the frequency of PTSD-related symptoms was significantly higher in the control group than in the intervention group (adjusted odds ratio, 1.7; 95% confidence interval [CI], 1.2 to 2.5; P = 0.004) and among family members who did not witness CPR than among those who did (adjusted odds ratio, 1.6; 95% CI, 1.1 to 2.5; P = 0.02). Relatives who did not witness CPR had symptoms of anxiety and depression more frequently than those who did witness CPR. Family-witnessed CPR did not affect resuscitation characteristics, patient survival, or the level of emotional stress in the medical team and did not result in medicolegal claims. Conclusions Family presence during CPR was associated with positive results on psychological variables and did not interfere with medical efforts, increase stress in the health care team, or result in medicolegal conflicts.
Family Presence During Resuscitation: A Double-Edged Sword
Purpose: To illuminate the meaning of the lived experiences of resuscitation team members with the presence of the patient's family during resuscitation in the cultural context of Iran. Design: An interpretative phenomenology was used to discover the lived experiences of the nurses and physicians of Tabriz hospitals, Iran, with family presence during resuscitation (FPDR). A total of 12 nurses and 9 physicians were interviewed over a 6-month period. Methods: The interviews were audio recorded and semistructured, and were transcribed verbatim. Van Manen's technique was used for data analysis. Findings: Two major themes and 10 subthemes emerged, including destructive presence (cessation of resuscitation, interference in resuscitation, disruption to the resuscitation team's focus, argument with the resuscitation team, and adverse mental image in the family) and supportive presence (trust in the resuscitation team, collaboration with the resuscitation team, alleviating the family's concern and settling their nerves, increasing the family's satisfaction, and reducing conflict with resuscitation team members). Conclusions: Participants stated that FPDR may work as a double-edged sword for the family and resuscitation team, hurting or preserving quality. It is thus recommended that guidelines be created to protect patients' and families' rights, while considering the positive aspects of the phenomenon for hospitals. Clinical Relevance: A liaison support person would act to decrease family anxiety levels and would be able to de-escalate any potentially aggressive or confrontational events during resuscitation. Well-trained and expert car-diopulmonary resuscitation team members do not have any stress in the presence of family during resuscitation. Resuscitation events tend to be prolonged when family members are allowed to be present.
Australasian Emergency Nursing Journal, 2008
Background: In March 2007 part of a staff attitudes to Family Presence during resuscitation project were presented as part of a 3-year research project examining the relatives and staff attitudes to family presence during resuscitation (Holzhauser K, Finucane J, De Vries SM. Family presence during resuscitation: a randomised controlled trial of the impact of family presence. Australas Emerg Nurs J 2006;8(4):139-147). This article presents the results of staff attitudes immediately post-resuscitation.
Health Care Providers' Evaluations of Family Presence During Resuscitation
Journal of Emergency Nursing, 2010
Introduction: The benefits of family presence (FP) during resuscitation are well documented in the literature, and it is becoming an accepted practice in many hospitals. There is sufficient evidence about health care provider (HCP) and family attitudes and beliefs about FP and little about the actual outcomes after family witnessed resuscitation. The purpose of this study was to evaluate FP at resuscitations. Methods: A descriptive design was used to collect data at an academic medical center in the western U.S. There were 106 resuscitations during the study period. Family presence was documented on 31 (29%) records. One hundred and seventy-four health care provider names were listed on the resuscitation records, and 40 names (23%) were illegible or incomplete. The convenience sample of 134 HCPs was invited to complete an electronic survey and 65 (49%) responded. Results: Respondents indicated that family members were able to emotionally tolerate the situation (59%), did not interfere with the care being provided to the patient (88%). In addition, team communication was not negatively affected (88%). A family facilitator was present 70% of the time, and it was usually a registered nurse (41%). Twenty-one narrative comments were summarized to reflect the following themes: 1) family presence is beneficial; 2) family presence is emotional; 3) a family facilitator is necessary. Discussion: These study findings demonstrate that having families present during resuscitations does not negatively impact patient care, is perceived to benefit family members and that a dedicated family facilitator is an integral part of the process.
Family presence during resuscitation: a critical review of the literature
American journal of critical care : an official publication, American Association of Critical-Care Nurses, 2005
Presence of patients' families during resuscitation has emerged as an important practice issue, sparking considerable controversy worldwide. Early advocates of allowing patients' families to be present during resuscitation faced more resistance than did current advocates because the former had little or no scientific research results to support their ideas. In the past 15 years, a number of quantitative studies, especially descriptive surveys, have been conducted. Qualitative researchers have also explored the lived experience of family members present during resuscitation and less commonly the perspectives of patients and health care providers. In this review of the literature, the current state of the science is critically reviewed and the ethical-theoretical perspectives of respective researchers and staff participants in the reviewed studies are discussed. Surveys were used to collect data in most studies to date. Limitations of these designs include small convenience sa...
Family presence during resuscitation: A concise narrative review
Trends in Anaesthesia and Critical Care, 2017
Background: The involvement of family members in end-of-life discussion is generally considered critical. Family members want to be present during the last moments of their beloved, even during resuscitation. Family presence during resuscitation (FPDR) is on the one side an opportunity for the family members to give a last farewell and may help them to understand the gravity of the situation. The aim of the present narrative review is to provide an overview of the current discussions on FPDR. Material and methods: Narrative review of recently published papers on FPDR. Results: and Discussion: FPDR has been proposed since 1987. Mostly, family members want to be present during CPR. Studies have shown that nursing staff are more supportive of FPDR than physicians are. Physicians, who do not often support FPDR, believe that FPDR may interfere with resuscitation, may induce psychological trauma, or be the object of legal repercussions. The presence of family members may also alter the performance of resuscitation. Surveys have shown that the majority of persons interviewed wanted their beloved to be present during resuscitation. Conclusions: Currently, several international organizations have published statements and guidelines supporting FPDR. There is no clear response if FPDR is always a safe procedure. Moreover, studies investigating FPDR contain various methodological flaws meaning it is difficult to make any definite conclusions.
Challenges in Conducting Research After Family Presence During Resuscitation
Journal of Trauma Nursing, 2012
Family presence during resuscitation (FPDR) is an option occurring in clinical practice. National clinical guidelines on providing the option of FPDR are available from the American Association of Critical-Care Nurses, American Heart Association, Emergency Nurses Association, and Society of Critical Care Medicine. The FPDR option currently remains controversial, underutilized, and not the usual practice with trauma patients. This article is based on the methodological and practical research challenges associated with an ongoing study to examine the effects of the FPDR option on family outcomes in patients experiencing critical injury after motor vehicle crashes and gunshot wounds. The primary aim of this study was to examine the effects of the FPDR option on family outcomes of anxiety, stress, well-being, and satisfaction and compare those outcomes in families who participate in FPDR to those families who do not participate in FPDR. Examples of real clinical challenges faced by the researchers are described throughout this article. Research challenges include design, sampling, inclusion/exclusion criteria, human subjects, and procedures. Recruitment of family members who participated in the FPDR option is a complex process, especially after admission to the critical care unit.
PLOS ONE, 2015
The present study evaluated the opinions of physicians working in the emergency and trauma surgery departments of Vienna Medical University, in Austria, and Tabriz Medical University, in Iran, regarding the presence of patients' relatives during resuscitation. In a descriptive-analytical study, the data obtained from questionnaires that had been distributed randomly to 40 specialists and residents at each of the participating universities were analyzed. The questionnaire consisted of two sections aimed at capturing the participants' demographic data, the participants' opinions regarding their support for the family's presence during resuscitation, and the multiple potential factors affecting the participants' attitudes, including health beliefs, triggers that could facilitate the procedure, self-efficacy, intellectual norms, and perceived behavioral control. The questionnaire also included a direct question (Question 16) on whether the participants approved of fa...