UMDNJ-New Jersey Medical School, Department of Emergency Medicine, Newark, New Jersey 07101, USA.
J Palliat Med. 2011 Jun;14(6):715-21. doi: 10.1089/jpm.2010.0463. Epub 2011 Apr 19.
After 20 years of debate regarding the appropriateness of family-witnessed resuscitations (FWR), little substantive data exist to suggest a benefit or harm to the family member.
To compare bereavement-related depression and post-traumatic stress disorder (PTSD) symptoms among cardiopulmonary resuscitation (CPR) patients' family members who remain in the waiting room of an urban emergency department (ED) with those who are invited to witness CPR.
A prospective comparison study was conducted at two large, urban, Midwestern teaching hospitals. Adult family members of nontraumatic CPR ≥18 years of age patients were eligible. In the intervention hospital, emergency physicians were trained and encouraged to invite family members to witness CPR (FWR). At the control hospital, family remained in the ED waiting room (Non-FWR). Family members from each hospital were interviewed 30 and 60 days post-event regarding bereavement-related depression and PTSD symptoms. Relevant demographic information was also collected. Comparisons between FWR and Non-FWR were conducted using independent samples t tests and χ(2) where appropriate.
Sixty-five family members (24 FWR and 41 Non-FWR) were included. There were no differences between groups in relationship to the patient (35% spouse/significant other), mean age (overall, 56 years), or race (75% African American). Patients in each group did not differ in need for assistance in any activities of daily living (overall, 44% needed assistance) prior to cardiac arrest. However, more FWR were female (83% versus 59%), and had higher levels of overall social support available. There were no differences between FWR and Non-FWR on overall PTSD scores (11.7 versus 11.4; mean difference = 0.3 [95 confidence interval (CI): -5.5; 6.1]) or depression scores (16.0 versus 20.6; mean difference = -4.5 [95CI: -12.0; 3.0]).
Bereavement related depression and PTSD symptoms are commonly seen in family members of cardiac arrest victims, however, the magnitude of the effect is not impacted by witnessing or not-witnessing CPR in the ED.
在经历了 20 年关于是否应让家庭成员目睹复苏抢救（FWR）的争论后，目前仅有少量实质性数据表明这对家庭成员有益还是有害。
比较心肺复苏（CPR）患者的家庭成员在城市急诊室（ED）的等候区与被邀请目睹 CPR 时的丧亲相关抑郁和创伤后应激障碍（PTSD）症状。
在两家大型城市中西部教学医院进行了前瞻性比较研究。非创伤性 CPR≥18 岁的成年家属符合入选标准。在干预医院，急诊医师接受了培训并鼓励邀请家属目睹 CPR（FWR）。在对照医院，家属留在 ED 等候区（非 FWR）。在事件发生后 30 和 60 天，对每个医院的家属进行丧亲相关抑郁和 PTSD 症状的采访。还收集了相关人口统计学信息。使用独立样本 t 检验和 χ(2)（在适当情况下）比较 FWR 和非 FWR 之间的差异。
共纳入 65 名家属（24 名 FWR 和 41 名非 FWR）。两组在与患者的关系（35%配偶/重要他人）、平均年龄（总体 56 岁）或种族（75%非洲裔美国人）方面无差异。每个组的患者在心脏骤停前日常生活活动的任何方面都不需要帮助（总体 44%需要帮助）。然而，更多的 FWR 是女性（83%对 59%），并且拥有更高水平的总体社会支持。FWR 和非 FWR 之间在总体 PTSD 评分（11.7 对 11.4；平均差异=0.3[95%置信区间（CI）：-5.5；6.1]）或抑郁评分（16.0 对 20.6；平均差异=-4.5[95%CI：-12.0；3.0]）方面均无差异。
心脏骤停患者家属中常见丧亲相关抑郁和 PTSD 症状，但在 ED 中目睹或不目睹 CPR 对其影响的程度并无差异。
