Gonzi Gianluca, Sestigiani Fiorella, D'errico Antonella, Vezzani Antonella, Bonfanti Laura, Noto Giancarlo, Artioli Giovanna
Unità Operativa Complessa di Cardiologia, Azienda Ospedaliero-Universitaria di Parma;.
Acta Biomed. 2015 Mar 13;86 Suppl 1:40-5.
The concept of self-assess it's a central mechanism in human agency for behavior change and should translate to desirable practice patterns. There are no many studies that have investigated the relationship between the perception of the ability to perform cardiopulmonary resuscitation (CPR) and the quality of the same. The aim of this work is to investigate the relation between physiological and psychosocial variables in cardiac resuscitation in order to improve the involvement and motivation of professionals in training courses.
During the year 2012, 322 medical staff of Ospedale-Universitario of Parma were trained to basic life support defibrillation (BLSD). Before started the course the partecipants were randomly selected among the staff working in the same department to create a team of two persons and involved in a simulation that reproduced the first five minutes that occurs for a cardiac arrest in a medical or surgical department in our hospital before the intervention of the hospital emergency team. Before and after simulation to each participant was asked to answer a self-efficacy questionnaire on a 10-point scale on the management of cardiac. During simulation were registered the activation time of the emergency response system, hands-on time, defibrillation time, number of compression and correct compression rate.
Activation time of the emergency response system was 70.52 ± 78.77 seconds. In 55 teams was not made the allert. The defibrillation time was 148.63 ± 58.43 seconds. In 44 teams the defibrillator were used within 120 seconds, in 36 (22.1%) it was not used. Hands-on time average was of 166.20 ± 62.9 seconds. The mean number of compression was 216.22 ± 115.57. The percentage of satisfactory compression was 9.97 ± 21.23 %. The level of self-efficacy was under the average for the 35.6%, while the 26.8% of the participants had a medium level of 5 and the 38.5% of the sample declared to feel an efficacy level included in 6-10. The sense of self efficacy after the simulation was constant in the 38.3% of the sample, while increased in the 30.5% and decreased in the 31.2%. We found no significant correlations between self-efficacy levels and specific results in scenario acting before simulation, instead, after the simulation the skills performances are much more correlated with self-efficacy.
The medical staff reported an individual's perception of good efficacy in the management of simulation of cardiac arrest, but it does not correspond to a high skills. An open question is if and how these psychosocial variables may play a role in improving the quality of CPR and if knowledge of the low capacity to manage a cardiac arrest can be translated into the need for the medical staff to be regularly engaged in BLSD retraining.
自我评估的概念是人类行为改变的核心机制，应该转化为理想的实践模式。目前很少有研究调查心肺复苏（CPR）能力认知与CPR质量之间的关系。这项工作的目的是研究心脏复苏中生理和心理社会变量之间的关系，以提高专业人员参与培训课程的积极性和动力。
2012年期间，帕尔马大学医院的322名医务人员接受了基础生命支持除颤（BLSD）培训。在课程开始前，从同一科室工作的人员中随机挑选参与者组成两人一组的团队，并参与一次模拟，该模拟再现了在医院急救团队干预之前，我院内科或外科发生心脏骤停后的前五分钟情况。在模拟前后，要求每位参与者就心脏管理方面以10分制回答一份自我效能问卷。在模拟过程中，记录应急响应系统的启动时间、实际操作时间、除颤时间、按压次数和正确按压率。
应急响应系统的启动时间为70.52±78.77秒。55个团队未发出警报。除颤时间为148.63±58.43秒。44个团队在120秒内使用了除颤器，36个团队（22.1%）未使用。实际操作时间平均为166.20±62.9秒。平均按压次数为216.22±115.57次。满意按压的百分比为9.97±21.23%。自我效能水平低于平均水平的占35.6%，26.8%的参与者自我效能水平为中等（5分），38.5%的样本表示自我效能水平在6 - 10分之间。模拟后，38.3%的样本自我效能感保持不变，30.5%的样本自我效能感增加，31.2%的样本自我效能感下降。我们发现模拟前自我效能水平与情景模拟中的具体结果之间无显著相关性，相反，模拟后技能表现与自我效能的相关性更强。
医务人员报告在心脏骤停模拟管理中个人对良好效能的认知，但这与高技能水平并不对应。一个悬而未决的问题是，这些心理社会变量是否以及如何在提高心肺复苏质量方面发挥作用，以及对心脏骤停管理能力低下的认知是否能转化为医务人员定期参与基础生命支持除颤再培训的需求。
