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一项在心脏康复计划中进行嵌入式培训后对患者复苏和除颤质量的社区干预研究。

A community intervention study on patients' resuscitation and defibrillation quality after embedded training in a cardiac rehabilitation program.

机构信息

Cardiology Department, University Clinical Hospital of Santiago (CIBER-CV), Universidade de Santiago de Compostela, Santiago de Compostela, Spain.

Institute of Health Research of Santiago de Compsotela (IDIS), Spain.

出版信息

Health Educ Res. 2019 Jun 1;34(3):289-299. doi: 10.1093/her/cyz002.

Abstract

The aim of this study was to examine the effectiveness of a novel cardiopulmonary resuscitation (CPR) training method embedded in a cardiac rehabilitation program at enhancing patients' CPR and defibrillation skills. One hundred and fourteen participants with coronary heart disease enrolled on an exercise-based cardiac rehabilitation program were included. Two groups were randomly allocated to different training programs: CPR-retraining based on hands-on rolling refreshers during the 2-month program (G-CPR, n = 53) versus standard one-time training (G-Stan, n = 61). Resuscitation and defibrillation skills and self-confidence were evaluated at baseline, following brief basic life support (BLS) instruction and after the distinct training programs. Baseline skills were equally poor, improving significantly although irregularly after brief instruction. After the program, CPR quality was further enhanced in G-CPR, which achieved better results regarding correct compressions by depth, rate, hands position and global CPR quality (P < 0.01, all analysis). Defibrillation skills improved similarly after instruction and were reasonably maintained after the program, although delay to shock was reduced in G-CPR. CPR self-confidence was superior in G-CPR (P < 0.001). In conclusion, CPR hands-on rolling refreshers embedded into an exercise-based cardiac rehabilitation program enhanced patients' CPR and defibrillation skills and self-confidence to perform CPR at 2 months, compared with standard one-time training. This method could help to bring effective training to high-risk populations.

摘要

本研究旨在考察将心肺复苏(CPR)培训嵌入心脏康复计划中对提高患者 CPR 和除颤技能的效果。共纳入 114 名患有冠心病的参与者,他们参加了基于运动的心脏康复计划。将两组随机分配到不同的培训计划中:在 2 个月的计划中基于实际操作的滚动刷新(G-CPR,n = 53)进行 CPR 再培训,与标准一次性培训(G-Stan,n = 61)。在基线时、接受简短的基本生命支持(BLS)指导后以及进行不同的培训计划后,评估复苏和除颤技能以及自我信心。基线技能同样较差,尽管在接受简短指导后有所提高,但提高并不规律。在计划之后,G-CPR 进一步增强了 CPR 质量,在正确的按压深度、频率、手位和整体 CPR 质量方面取得了更好的结果(所有分析 P < 0.01)。指导后除颤技能也得到了类似的改善,并且在计划后得到了合理的维持,尽管 G-CPR 中的电击延迟减少了。G-CPR 中的 CPR 自我信心更优(P < 0.001)。总之,与标准一次性培训相比,将心肺复苏实际操作的滚动刷新嵌入基于运动的心脏康复计划中,可以在 2 个月时提高患者的 CPR 和除颤技能以及进行 CPR 的自我信心。这种方法可以帮助将有效的培训带给高风险人群。

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