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自愿成为院外心脏骤停第一反应者的全科医生:一项定性研究。

GPs who volunteer to be first responders for out-of-hospital cardiac arrest: A qualitative study.

机构信息

UCD Centre for Emergency Medical Science, School of Medicine, Health Sciences Centre, University College Dublin, Dublin, Ireland.

School of Psychology, University College Dublin, Dublin, Ireland.

出版信息

Eur J Gen Pract. 2020 Dec;26(1):33-41. doi: 10.1080/13814788.2019.1681194. Epub 2019 Nov 5.

Abstract

Out-of-hospital cardiac arrest (OHCA) is a major cause of premature mortality. Survival is possible when timely cardiopulmonary resuscitation and defibrillation are available in the community. GPs are well placed to provide early OHCA care and significantly increased rates of survival are achieved when GPs participate in resuscitation. A novel project alerts volunteer GP first responders to nearby OHCAs in Ireland. To explore the reasons why GPs volunteer to be OHCA first responders and their experience of participation. A qualitative study involving in-depth, semi-structured interviews followed by thematic analysis was undertaken in 2017/18. Fourteen GPs from differing geographical areas in Ireland, who volunteered as OHCA first-responders were recruited to participate by purposive methods.Results: GP participation in OHCA voluntary first response was understood as a function of GPs relationship to the community, their ability to manage competing demands in their personal and professional lives and also specific participatory gains. GPs expressed both altruistic motivations and a sense of obligation. GPs described a complex, multifaceted role in providing OHCA first response; they derived an inherent sense of satisfaction in delivering potentially life-saving interventions but also in the provision of holistic, compassionate end-of-life care for patients and their families. Participation was not without psychosocial risk for GPs. GPs volunteer to provide early OHCA emergency care because of their relationship to the community. Care provided is complex and includes both resuscitation and end-of-life care.

摘要

院外心脏骤停 (OHCA) 是导致过早死亡的主要原因。当社区能够及时进行心肺复苏和除颤时,生存是有可能的。全科医生处于提供早期 OHCA 护理的有利位置,如果全科医生参与复苏,生存率会显著提高。爱尔兰的一个新项目提醒志愿全科医生注意附近的 OHCA。旨在探讨全科医生自愿成为 OHCA 第一反应者的原因及其参与体验。2017/18 年进行了一项定性研究,包括深入的半结构化访谈和主题分析。通过有目的的方法招募了来自爱尔兰不同地理区域的 14 名自愿担任 OHCA 第一反应者的全科医生参与研究。结果:全科医生参与 OHCA 自愿第一响应被理解为全科医生与社区的关系、他们在个人和职业生活中管理竞争需求的能力以及特定参与收益的函数。全科医生表达了利他主义和责任感。全科医生在提供 OHCA 第一响应方面描述了一个复杂的、多方面的角色;他们在提供潜在救生干预措施的过程中获得了内在的满足感,同时也为患者及其家人提供了全面的、富有同情心的临终关怀。对全科医生来说,参与并非没有心理社会风险。全科医生自愿提供早期 OHCA 紧急护理,因为他们与社区的关系。提供的护理很复杂,包括复苏和临终关怀。

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