Medical Intensive Care Unit, University Hospital Basel, University of Basel, Basel, Switzerland.
Medical Communication and Psychosomatic Medicine, University Hospital Basel, University of Basel, Basel, Switzerland.
PLoS One. 2020 May 14;15(5):e0233155. doi: 10.1371/journal.pone.0233155. eCollection 2020.
Gender composition, stress and leadership of a resuscitation team influence CPR performance. Whether psychological variables such as self-esteem, motivation and personality traits are associated with resuscitation performance, stress levels and gender of rescuers during a cardiac arrest scenario remains uncertain.
We included 108 medical students in this prospective, observational simulator study. We videotaped the resuscitation performance and assessed self-esteem, perceived stress-overload and personality traits using validated questionnaires. In addition, we analysed leadership utterances and ECG data of all participants during the simulation. The primary endpoint was cardiopulmonary resuscitation performance, defined as hands-on time within the first 180 sec. Secondary outcomes included first meaningful measure of resuscitation, leadership statements of group leaders and physiological stress parameters of rescuers.
Adjusted for group size and leadership designation, mean self-esteem of students was significantly associated with hands-on time (adjusted regression coefficient 7.94 (95%CI 2.61 to 13.27), p<0.01). The personality trait conscientiousness was positively associated with hands-on time (adjusted regression coefficient 38.4, [95%CI 7.41 to 69.38, p = 0.02]). However, after additional adjustment for self-esteem, this association was no longer significant. Further, agreeableness of team leaders was significantly associated with longer hands-on time (adjusted regression coefficient 20.87 [95%CI 3.81 to 37.94], p = 0.02). Openness to experience was negatively associated with heart rate reactivity (-5.92 (95%CI -10 to -1.85), p<0.01). Male students showed significantly higher (mean, [±SD]) self-esteem levels (24.6 [±3.8] vs. 22.0 [±4.4], p<0.01), expressed significantly more leadership statements (7.9 [±7.8] vs. 4.6 [±3.8], p<0.01) and initiated first resuscitation measures more often (n, [%]) compared to female students (16, [23] vs. 7, [12], p = 0.01).
This simulator study found that self-esteem of resuscitation teams and agreeableness of team leaders of inexperienced students was associated with cardiopulmonary resuscitation performance. Whether enhancing these factors during resuscitation trainings serve for better performance remains to be studied.
复苏团队的性别构成、压力和领导力会影响心肺复苏（CPR）的效果。在心脏骤停的情况下，心理变量（如自尊、动机和人格特质）是否与复苏表现、压力水平和救援人员的性别有关，目前尚不确定。
我们纳入了 108 名医学生参与本项前瞻性观察性模拟研究。我们使用经过验证的问卷对自尊、感知压力负荷和人格特质进行了录像评估。此外，我们还分析了所有参与者在模拟过程中的领导言论和心电图数据。主要终点是心肺复苏表现，定义为前 180 秒内的实际操作时间。次要结局包括首次有意义的复苏测量、组长的领导言论和救援人员的生理压力参数。
调整团队规模和领导指定后，学生的平均自尊与实际操作时间显著相关（调整后的回归系数为 7.94（95%CI 2.61 至 13.27），p<0.01）。人格特质尽责性与实际操作时间呈正相关（调整后的回归系数为 38.4（95%CI 7.41 至 69.38，p = 0.02））。然而，在进一步调整自尊后，这种关联不再显著。此外，团队领导的宜人性与较长的实际操作时间显著相关（调整后的回归系数为 20.87（95%CI 3.81 至 37.94），p = 0.02）。开放性与心率反应呈负相关（-5.92（95%CI -10 至 -1.85），p<0.01）。男学生的自尊水平明显较高（均值[±标准差]）（24.6 [±3.8] 比 22.0 [±4.4]，p<0.01），发表的领导言论明显更多（7.9 [±7.8] 比 4.6 [±3.8]，p<0.01），并更频繁地启动首次复苏措施（n，[%]）比女学生（16，[23] 比 7，[12]，p = 0.01）。
本模拟研究发现，复苏团队的自尊和无经验学生的团队领导宜人性与心肺复苏表现相关。在复苏培训中增强这些因素是否有助于提高表现，还有待研究。
