Department of Psychology, University of Colorado Denver, Denver, Colorado, USA.
Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA.
Ther Hypothermia Temp Manag. 2022 Jun;12(2):61-67. doi: 10.1089/ther.2021.0003. Epub 2021 May 11.
We aimed to elucidate gaps in the provision of cognitive and psychological resources in cardiac arrest survivors. We conducted an online survey study between October 29, 2019, and November 15, 2019 with cardiac arrest survivors and caregiver members of the Sudden Cardiac Arrest Foundation. We queried survivors as to whether they experienced cognitive or psychological symptoms since their cardiac arrest. Next, we queried both survivors and caregivers on the provision of resources through three metrics: (1) discussions with providers about potential cognitive or psychological symptoms, (2) neurologist or psychologist appointments scheduled by providers, and (3) mental health referrals by providers. We then ran Chi-square goodness-of-fit tests to compare the proportion of survivors and caregivers who reported resource provision (observed values) to the proportion of survivors who reported experiencing cognitive and psychological symptoms, respectively (expected values). We included responses from 167 survivors and 52 caregivers. A total of 73.1% ( = 122) survivors reported experiencing cognitive symptoms and 67.1% ( = 112) psychological symptoms since their cardiac arrest. When compared to these two proportions, provision of resources was significantly lower in all three metrics: (1) fewer discussions with providers about potential for developing cognitive symptoms (31%) and psychological symptoms (26.3%), (2) fewer neurologist appointments scheduled (8.4%) and psychologist appointments scheduled (4.8%), and (3) fewer referrals to mental health (6%). Informal caregivers also reported significantly lower provision of resources in all three metrics, with the exception of discussions about developing cognitive symptoms. Our results suggest that there are discrepancies in the provision of cognitive and psychological resources in cardiac arrest survivors with good neurologic recovery. Systematic referral processes may be needed to standardize resource provision to consistently meet the pervasive cognitive and psychological needs of cardiac arrest survivors.
我们旨在阐明心脏骤停幸存者认知和心理资源提供方面的差距。我们于 2019 年 10 月 29 日至 11 月 15 日期间通过心脏骤停幸存者和心脏骤停基金会的护理人员成员进行了一项在线调查研究。我们询问幸存者自心脏骤停以来是否经历过认知或心理症状。接下来，我们通过三个指标询问幸存者和护理人员资源提供情况：（1）与提供者讨论潜在的认知或心理症状，（2）提供者安排的神经科医生或心理学家预约，以及（3）提供者的心理健康转介。然后，我们运行了卡方拟合优度检验，以比较报告资源提供情况的幸存者和护理人员的比例（观察值）与分别报告经历认知和心理症状的幸存者的比例（预期值）。我们包括了 167 名幸存者和 52 名护理人员的回复。共有 73.1%（ = 122）的幸存者报告自心脏骤停以来经历了认知症状，67.1%（ = 112）的幸存者报告经历了心理症状。与这两个比例相比，所有三个指标的资源提供情况都明显较低：（1）与提供者讨论潜在认知症状（31%）和心理症状（26.3%）的次数较少，（2）安排神经科医生预约的次数较少（8.4%）和心理学家预约的次数较少（4.8%），以及（3）向心理健康转介的次数较少（6%）。非专业护理人员在所有三个指标中的资源提供情况也明显较低，除了讨论发展认知症状的情况。我们的结果表明，在神经功能良好恢复的心脏骤停幸存者中，认知和心理资源的提供存在差异。可能需要系统的转介流程来规范资源提供，以始终满足心脏骤停幸存者普遍存在的认知和心理需求。
