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院外心脏骤停后的随访护理:一项关于幸存者及其家属经历与建议的试点研究。

Follow-up care after out-of-hospital cardiac arrest: A pilot study of survivors and families' experiences and recommendations.

作者信息

Mion Marco, Case Rosalind, Smith Karen, Lilja Gisela, Blennow Nordström Erik, Swindell Paul, Nikolopoulou Eleni, Davis Jean, Farrell Kelly, Gudde Ellie, Karamasis Grigoris V, Davies John R, Toff William D, Abella Benjamin S, Keeble Thomas R

机构信息

Essex Cardio Thoracic Centre, Basildon and Thurrock University Hospitals, Essex, UK.

Anglia Ruskin University - Faculty of Health, Education, Medicine and Social Care, Chelmsford, UK.

出版信息

Resusc Plus. 2021 Jul 29;7:100154. doi: 10.1016/j.resplu.2021.100154. eCollection 2021 Sep.

Abstract

BACKGROUND AND OBJECTIVES

Cognitive and physical difficulties are common in survivors of out-of-hospital cardiac arrest (OHCA); both survivors and close family members are also at risk of developing mood disorders. In the UK, dedicated follow-up pathways for OHCA survivors and their family are lacking. A cohort of survivors and family members were surveyed regarding their experience of post-discharge care and their recommended improvements.

METHOD

123 OHCA survivors and 39 family members completed questionnaires during an educational event or later online. Questions addressed both the actual follow-up offered and the perceived requirements for optimal follow-up from the patient and family perspective, including consideration of timing, professionals involved, involvement of family members and areas they felt should be covered.

RESULTS

Outpatient follow-up was commonly arranged after OHCA (77%). This was most often conducted by a cardiologist alone (80%) but survivors suggested that other professionals should also be involved (e.g. psychologist/counsellor, 64%). Topics recommended for consideration included cardiac arrest-related issues (heart disease; cause of arrest) mental fatigue/sleep disturbance, cognitive problems, emotional problems and daily activities. Most survivors advocated an early review (<1month; 61%). Most family members reported some psychological difficulties (95%); many of them (95%) advocated a dedicated follow-up appointment for family members of survivors.

CONCLUSIONS

The majority of OHCA survivors advocated an early follow-up following hospital discharge and a holistic, multidimensional assessment of arrest sequelae. These results suggest that current OHCA follow-up often fails to address patient-centred issues and to provide access to professionals deemed important by survivors and family members.

摘要

背景与目的

认知和身体方面的困难在院外心脏骤停(OHCA)幸存者中很常见;幸存者及其近亲也有患情绪障碍的风险。在英国,缺乏针对OHCA幸存者及其家人的专门随访途径。对一组幸存者及其家人进行了调查,了解他们出院后护理的经历以及他们建议的改进措施。

方法

123名OHCA幸存者和39名家庭成员在一次教育活动期间或之后通过在线方式完成了问卷调查。问题涉及实际提供的随访情况以及从患者和家属角度对最佳随访的认知需求,包括对时间安排、参与的专业人员、家庭成员的参与以及他们认为应涵盖的领域的考虑。

结果

OHCA后通常会安排门诊随访(77%)。这最常由心脏病专家单独进行(80%),但幸存者建议也应有其他专业人员参与(如心理学家/顾问,64%)。建议考虑的主题包括与心脏骤停相关的问题(心脏病;骤停原因)、精神疲劳/睡眠障碍、认知问题、情绪问题和日常活动。大多数幸存者主张早期复查(<1个月;61%)。大多数家庭成员报告有一些心理困难(95%);其中许多人(95%)主张为幸存者的家庭成员安排专门的随访预约。

结论

大多数OHCA幸存者主张出院后尽早进行随访,并对骤停后遗症进行全面、多维度的评估。这些结果表明,目前OHCA的随访往往未能解决以患者为中心的问题,也未能让幸存者和家庭成员认为重要的专业人员参与进来。

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