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病情好转还是勉强维持?一项关于院内心脏骤停幸存者长期康复经历的定性研究。

Getting better or getting by?: A qualitative study of in-hospital cardiac arrest survivors long-term recovery experiences.

作者信息

Harrod Molly, Kamphuis Lee A, Hauschildt Katrina, Seigworth Claire, Korpela Peggy R, Rouse Marylena, Vincent Brenda M, Nallamothu Brahmajee K, Iwashyna Theodore J

机构信息

Lieutenant Colonel Charles S. Kettles VA Medical Center, Center for Clinical Management Research, 2800 Plymouth Road, Building 16, Ann Arbor, MI, 48109, USA.

Department of Sociology, Population Studies Center, University of Michigan, 426 Thompson St, Ann Arbor, MI, 48104, USA.

出版信息

SSM Qual Res Health. 2021 Dec;1:100002. doi: 10.1016/j.ssmqr.2021.100002. Epub 2021 Aug 23.

Abstract

In the United States, approximately 292,000 adults (>18 years old) per year suffer an in-hospital cardiac arrest (IHCA). Survival rates have increased over the last decade and many survivors return to their communities. IHCA has been recognized as a unique disease entity because the arrest happens in a medical care setting and survivors often have more medical co-morbidities. Although more individuals are surviving IHCA, very little is known about their long-term recovery experiences. Semi-structured interviews with 19 IHCA survivors were conducted to better understand their recovery experiences and identify strategies of adaptation that they felt aided their recovery. Thematic analysis indicated that IHCA survivors experience ongoing challenges to recovery. Reconceptualization of independence was necessary for some participants to re-engage in social and physical activities and a few were able to engage in new activities. Our findings suggest that IHCA survivors often develop their own strategies for adaptation in order to continue participation in their social lives and that their recovery experiences are ongoing. Intervention programs and follow-up care should continuously ask survivors what is important to them and identify resources that will support their goals. Questions should include physical, cognitive, psychological and social goals that extend beyond those specifically related to IHCA since our findings indicate that the effects of IHCA are long-lasting and encompass all aspects of survivors' lives.

摘要

在美国,每年约有29.2万成年人(年龄超过18岁)在医院发生心脏骤停(IHCA)。在过去十年中,生存率有所提高,许多幸存者重返社区。IHCA被认为是一种独特的疾病实体,因为心脏骤停发生在医疗环境中,幸存者往往有更多的合并症。尽管有更多的人在IHCA后存活下来,但对于他们的长期康复经历却知之甚少。我们对19名IHCA幸存者进行了半结构化访谈,以更好地了解他们的康复经历,并确定他们认为有助于康复的适应策略。主题分析表明,IHCA幸存者在康复过程中持续面临挑战。对于一些参与者来说,重新定义独立性对于重新参与社交和体育活动是必要的,少数人能够参与新的活动。我们的研究结果表明,IHCA幸存者通常会制定自己的适应策略,以便继续参与社会生活,并且他们的康复经历是持续的。干预项目和后续护理应该持续询问幸存者对他们来说重要的事情,并确定能够支持他们目标的资源。问题应该包括身体、认知、心理和社会目标,这些目标超出了与IHCA具体相关的目标,因为我们的研究结果表明,IHCA的影响是持久的,涵盖了幸存者生活的各个方面。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7077/9453782/5f73e273adb5/nihms-1833935-f0001.jpg

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