Warwick Research in Nursing, Division of Health Sciences, Warwick Medical School, University of Warwick, England.
Warwick Research in Nursing, Division of Health Sciences, Warwick Medical School, University of Warwick, England; Kadoorie, Oxford Trauma Research and Emergency Care, NDORMS, Oxford University, UK; Major Trauma Unit, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford UK.
Resuscitation. 2024 May;198:110188. doi: 10.1016/j.resuscitation.2024.110188. Epub 2024 Mar 26.
To review qualitative studies on the experience of sudden cardiac arrest survival from the perspective of both survivors and their key supporters, including family/close friends.
A seven-step meta-ethnography and synthesis of qualitative evidence was undertaken, informed by the Meta-Ethnography Reporting Guidelines (eMERGe). Four major databases were searched (Medline, EMBASE, CINAHL, PsycINFO; January 1995-January 2022, updated July 2023) for qualitative studies exploring survivors' and/or key supporters' experiences of cardiac arrest survival. The Critical Appraisal Skills Programme checklist and Grading of Recommendations Assessment, Development and Evaluation - Confidence in Evidence from Reviews of Qualitative Research (GRADE-CERQual) were applied to evaluate the overall confidence in research findings. Constructs were identified from each paper, informing theme and sub-theme development.
From 15,917 unique titles/abstracts and 196 full-text articles, 32 met the inclusion criteria. Three themes captured the survivors' experiences: 1) Making sense of my cardiac arrest; 2) Learning to trust my body and mind; and 3) Re-evaluating my life. A further three themes reflected key supporters' experiences: 1) Emotional turmoil; 2) Becoming a carer: same person but different me; and 3) Engaging with a new and unknown world. However, limited data and some methodological weaknesses in included studies reduced confidence in several themes. The findings were conceived within the overarching concept of 'negotiating a new normal'.
The enduring psychosocial and physical sequelae of cardiac arrest survival substantially impacts the lives of survivors and their key supporters, requiring negotiation of their 'new normality'. The need for sense-making, physical and psychological recovery, and the new roles for key supporters should be strong considerations in the development of future interventions.
从幸存者及其主要支持者（包括家人/亲密朋友）的角度回顾心脏骤停生存的定性研究。
采用七步元分析和综合定性证据的方法，以元分析报告指南（eMERGe）为指导。在四个主要数据库（Medline、EMBASE、CINAHL、PsycINFO；1995 年 1 月至 2022 年 1 月，2023 年 7 月更新）中搜索了探索幸存者和/或主要支持者经历心脏骤停生存的定性研究。应用批判性评估技能计划检查表和推荐评估、发展和评估的分级 - 来自定性研究的证据可信度（GRADE-CERQual）对研究结果的整体可信度进行评估。从每篇论文中确定了构建，为主题和子主题的发展提供了信息。
从 15917 个独特的标题/摘要和 196 篇全文文章中，有 32 篇符合纳入标准。三个主题捕捉到了幸存者的经历：1）理解我的心脏骤停；2）学会信任我的身心；3）重新评估我的生活。进一步的三个主题反映了主要支持者的经历：1）情绪动荡；2）成为照顾者：同一个人但不同的我；3）参与一个新的和未知的世界。然而，纳入研究的数据有限和一些方法学上的弱点降低了几个主题的可信度。这些发现是在“协商新常态”的总体概念框架内提出的。
心脏骤停生存后的持久的心理社会和身体后遗症极大地影响了幸存者及其主要支持者的生活，需要协商他们的“新常态”。理解、身体和心理恢复以及主要支持者的新角色的需求应该是未来干预措施发展的重要考虑因素。
