To Survive Out-of-Hospital Cardiac Arrest: A Search for Meaning and Coherence

Abstract

The primary responsibility of prehospital emergency personnel at out-of-hospital cardiac arrests (OHCA) is to provide lifesaving care. Ethical considerations, decisions, and actions should be based in the patient's beliefs about health and well-being. In this article, we describe patients' experiences of surviving OHCA. By using a phenomenological approach, we focus on how OHCA influences patients' well-being over time. Nine survivors were interviewed. Out-of-hospital cardiac arrest is described as a sudden and elusive threat, an awakening in perplexity, and the memory gap as a loss of coherence. Survival means a search for coherence with distressing and joyful understanding, as well as existential insecurity exposed by feelings of vulnerability. Well-being is found through a sense of coherence and meaning in life. The study findings show survivors' emotional needs and a potential for prehospital emergency personnel to support them as they try to make sense of what has happened to them.

Revealed by degrees: Patients’ experience of receiving information after in‐hospital cardiac arrest

“…This study shows that patients who suffer a cardiac arrest in hospital would like to receive information about what has happened. This is consistent with previous research on patients suffering a cardiac arrest outside the hospital context (Bremer et al, ; Dougherty et al, ; Forslund et al, ; Ketilsdottir et al, ; Palacios‐Cena et al, ; Uren & Galdas, ). Although the patients could rarely remember who had informed them, it was important for them to get information; they were less concerned about who should present the information.…”

“…Many patients were afraid that they could have another cardiac arrest, which has also been shown in previous research on patients who had a cardiac arrest outside hospital (Bremer et al, 2009;Ketilsdottir et al, 2014 (Forslund et al, 2014). Previous research also confirmed our finding that patients could fill the gaps in their memory and understand the context if they were able to listen to other people's narratives (Bremer et al, 2009 (Wiles & Kinmonth, 2001).…”

Revealed by degrees: Patients’ experience of receiving information after in‐hospital cardiac arrest

“…This study shows that patients who suffer a cardiac arrest in hospital would like to receive information about what has happened. This is consistent with previous research on patients suffering a cardiac arrest outside the hospital context (Bremer et al, ; Dougherty et al, ; Forslund et al, ; Ketilsdottir et al, ; Palacios‐Cena et al, ; Uren & Galdas, ). Although the patients could rarely remember who had informed them, it was important for them to get information; they were less concerned about who should present the information.…”

“…Many patients were afraid that they could have another cardiac arrest, which has also been shown in previous research on patients who had a cardiac arrest outside hospital (Bremer et al, 2009;Ketilsdottir et al, 2014 (Forslund et al, 2014). Previous research also confirmed our finding that patients could fill the gaps in their memory and understand the context if they were able to listen to other people's narratives (Bremer et al, 2009 (Wiles & Kinmonth, 2001).…”

The experience of sudden cardiac arrest: Becoming reawakened to life

“…With the act of placing the family first, concern for family members' experience and their need for support arose. Similar results have been reported in previous studies, 12,13,26,28 in which participants expressed gratitude for being alive, developed a new perspective on life and learned to live again.…”

Surviving cardiac arrest: Patients’ experiences of the in-hospital phase of recovery

“…The temporary loss of coherence and the development of an immediate coping strategy can be readily understood and interpreted through the lens of existentialism (Lee and McCormick, 2002). However, the finding regarding an initial phase of existential crisis in this study was incongruous with the accounts of the experiences of participants in the publication by Bremer, Dahlberg and Sandman (2009) as detailed in the literature review.…”

Revealed by degrees: Patients’ experience of receiving information after in‐hospital cardiac arrest

“…This study shows that patients who suffer a cardiac arrest in hospital would like to receive information about what has happened. This is consistent with previous research on patients suffering a cardiac arrest outside the hospital context (Bremer et al, ; Dougherty et al, ; Forslund et al, ; Ketilsdottir et al, ; Palacios‐Cena et al, ; Uren & Galdas, ). Although the patients could rarely remember who had informed them, it was important for them to get information; they were less concerned about who should present the information.…”

“…Many patients were afraid that they could have another cardiac arrest, which has also been shown in previous research on patients who had a cardiac arrest outside hospital (Bremer et al, 2009;Ketilsdottir et al, 2014 (Forslund et al, 2014). Previous research also confirmed our finding that patients could fill the gaps in their memory and understand the context if they were able to listen to other people's narratives (Bremer et al, 2009 (Wiles & Kinmonth, 2001).…”

The experience of sudden cardiac arrest: Becoming reawakened to life

“…With the act of placing the family first, concern for family members' experience and their need for support arose. Similar results have been reported in previous studies, 12,13,26,28 in which participants expressed gratitude for being alive, developed a new perspective on life and learned to live again.…”

Surviving cardiac arrest: Patients’ experiences of the in-hospital phase of recovery

“…The temporary loss of coherence and the development of an immediate coping strategy can be readily understood and interpreted through the lens of existentialism (Lee and McCormick, 2002). However, the finding regarding an initial phase of existential crisis in this study was incongruous with the accounts of the experiences of participants in the publication by Bremer, Dahlberg and Sandman (2009) as detailed in the literature review.…”

Revealed by degrees: Patients’ experience of receiving information after in‐hospital cardiac arrest

“…This study shows that patients who suffer a cardiac arrest in hospital would like to receive information about what has happened. This is consistent with previous research on patients suffering a cardiac arrest outside the hospital context (Bremer et al, ; Dougherty et al, ; Forslund et al, ; Ketilsdottir et al, ; Palacios‐Cena et al, ; Uren & Galdas, ). Although the patients could rarely remember who had informed them, it was important for them to get information; they were less concerned about who should present the information.…”

“…Many patients were afraid that they could have another cardiac arrest, which has also been shown in previous research on patients who had a cardiac arrest outside hospital (Bremer et al, 2009;Ketilsdottir et al, 2014 (Forslund et al, 2014). Previous research also confirmed our finding that patients could fill the gaps in their memory and understand the context if they were able to listen to other people's narratives (Bremer et al, 2009 (Wiles & Kinmonth, 2001).…”

The experience of sudden cardiac arrest: Becoming reawakened to life

“…With the act of placing the family first, concern for family members' experience and their need for support arose. Similar results have been reported in previous studies, 12,13,26,28 in which participants expressed gratitude for being alive, developed a new perspective on life and learned to live again.…”

Surviving cardiac arrest: Patients’ experiences of the in-hospital phase of recovery

“…The temporary loss of coherence and the development of an immediate coping strategy can be readily understood and interpreted through the lens of existentialism (Lee and McCormick, 2002). However, the finding regarding an initial phase of existential crisis in this study was incongruous with the accounts of the experiences of participants in the publication by Bremer, Dahlberg and Sandman (2009) as detailed in the literature review.…”