With Fearful Eyes: Exploring Relatives' Experiences With Out-of-Hospital Cardiac Arrest

Abstract

Background: Out-of-hospital cardiac arrest (OHCA) imposes significant consequences for a family, but little is known about relatives' experiences. Objective: Our aim was to explore relatives' experiences with the OHCA and the following months after. Method: A qualitative approach using phenomenological-hermeneutic methodology was applied. Data consisted of semistructured interviews with 12 relatives of OHCA survivors. We analyzed data based on Paul Ricoeur's theory of interpretation. Results: Relatives experienced OHCA as an abrupt and stressful event filled with imposing concerns for the cardiac arrest survivor. Relatives were fellow sufferers confronted with the possibility of bereavement, watching from the sideline with fearful eyes. After the OHCA, relatives experienced a troubled time with anxiety and edginess, monitoring the survivor for signs of a new cardiac arrest and trying to adapt to a new normality. Relatives' previous identities and positions within their families were disrupted. Conclusion: Relatives were challenged with the OHCA and the trajectory after it, experiencing a high level of distress and anxiety. Relatives took on an immense responsibility, always watching the survivor for potential symptoms of a new cardiac arrest. The cardiac arrest and the survivor's possible cognitive impairments gave rise to assuming a new authority as a relative. We advocate for a new family approach to relatives, acknowledging relatives' stress and central role in supporting cardiac arrest survivors.

Family & bystander experiences of emergency ambulance services care: a scoping review

“…Articles which included ambulance staff ( n = 20), patients ( n = 4), family ( n = 2) Systematic integrative review Paramedics can play an important role in facilitating home-based death & reducing avoidable hospital admissions. There is a strong desire amongst ambulance staff, family members & patients for paramedics to refocus their attention on holistic home-based management of palliative symptoms instead of hospital conveyance 1, 2, 4 Larsen et al, (2022) [ 39 ] Denmark To explore relatives’ experience of out-of-hospital cardiac arrest during & post-event 12 relatives of adult OHCA survivors Qualitative, semi-structured interviews Relatives were challenged with witnessing OHCA & the trajectory after it, experiencing a high level of distress & anxiety. The development of support networks & education programs for patients & relatives is a critical element in supporting relatives of cardiac arrest survivors after discharge 1, 2, 5 Mathiesen et al, (2016) [ 40 ] Norway To explore reactions & coping strategies in lay rescuers who have provided CPR to OHCA victims 20 lay rescuers who performed CPR Qualitative, semi-structured interviews Reactions after providing CPR to OHCA victims may cause serious & persistent concerns in lay rescuers.…”

“…Of the 35 included articles, 21 utilised a qualitive research design [ 25 , 26 , 31 , 34 , 35 , 37 – 41 , 43 – 47 , 49 , 51 – 55 ]; Two used quantitative design [ 32 ] (including one randomised control trial)[ 36 ]; two were review papers (one systematic integrative review[ 6 ], one scoping review)[ 5 ]; and 10 were mixed-methods [ 23 , 24 , 27 – 30 , 33 , 42 , 48 , 50 ]. The predominate population group of the included studies was family members with 18 studies solely focused on family perspectives [ 26 , 29 , 31 – 33 , 35 , 37 – 39 , 42 , 47 – 49 , 51 – 55 ]. Some studies included family participants alongside other perspectives including patients [ 28 ] and emergency ambulance personnel [ 27 , 36 , 44 ].…”

“…The nature of the emergency event also varied between studies. Seventeen studies focused on out-of-hospital cardiac arrest [OHCA] [ 23 – 26 , 28 , 30 , 32 , 33 , 36 , 39 – 41 , 43 , 51 – 54 ]. A further five articles included a variety of incidents (including trauma, OHCA, suicide, and other medical emergencies) resulting in out-of-hospital death [ 5 , 31 , 42 , 44 , 48 ].…”

“…Studies included covered a date range of 1989 [ 29 ] till 2022 [ 6 , 39 ]. A high proportion of studies came from the Nordic region ( n = 17) [ 23 – 26 , 34 , 35 , 37 – 40 , 43 – 45 , 51 – 53 , 55 ].…”

“…Studies exploring the experience of family members [ 26 , 37 , 39 , 52 ] and bystanders [ 25 , 41 ] revealed feelings of chaos and confusion. A sense of panic often affected the ability of family members and bystanders to perform medical aid, with many describing an inability to think or act clearly [ 37 , 41 , 43 , 45 , 51 , 53 ].…”