Survivors' quality of life after cardiopulmonary resuscitation: an integrative review of the literature.

BACKGROUND: The incidence of cardiac arrest and cardiopulmonary resuscitation continues to increase worldwide largely due to greater awareness of the symptoms of cardiac events and increased attention to cardiopulmonary resuscitation training in the community. Globally, predicted survival rates after cardiopulmonary resuscitation have remained at 10% for decades and although patient outcome remains unpredictable, there is a positive trend in life expectancy. For a resuscitation attempt to be classed as successful, not only survival but also quality of life has to be evaluated. AIM: The aim of this review was to examine literature that explores the quality of life (QOL) for survivors' after CPR and the influence cognitive impairment, anxiety, depression and post-traumatic stress disorder (PTSD) has had on their QOL. REVIEW METHODS: This review follows Whittemore and Knafl's framework for an integrative literature review. Electronic databases EBSCO, Ovid, PubMed and EMBASE were searched. After application of the inclusion and exclusion criteria, thirty-six papers published from January 2000 to June 2015 were included in this review. RESULTS: These papers represent a broad spectrum of research evaluating quality of life for survivors of cardiopulmonary resuscitation. The heterogeneous research methods and vast number of different research tools make it challenging to compare the findings. The majority of papers concluded that quality of life for survivors of cardiac arrest and cardiopulmonary resuscitation was generally acceptable. However, studies also described survivors' experience of anxiety, depression, post-traumatic stress and cognitive dysfunction. CONCLUSION: A majority of papers reported an acceptable quality of life if the patient survived to hospital discharge. The heterogeneity in quantitative papers was noticeable and indicates a marked variance in patient outcomes. This review highlights the absence of specialized tools used to investigate survivors' experience of the event. Further exploration of the impact cardiopulmonary resuscitation has on the individual may improve ongoing rehabilitation and quality of life levels for survivors.

Home care packages: insights into the experiences of older people leading up to the introduction of consumer directed care in Australia.

This paper reports phase one, conducted from March to June 2015, of a two-phase, qualitative descriptive study designed to explore the perceptions and experiences of older people before and after the introduction of consumer directed care (CDC) to home care packages (HCP) in Australia. Eligible consumers with a local HCP provider were mailed information about the study. Data collection occurred before the introduction of CDC and included face-to-face, in-depth interviews, summaries of interviews, field notes and reflective journaling. Semi-structured questions and 'emotional touchpoints' relating to home care were used to guide the interview conversation. Line-by-line data analysis, where significant statements were highlighted and clustered to reveal emergent themes, was used. Five older people, aged 81 to 91 years, participated in the study. The four emergent themes were: seeking quality and reciprocity in carer relationships; patchworking services; the waiting game; and technology with utility. Continuity of carers was central to the development of a trusting relationship and perceptions of care quality among older consumers. Care coordinators and workers should play a key role in ensuring older people receive timely information about CDC and their rights and responsibilities. Participants' use of contemporary technologies suggests opportunities to improve engagement of HCP clients in CDC.

A narrative inquiry: Humour and gender differences in the therapeutic relationship between nurses and their patients.

BACKGROUND: Although the use of humour in health care has been well investigated, the humorous interactions between nurse and patient are not. This research project investigated the humorous interaction between patient and nurse. AIMS: This study aimed to explore four registered nurses' experiences of the use of humour in relation to gender differences and how humour influences the therapeutic relationship. DESIGN: Narrative inquiry was the chosen methodology as it allows participants to include what is important to participants and highlights how experiences shape social interaction and understanding of events. METHODS: Registered nurses were recruited from a regional hospital. Interested participants contacted the researchers and shared their stories. Data were analysed using a narrative enquiry methodology. RESULTS: The study indicated gender differences in the way humour is used by patients. For female patients, humour is often instant and situation bound and used as a reassuring discourse for others, whereas male patients' humour through stories and anecdotes is designed to establish a sense of equalising power between the patient and nurse.

A narrative inquiry: how do nurses respond to patients' use of humour?

In today's healthcare system where technical instruments and test results are used to implement care it is easy to lose the human aspect of nursing. Personal interaction can get lost and nurses sometimes miss humorous attempts made by patients. Humour is a very personal concept, what one person thinks is funny does not necessarily make another person smile, or might even be hurtful. Humour is an important communication tool for patients as it humanises the nurses, creates a bond and opens communication lines. Humour has the potential to change the hospital experience for patients. The aim of this paper is to highlight the importance of humour in the therapeutic relationship between patient and nurse. Semi-structured interviews were held with four registered nurses and narrative inquiry was used to analyse and present the findings because of its ability to capture human interaction and experience.

The use of humour in nursing education: An integrative review of research literature.

OBJECTIVES: Humour is an integral part of communication and often used in education to support learning, build relationships, lessen stress, and create a positive environment. This paper presents results from an integrative review of literature that aimed to explore how humour is used in nursing education. DESIGN: Integrative literature review. DATA SOURCES: CINAHL, INFORMIT, Medline and Proquest education. REVIEW METHODS: An integrative review of published research was conducted in the above-mentioned databases during March to June 2022. A hand search in reference lists of published articles was also conducted. Search terms followed PEO (population, exposure and outcome) and included 'Faculty, Nursing', 'Nurse* Student*', 'Baccalaureate', 'Humo?r', 'Laugh*', 'Wit', 'Fun*', 'Comedy', 'Educat*', 'Teach*', 'Learn*' and 'Curricul*'. Inclusion criteria stated articles must have a research component investigating how humour is used and received by students in nursing education. The articles were peer reviewed and published after 2001. Conference abstracts, editorials and articles describing the use of humour in nursing education without research evidence were excluded. Grey literature was not included. RESULTS: The search yielded two hundred and one articles, 10 of which met the inclusion criteria. Studies were primarily qualitative (n = 9) with 1 quantitative study. Five themes were found among the articles (1) Humour builds social relationships (2) Humour aids learning/critical thinking (3) Humour and stress relief (4) Humour to focus attention and (5) Negative use of humour. CONCLUSION: Findings suggest that the use of humour in nursing education lowers stress, improves attention, increases focus and improved information retention. However, findings also conclude that negative humour is not conducive to learning. Research is needed to explore the use of humour in nurse education in order to develop teaching approaches that include culturally sensitive humour to enhance the student learning experience and reduce stress.

Long-term survivors of cardiac arrest: A narrative inquiry.

BACKGROUND: Despite extensive knowledge and research in cardiac health there is limited understanding in how a cardiac arrest influences the life of long-term survivors. OBJECTIVE: The aim of this study was to explore how long-term survivors of a cardiac arrest adjusted to their new reality, expressed in their re-storied narratives. METHODS: Seven individuals surviving a cardiac arrest 5-26 years ago were interviewed through in-depth conversations over a six-month period. These interviews were analysed using Clandinin and Connelly's framework of narrative inquiry. RESULTS: Seven threads were found: Disbelief, Surveillance of their body, Loss of control and desire for normality, Keeping fit and informing others, Gratefulness, Spirituality - luck and fate, and Fragility of life and dying. CONCLUSIONS: All seven long-term survivors of cardiac arrest expressed a positive attitude. Despite the nature of the cardiac arrest and the hurdles that followed, they have a heightened appreciation for life. This indicates that after the adaptation to their new reality of being a cardiac arrest survivor life returns to a new normality.

Experiences of older people following the introduction of consumer-directed care to home care packages: A qualitative descriptive study.

OBJECTIVE: To explore the experiences of older people receiving home care package (HCP) support following the introduction of consumer-directed care (CDC) by the Australian government on 1 July 2015. METHODS: Thirty-one older people with existing HCP support from two service providers in regional New South Wales, Australia, participated in a face-to-face interview and/or a qualitative survey. RESULTS: Analysis revealed the theme of Choices: Preferences, constraints, balancing and choosing. Participants described choosing to live at home with HCP support; however, they were constrained by poor communication and information about service changes and options, personal budgets and access to future care. HCP services remained largely unchanged during transition to CDC. CONCLUSION: Many aspects of the initial implementation of CDC were challenging for older people. Clear, relevant and timely communication and information about CDC and its consequences for consumers appear to be needed to enhance CDC.

A systematic review and meta-synthesis of the qualitative literature exploring the experiences and quality of life of survivors of a cardiac arrest.

BACKGROUND: Survival following cardiac arrest and subsequent cardiopulmonary resuscitation (CPR) is increasing worldwide, mainly due to greater awareness of the symptoms of cardiac events and an increased attention to CPR training. Although patient outcomes remain unpredictable and quantitative studies suggest that the overall quality of life (QOL) is acceptable, it is valuable to synthesise qualitative studies exploring these phenomena in depth, providing a deeper knowledge of survivors' experiences and QOL. AIMS: To critically appraise and synthesise the qualitative literature on survivors' experiences of a cardiac arrest and CPR with the aim of identifying common themes that can inform clinical pathways and thereby improve survivor outcomes and QOL. METHODS: A systematic review and meta-synthesis of the qualitative literature, using Thomas and Harden's framework, and confined to peer-reviewed papers published from 2000 to 2015, which were identified through database searches of EBSCO, OVID and ProQuest. RESULTS: The search produced 204 papers, and of these, seven relevant papers were identified for review. Data extraction included setting, participants, research design, data collection, analysis and themes. Five qualitative themes were identified and were the subject of this meta-synthesis: multitude of contrasting feelings; disruption in the continuum of time; new reality and psychological challenges; changed body with new limitations; and confrontation with death. CONCLUSION: This review provides insights into the experiences of survivors' QOL after CPR. Increased knowledge can improve person-centred care in the immediate and forthcoming care after the event, both in terms of planning for discharge and in the future care of people who survive a cardiac arrest.

A Narrative Inquiry: How do nurses respond to patients' use of humour?

Abstract In today's healthcare system where technical instruments and test results are used to implement care it is easy to lose the human aspect of nursing. Personal interaction can get lost and nurses sometimes miss humorous attempts made by patients. Humour is a very personal concept, what one person thinks is funny does not necessarily make another person smile, or might even be hurtful. Humour is an important communication tool for patients as it humanises the nurses, creates a bond and opens communication lines. Humour has the potential to change the hospital experience for patients. The aim of this paper is to highlight the importance of humour in the therapeutic relationship between patient-nurse. Semi structured interviews were held with four registered nurses and narrative inquiry was used to analyse and present the findings because of its ability to capture human interaction and experience.