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1.
J Clin Ethics ; 30(4): 347-355, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31851626

RESUMEN

Most professional guidelines advocate family presence during resuscitation (FPDR). Many clinicians, however, are still reluctant to implement this recommendation. In this article I present the most comprehensive case for FPDR to date. I review the little that has been written about the ethics of FPDR, as well as the available empirical evidence. More importantly, I present and defend three arguments for FPDR: adherence to professional guidelines, benefit to patients and relatives, and patients' autonomy. I conclude with suggestions for future research.


Asunto(s)
Reanimación Cardiopulmonar/ética , Cuidados Críticos/ética , Familia , Relaciones Profesional-Familia/ética , Actitud del Personal de Salud , Reanimación Cardiopulmonar/psicología , Cuidados Críticos/psicología , Familia/psicología , Humanos , Guías de Práctica Clínica como Asunto
3.
PLoS One ; 14(4): e0215432, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31034486

RESUMEN

This study examined the mediation effect of practical training on the relationship of demographic characteristics with bystander self-efficacy in cardiopulmonary resuscitation (CPR) performance. We used nationwide, cross-sectional data from the Korea Community Health Survey and analyzed 25,082 Korean adults who participated in CPR training within the last 2 years. A mediation model was applied to explore the pathway from demographic characteristics via CPR practical training to self-efficacy in CPR performance. A multiple logistic regression analysis was performed to examine each path in the mediation model. Of the 25,082 respondents recently trained, 19,168 (76.8%) practiced on a manikin. In the unadjusted CPR practical training model, the demographic characteristics associated with high self-efficacy in CPR performance were male gender (odds ratio [OR] = 2.54); 50s age group (OR = 1.30); college or more (OR = 1.39) and high school education (OR = 1.32); white collar (OR = 1.24) and soldier (OR = 2.98) occupational statuses. The characteristics associated with low self-efficacy were 30s age group (OR = 0.69) and capital (OR = 0.79) and metropolitan (OR = 0.84) areas of residence (p < 0.05). In the adjusted CPR practical training model, the significance of the relationship between demographics and self-efficacy in CPR performance decreased in male gender, 30s age group, college or more and high school education, and soldier occupational status (i.e., partial mediation), and disappeared in metropolitan residents (i.e., complete mediation). The degree of the mediating effect of CPR practical training on self-efficacy differed for each demographic characteristic. Thus, individualized educational strategies considering recipient demographics are needed for effective practice-based CPR training and improving bystander CPR performance.


Asunto(s)
Reanimación Cardiopulmonar/educación , Adulto , Anciano , Reanimación Cardiopulmonar/psicología , Estudios Transversales , Demografía , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Modelos Logísticos , Masculino , Maniquíes , Persona de Mediana Edad , Paro Cardíaco Extrahospitalario/terapia , República de Corea , Autoeficacia , Adulto Joven
4.
Artículo en Inglés | MEDLINE | ID: mdl-30909545

RESUMEN

Background: Literature indicates that patients who receive cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) from bystanders have a greater chance of surviving out-of-hospital cardiac arrest (OHCA). A few evaluative studies involving CPR/AED education programs for rural adolescents have been initiated. This study aimed to examine the impact of a 50 min education program that combined CPR with AED training in two rural campuses. Methods: A quasi-experimental pre-post design was used. The 50 min CPR/AED training and individual performance using a Resusci Anne manikin was implemented with seventh grade students between August and December 2018. Results: A total of 336 participants were included in this study. The findings indicated that the 50 min CPR/AED education program significantly improved participant knowledge of emergency responses (p < 0.001), correct actions at home (p < 0.01) and outside (p < 0.001) during an emergency, and willingness to perform CPR if necessary (p < 0.001). Many participants described that "I felt more confident to perform CPR/AED," and that "It reduces my anxiety and saves the valuable rescue time." Conclusions: The brief education program significantly improved the immediate knowledge of cardiac emergency in participants and empowered them to act as first responders when they witnessed someone experiencing a cardiac arrest. Further studies should consider the study design and explore the effectiveness of such brief programs.


Asunto(s)
Reanimación Cardiopulmonar/educación , Desfibriladores/psicología , Aprendizaje , Paro Cardíaco Extrahospitalario/psicología , Adolescente , Reanimación Cardiopulmonar/psicología , Femenino , Humanos , Masculino , Paro Cardíaco Extrahospitalario/prevención & control , Estudiantes/estadística & datos numéricos
5.
Simul Healthc ; 14(2): 104-112, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-30730471

RESUMEN

BACKGROUND: Virtual reality (VR) is a promising simulation medium for high-stakes, low-frequency events such as pediatric resuscitation. The psychological fidelity of VR compared with a real resuscitation in an emergency department (ED) is relatively unknown. The objective was to determine whether stress physiology changes were equivalent between ED and VR resuscitations. METHODS: This was a single-site pilot equivalence study evaluating head-mounted VR resuscitation scenarios using board-certified/eligible pediatric ED physicians. Subjects had heart rates (HRs) and salivary cortisol levels recorded throughout 8-hour evening ED shifts and during one 1-hour VR session. Additional samples and subjective workload perception (NASA Task Load Index) were collected for critical resuscitations. A delta HR and delta cortisol level described the difference in mean HR and mean cortisol level between shifts with and shifts without resuscitations. Another delta calculation was performed from pre-VR to post-VR. Nonparametric univariate statistics was examined for significant differences in delta HR or cortisol levels between the ED setting and VR. RESULTS: Sixteen subjects had 69 shifts monitored with 31 resuscitations. In the ED, delta HR was +13.9 bpm (P < 0.001) and delta cortisol was +0.10 µg/dL (P = 0.006). In VR, delta HR was +6.5 bpm (P < 0.001) but minimal delta cortisol (-0.02 µg/dL, P = 0.05). Emergency department resuscitations both HR and cortisol levels were more than VR resuscitations (P < 0.03). NASA Task Load Index scores were higher in VR resuscitations with +26 score difference (P = 0.01). CONCLUSIONS: Virtual reality resuscitations increase HR but show less stress physiology changes than ED resuscitations within an actual 8-hour shift. Further inquiry into stress physiology and optimal VR simulation is warranted.


Asunto(s)
Reanimación Cardiopulmonar/psicología , Servicio de Urgencia en Hospital , Hidrocortisona/análisis , Estrés Laboral/fisiopatología , Realidad Virtual , Reanimación Cardiopulmonar/educación , Femenino , Frecuencia Cardíaca/fisiología , Hospitales Pediátricos , Humanos , Masculino , Estrés Laboral/epidemiología , Entrenamiento Simulado/métodos
6.
Int J Public Health ; 64(5): 755-762, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-30603940

RESUMEN

OBJECTIVES: Drowning is a public health challenge. Children of migrants may be at increased risk as parents may be unaware of local water safety issues. This study explores differences between Australian-born and migrant parents in Western Australia for: (1) swimming ability; (2) supervision; (3) water familiarisation; and (4) cardiopulmonary resuscitation (CPR) training. METHODS: A cross-sectional survey of parents and carers of children aged under 5 years residing in WA (n = 1506) captured demographics, knowledge of appropriate supervision, water safety knowledge and skills. Logistic regression was conducted. RESULTS: Migrants were significantly less likely to identify adequate supervision (p = 0.004); have participated in child water familiarisation programmes (p = 0.000); or perceived themselves as able swimmers (p = 0.000). Significantly less migrants had also undertaken CPR training (p = 0.000). CONCLUSIONS: Findings add to the small but growing body of literature highlighting the importance of tailored drowning prevention strategies for migrants in countries such as Australia with a strong aquatic culture.


Asunto(s)
Reanimación Cardiopulmonar/psicología , Cuidadores/psicología , Ahogamiento/prevención & control , Ahogamiento/psicología , Responsabilidad Parental/psicología , Padres/psicología , Migrantes/psicología , Adulto , Australia , Reanimación Cardiopulmonar/educación , Reanimación Cardiopulmonar/estadística & datos numéricos , Preescolar , Estudios Transversales , Femenino , Humanos , Lactante , Recién Nacido , Modelos Logísticos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Administración de la Seguridad/estadística & datos numéricos , Encuestas y Cuestionarios , Migrantes/estadística & datos numéricos , Australia Occidental , Adulto Joven
7.
Acta Clin Belg ; 74(5): 297-316, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-29874976

RESUMEN

OBJECTIVES: Training children in cardiopulmonary resuscitation (CPR) is one of the strategies to increase bystander CPR in society. Reinforcing knowledge and awareness and increasing willingness to perform bystander CPR contributes to a better outcome after cardiac arrest. We questioned schoolchildren, teachers and principals about their awareness of the importance of CPR and about their willingness to perform CPR. METHODS: During a four-month period, Flemish schoolchildren aged 10-18 years, teachers and principals were invited to complete a survey consisting of three parts: (1) demographics, (2) CPR (training) experience and (3) attitude towards CPR teaching and training. RESULT: In total, 390 schoolchildren, 439 teachers and 100 principals completed the survey. Previous CPR training was reported by 33% of the schoolchildren (in 82% as part of the curriculum) and by 81% teachers and 82% principals. Willingness to participate in CPR training was 77% in schoolchildren, 79% in teachers and 86% in principals with 88% of the principals convinced that schoolchildren should learn how to perform CPR. Willingness to perform CPR in a real-life situation was 68% in schoolchildren, 84% in teachers and 92% in principals. CONCLUSION: Schoolchildren are well aware of the importance of CPR and are willing to acquire the related knowledge and skills. Noteworthy is the larger awareness among principals and teachers, establishing a strong base for increasing implementation of CPR training in schools. However, a majority of children indicated a lack of training opportunities, highlighting the need for a stronger implementation.


Asunto(s)
Reanimación Cardiopulmonar/educación , Reanimación Cardiopulmonar/psicología , Personal Docente/psicología , Paro Cardíaco Extrahospitalario/terapia , Adolescente , Concienciación , Bélgica , Niño , Encuestas de Atención de la Salud , Conocimientos, Actitudes y Práctica en Salud , Humanos , Internet , Paro Cardíaco Extrahospitalario/psicología
8.
BMJ Support Palliat Care ; 9(1): e20, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-28735269

RESUMEN

OBJECTIVES: To quantify agreement between patients and their family members on their own values and preferences for use or non-use of life-sustaining treatments for the patient. METHODS: Hospitalised patients aged 55 years or older with advanced pulmonary, cardiac, liver disease or metastatic cancer or aged 80 years or older from medical wards at 16 Canadian hospitals and their family members completed a questionnaire including eight items about values related to life-sustaining treatment and a question about preferences for life-sustaining treatments. RESULTS: We recruited a total of 313 patient-family member dyads. Crude agreement between patients and family members about values related to life-sustaining treatment was 42% across all eight items but varied widely: 20% when asking how important it was for the patient to respect the wishes of family members regarding their care; 72% when asking how important it was for the patient to be kept comfortable and suffer as little as possible. Crude agreement on preferences for life-sustaining treatment was 91% (kappa 0.60; 95%CI 0.45 to 0.75) when looking at preferences for cardiopulmonary resuscitation (CPR) versus no CPR but fell to 56% when including all five response options with varying degrees of resuscitative, medical or comfort options (kappa 0.39; 95%CI 0.31 to 0.47). CONCLUSIONS: There is appreciable disagreement between seriously ill hospitalised patients and family members in their values and preferences for life-sustaining treatment. Strategies are needed to improve the quality of advance care planning, so that surrogates are better able to honour patient's wishes at the end of life.


Asunto(s)
Reanimación Cardiopulmonar/psicología , Familia/psicología , Cuidados para Prolongación de la Vida/psicología , Neoplasias/enfermería , Prioridad del Paciente/psicología , Pacientes/psicología , Cuidado Terminal/psicología , Planificación Anticipada de Atención , Anciano , Anciano de 80 o más Años , Canadá , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios
9.
BMJ Support Palliat Care ; 9(1): 1-11, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30108041

RESUMEN

OBJECTIVES: Do Not Attempt Cardio-Pulmonary Resuscitation (DNACPR) discussions with patients and their caregivers have been subjected to intense ethical and legal debate in recent years. Legal cases and national guidelines have tried to clarify the best approach to DNACPR discussions; however, there is little evidence of how best to approach them from the patient, family or caregiver perspective. This paper describes published accounts of patient, family and caregiver experiences of discussions about advance cardiopulmonary resuscitation (CPR) decision making. METHODS: An integrative review of the UK literature between 2000 and 2016 including qualitative and quantitative studies was conducted. Worldwide, 773 abstracts were identified, and 20 papers from the UK were included in the final analysis. RESULTS: Patient, family and caregivers prefer discussions to be initiated by someone trusted, and wishes for family involvement vary depending on the context. Timing of discussions should be individualised, though discussions earlier in the illness are often preferable. Discussions held in the acute setting are suboptimal. CPR decisions should be part of a wider discussion about future care and adequate communication skills training is important. CONCLUSIONS: The findings of this review are at odds with the current statutory framework and potentially challenging for medical professionals who are working in a stretched health service, with pressure to discuss DNACPR decisions at the earliest opportunity. With increasing focus on person-centred care and realistic medicine, patient narratives must be considered by doctors and policy makers alike, to minimise harm.


Asunto(s)
Planificación Anticipada de Atención , Reanimación Cardiopulmonar/psicología , Toma de Decisiones , Órdenes de Resucitación/psicología , Comunicación , Femenino , Humanos , Masculino , Médicos/psicología , Reino Unido
10.
J Clin Nurs ; 28(1-2): 32-46, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30129259

RESUMEN

OBJECTIVE: The objective was to consider family presence during resuscitation (FPDR) from the perspective of the family member. BACKGROUND: FPDR has been a topic of interest internationally since the first report of this practice more than 25 years ago. Worldwide, many studies have provided insight into the perspective of healthcare professionals (HCPs); however, there is limited research on the perspective and experiences of family members. DESIGN: An integrative review was conducted. An electronic database search was conducted for the years from 1994-2017. METHODS: The Cumulative Index of Nursing and Allied Health Literature (CINAHL), PyschINFO, Academic Search, SocINDEX, PubMed, ProQuest databases and Google Scholar were searched. Search terms were family perceptions, family presence and resuscitation. RESULTS: Twelve reviews met inclusion criteria. Findings suggest that family members view family presence as a fundamental right. Family members involved in a FPDR experience reported that their presence benefitted the patient and healthcare team. In an international sample of studies, family presence overall was viewed positively by family members and they voiced wanting to be given an option to be present during a loved one's resuscitation. CONCLUSIONS: Findings support that family members' desire for FPDR; however, the literature reflects that HCPs do not always embrace the practice of FPDR. Stronger educational preparation of nurses and other HCPs related to FPDR is warranted. Policy initiatives include the formulation of policies that allow family presence during resuscitation of a family member. RELEVANCE TO CLINICAL PRACTICE: The findings are relevant for a clinical practice that promotes a more family-centred approach to allowing FPDR. Creating policy and providing FPDR education for HCPs based on evidence provide more consistency in clinical practice and help to eliminate the moral distress experienced by clinical nurses forced to make difficult decisions during a stressful event.


Asunto(s)
Reanimación Cardiopulmonar/psicología , Familia/psicología , Relaciones Profesional-Familia , Visitas a Pacientes/psicología , Actitud del Personal de Salud , Reanimación Cardiopulmonar/enfermería , Personal de Salud , Humanos
11.
J Formos Med Assoc ; 118(2): 572-581, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-30190091

RESUMEN

BACKGROUND: A low bystander cardiopulmonary resuscitation (CPR) rate is one of the factors associated with low cardiac arrest survival. This study aimed to assess knowledge, attitudes, and willingness towards performing CPR and the barriers for implementation of bystander-initiated CPR. METHODS: Telephone interviews were conducted using an author-designed and validated structured questionnaire in Taiwan. After obtaining a stratified random sample from the census, the results were weighted to match population data. The factors affecting bystander-initiated CPR were analysed using logistic regression. RESULTS: Of the 1073 respondents, half of them stated that they knew how to perform CPR correctly, although 86.7% indicated a willingness to perform CPR on strangers. The barriers to CPR performance reported by the respondents included fear of legal consequences (44%) and concern about harming patients (36.5%). Most participants expressed a willingness to attend only an hour-long CPR course. Respondents who were less likely to indicate a willingness to perform CPR were female, healthcare providers, those who had no cohabiting family members older than 65 years, those who had a history of a stroke, and those who expressed a negative attitude toward CPR. CONCLUSION: The expressed willingness to perform bystander CPR was high if the respondents possessed the required skills. Attempts should be made to recruit potential bystanders for CPR courses or education, targeting those respondent subgroups less likely to express willingness to perform CPR. The reason for lower bystander CPR willingness among healthcare providers deserves further investigation.


Asunto(s)
Reanimación Cardiopulmonar/psicología , Conocimientos, Actitudes y Práctica en Salud , Adulto , Reanimación Cardiopulmonar/educación , Estudios Transversales , Servicios Médicos de Urgencia/métodos , Femenino , Humanos , Entrevistas como Asunto , Modelos Logísticos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Paro Cardíaco Extrahospitalario/mortalidad , Paro Cardíaco Extrahospitalario/terapia , Factores Socioeconómicos , Encuestas y Cuestionarios , Taiwán , Adulto Joven
12.
J Adv Nurs ; 75(4): 783-792, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-30375018

RESUMEN

AIM: To assess the factors associated with the knowledge and expectations among the general public about dispatcher assistance in out-of-hospital cardiac arrest incidents. BACKGROUND: In medical dispatch centres, emergency calls are frequently operated by specially trained nurses as dispatchers. In cardiac arrest incidents, efficient communication between the dispatcher and the caller is vital for prompt recognition and treatment of the cardiac arrest. DESIGN: A cross-sectional observational survey containing six questions and seven demographic items. METHOD: From January-June 2017 we conducted standardized interviews among 500 members of the general public in Norway. In addition to explorative statistical methods, we used multivariate logistic analysis. RESULTS: Most participants expected cardiopulmonary resuscitation instructions, while few expected "help in deciding what to do." More than half regarded the bystanders present to be responsible for the decision to initiate cardiopulmonary resuscitation. Most participants were able to give the correct emergency medical telephone number. The majority knew that the emergency call would not be terminated until the ambulance arrived at the scene. However, only one-third knew that the emergency telephone number operator was a trained nurse. CONCLUSION: The public expect cardiopulmonary resuscitation instructions from the emergency medical dispatcher. However, the majority assume it is the responsibility of the bystanders to make the decision to initiate cardiopulmonary resuscitation or not. Based on these findings, cardiopulmonary resuscitation training initiatives and public campaigns should focus more on the role of the emergency medical dispatcher as the team leader of the first resuscitation team in cardiac arrest incidents.


Asunto(s)
Operador de Emergencias Médicas/psicología , Conocimientos, Actitudes y Práctica en Salud , Paro Cardíaco Extrahospitalario/psicología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Reanimación Cardiopulmonar/psicología , Estudios Transversales , Asesoramiento de Urgencias Médicas , Femenino , Humanos , Masculino , Persona de Mediana Edad , Motivación , Noruega , Opinión Pública , Salud Rural , Salud Urbana , Adulto Joven
13.
Intensive Crit Care Nurs ; 50: 95-102, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-29699912

RESUMEN

OBJECTIVES: To describe preferences of intensive care patients' family members regarding the idea of an inpatient family-witnessed cardiopulmonary resuscitation. RESEARCH METHODOLOGY/DESIGN: A descriptive qualitative design was used in this study. Twelve family members of intensive care patients took part in individual semi-structured interviews. Data were analysed using thematic analysis. SETTING: A population of Finnish and Polish former intensive care adult patients' relatives. FINDINGS: The thematic analysis resulted in two main themes with four subthemes each: (Theme 1) Being more involved and engaged in patient's care in case of cardiopulmonary resuscitation, with subthemes: (a) Having an option to decide, (b) Being in physical proximity to the patient, (c) Feeling like having more control and impact and (d) Having a better idea about the situation. (Theme 2) Being cared for and treated respectfully during possible cardiopulmonary resuscitation, with subthemes: (a) Need for more support and understanding from the staff, (b) Uniqueness of the family - patient relationship, (c) Need for staff to be more humane and less mechanical and (d) Professional and highly qualified staff. CONCLUSION: Results of this study suggest a possible gap in family-centred care delivery in intensive care settings. System changes are necessary in order to increase nurses' awareness of patients' families' preferences, and successfully implement recommended family-witnessed cardiopulmonary resuscitation.


Asunto(s)
Reanimación Cardiopulmonar/métodos , Familia/psicología , Unidades de Cuidados Intensivos/normas , Percepción , Adulto , Reanimación Cardiopulmonar/psicología , Política de Planificación Familiar , Femenino , Finlandia , Humanos , Unidades de Cuidados Intensivos/organización & administración , Masculino , Persona de Mediana Edad , Polonia , Investigación Cualitativa
14.
Medicine (Baltimore) ; 97(52): e13819, 2018 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-30593176

RESUMEN

The study was aimed to identify the training received in Emergency Medicine by physicians and the limitations and difficulties self-perceived by those physicians to assist in emergencies, as well as to analyze the differences according to the work context.Observational cross-sectional study made by a survey using a self-administered questionnaire to a representative simple random sample (with replacement) of 294 doctors (n) working at the Primary Health Care centers out of the total of 851 doctors (N) that form the staff of physicians of Primary Health Care system of Asturias (Spain).In rural areas, the most frequently mentioned reasons were the lack of practical skills (32.65%), absence of adequate material (20.41%), lack of theoretical knowledge (8.16%), and poor equipment conditions (4.08%). In the semi-urban area, the most common reasons were the lack of practical skills (19.61%), lack of theoretical knowledge (10.78%), absence of adequate material (8.82%), and poor equipment conditions (4.90%). Finally, in the urban area, the main reason was the lack of practical skills (23.40%), absence of adequate material (20.21%), lack of theoretical knowledge (9.57%), and poor equipment conditions (4.26%). The differences were significant (P = .003) among the 3 work context.The absence of practical skills is the most frequent cause referred by doctors of the 3 areas as a key to not act correctly in an emergency. The doctors of the rural area perceive that they are better prepared in general to solve emergencies and it is the professionals of 3 areas that report having carried out more basic cardiopulmonary resuscitation, advanced and attention to the polytraumatized patient courses.


Asunto(s)
Actitud del Personal de Salud , Competencia Clínica , Urgencias Médicas/psicología , Médicos de Atención Primaria/psicología , Autoimagen , Adulto , Reanimación Cardiopulmonar/psicología , Estudios Transversales , Medicina de Emergencia/educación , Femenino , Humanos , Masculino , Persona de Mediana Edad , Médicos de Atención Primaria/educación , Servicios de Salud Rural , España
15.
Rev Lat Am Enfermagem ; 26: e3046, 2018 Nov 14.
Artículo en Inglés, Portugués, Español | MEDLINE | ID: mdl-30462781

RESUMEN

OBJECTIVE: to develop and validate instruments to identify health professionals' beliefs related to the presence of the child's family in invasive procedures and in cardiopulmonary resuscitation. METHOD: study based on Psychometrics to conduct the theoretical, empirical and analytical stages, developed in a neonatal unit of a university hospital. The two instruments were constructed based on the literature and applied to 96 health professionals. RESULTS: the Cronbach's Alpha of the instrument related to the professionals' beliefson invasive procedures was 0.863 and the instrument on cardiopulmonary resuscitation was 0.882. In both instruments, the tests performed indicated a correlation between the items. From the factorial analysis, four factors were generated: (1) benefits of the presence of the family; (2) impairment for professional practice; (3) strategies for the inclusion of the family; and (4) limitation of learning and decision making by the professional. CONCLUSION: the instruments analyzed obtained a good internal consistency and are indicators of the professionals' beliefs with the potential to evaluate the quality of family care in this context.


Asunto(s)
Actitud del Personal de Salud , Reanimación Cardiopulmonar/psicología , Familia/psicología , Adulto , Femenino , Humanos , Masculino , Psicometría , Encuestas y Cuestionarios
16.
BMC Palliat Care ; 17(1): 118, 2018 Oct 19.
Artículo en Inglés | MEDLINE | ID: mdl-30340632

RESUMEN

BACKGROUND: A national Do Not Attempt Cardiopulmonary Resuscitation policy was rolled out for the National Health Service in Wales in 2015. A national steering group led on producing information videos and a website for patients, carers and healthcare professionals, forming part of a quality improvement program. Videos were planned, scripted and produced with healthcare professionals and patient/carer representatives, and were completed with both English and Welsh language versions. The TalkCPR videos encourage and promote open discussion about Cardiopulmonary Resuscitation (CPR) and DNACPR in palliative care situations. METHODS: We worked with patient/carer groups to evaluate whether video resources to convey the salient facts involved in CPR and DNACPR decisions for people with palliative and life-limiting illness were acceptable or not. We conducted a mixed-method design service review in five phases to evaluate whether this technological resource could help. After creating video and website materials, they were evaluated by doctors, nurses and a patient/carer group. We also sent out one lightweight TalkCPR video media pad to each practice in Wales. These rechargeable electronic video media pads had communication videos pre-loaded for easy viewing, especially in areas with poor roaming data coverage. RESULTS: Videos were demonstrably acceptable to both patient and carer groups, and improved healthcare professional confidence and understanding. Videos went live on the TalkCPR website, in all Welsh Health Boards and on Youtube, and are now used in routine practice throughout Wales. CONCLUSION: This is the first time that DNACPR information videos are aimed directly at palliative care patients and carers, to explore this sensitive subject with them, and to encourage them to approach their doctor or nurse about it. The website, app and video media pads were developed by patients, the Digital Legacy Association, Welsh NHS IT services, Welsh Government, the Bevan Commission and the Dying Matters Charity in Wales 'Byw Nawr'. The GMC, the Royal College of General Practitioners and NICE have listed TalkCPR as a learning resource. There has also been a collaboration with Falmouth University Art College, who helped produce graphic designs to facilitate and encourage discussions about CPR and end of life care.


Asunto(s)
Reanimación Cardiopulmonar , Cuidados Paliativos , Órdenes de Resucitación , Cuidado Terminal , Reanimación Cardiopulmonar/psicología , Toma de Decisiones , Política de Salud , Investigación sobre Servicios de Salud , Humanos , Consentimiento Informado , Educación del Paciente como Asunto , Órdenes de Resucitación/psicología , Cuidado Terminal/psicología , Grabación en Video , Gales
19.
BMC Palliat Care ; 17(1): 114, 2018 Oct 10.
Artículo en Inglés | MEDLINE | ID: mdl-30305068

RESUMEN

BACKGROUND: As the "do not resuscitate" (DNR) discussion involves communication, this study explored (1) the effects of a title that included "allow natural death", and of information contents and outcomes of the decision; and (2) the information needs and consideration of the DNR decision, and benefits and barriers of the DNR discussion. METHODS: Healthy adults (n = 524) were presented with a scenario with different titles, information contents, and outcomes, and they rated the probability of a DNR decision. A questionnaire including information needs, consideration of the decision, and benefits and barriers of DNR discussion was also used. RESULTS: There was a significantly higher probability of signing the DNR order when the title included "allow natural death" (t = - 4.51, p < 0.001), when comprehensive information was provided (F = 60.64, p < 0.001), and when there were worse outcomes (F = 292.16, p < 0.001). Common information needs included remaining life period and the prognosis. Common barriers were the families' worries and uncertainty about future physical changes. CONCLUSION: The title, information contents, and outcomes may influence the DNR decisions. Health-care providers should address the concept of natural death, provide comprehensive information, and help patients and families to overcome the barriers.


Asunto(s)
Reanimación Cardiopulmonar , Toma de Decisiones , Revelación , Eutanasia Pasiva , Órdenes de Resucitación , Cuidado Terminal , Adulto , Reanimación Cardiopulmonar/ética , Reanimación Cardiopulmonar/psicología , Barreras de Comunicación , Eutanasia Pasiva/ética , Eutanasia Pasiva/psicología , Femenino , Humanos , Masculino , Evaluación de Necesidades , Investigación Cualitativa , Órdenes de Resucitación/ética , Órdenes de Resucitación/psicología , Percepción Social , Taiwán , Cuidado Terminal/ética , Cuidado Terminal/métodos , Cuidado Terminal/psicología , Revelación de la Verdad
20.
Eur J Pediatr ; 177(12): 1859-1862, 2018 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-30196426

RESUMEN

The aim of this study is to describe the experience of parents present in the resuscitation room during the attention given to their children in the pediatric emergency department, and to identify areas for improvement in this regard. This was a prospective study carried out in a third-level pediatric hospital. Children with life-threatening pathologies are treated in the resuscitation room of the pediatric emergency department. A survey was carried out among parents present in the resuscitation room during the period September 2016-August 2017. Excluded were the parents of children that died and those with a language barrier. The parents were interviewed in person or over the phone within 72 h of the care provided in the resuscitation room. Fifty surveys were completed (15 in person and 35 by phone). Forty mothers and 10 fathers responded, with an average age of 41. In the resuscitation room, 39 parents were accompanied by a health professional and 22 were given information about how the resuscitation room operated. The feelings most frequently reported by the parents were nervousness (39) and trust in the healthcare provided (20). All of the parents wished to be present. They felt that their presence was beneficial for the child (46), for themselves (50), and for the healthcare personnel (28).Conclusion: The experience of the parents in our resuscitation room is a positive one. Nevertheless, some aspects need to be improved, such as accompaniment of the parents and the information that they are provided. What is Known: • There is an international recommendation for parental presence during invasive procedures and cardiopulmonary resuscitation. • Few studies have been carried out on how parents in the resuscitation room feel and how they encounter the experience. What is New: • Even though most of the parents feel nervous in the resuscitation room, they expressed confidence in the medical team and they would wish to be present under similar circumstances.


Asunto(s)
Actitud Frente a la Salud , Reanimación Cardiopulmonar/psicología , Padres/psicología , Adulto , Niño , Servicio de Urgencia en Hospital , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Encuestas y Cuestionarios
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