The views and preferences of resuscitated and non-resuscitated patients towards family witnessed resuscitation: A qualitative study.

摘要

BACKGROUND: A number of international studies have explored the views of family members and healthcare professionals on the concept of family witnessed resuscitation (FWR). In contrast the perspective and preferences of patients have been under-researched, particularly in relation to those who have survived resuscitation. OBJECTIVES: To explore the views and preferences of resuscitation survivors and those admitted as emergency cases, as to whether family members should be present at their resuscitation. DESIGN: This paper reports the qualitative findings of a study, whose aim was to explore and describe patients' views and preferences towards family witnessed resuscitation. SETTINGS: Study sites included four acute hospitals in two large cities of the South-West of England. PARTICIPANTS: Based on specific criteria, patients (n=21) who had been successfully resuscitated and individuals presenting to hospital as emergency cases but without the experience of resuscitation (control group n=40) comprised the study population. The groups were matched by age and gender. METHODS: To generate in-depth understanding about the phenomenon under inquiry, qualitative data were collected from face-to-face interviews. All responses were hand written and analysed using recognised qualitative techniques. FINDINGS: From the analysis of data three main themes emerged which captured the experiences and perceptions of participants through: 'being there', 'welfare of others' and 'professionals'management of the event'. While the majority of participants supported the premise of having loved ones present during resuscitation, their motives varied and often related to the needs of families and occasionally themselves. Participants also recognised that healthcare professionals had to exercise discretionary judgements to manage the resuscitation, which could embrace shielding relatives from distressing scenes and dealing with issues of confidentiality. CONCLUSIONS: The study provides a unique understanding of patient preferences of FWR and some of their views begin to contest arguments in the literature. Patients' perspectives suggest both relatives and they themselves benefit in different ways. Although participants recognised that family members had emotional, informational and proximity needs, these had to be balanced with allowing the resuscitation team to manage the clinical emergency and make decisions. It is also evident that not all patients wish their families to be present. Healthcare professionals should therefore strive to identify the wishes of patients and relatives in respect to FWR and facilitate the presence of loved ones as appropriate. Further research into the area is still required.