WHAT ARE THE CARE NEEDS OF FAMILIESEXPERIENCING SUDDEN CARDIAC ARREST? ASURVIVOR- AND FAMILY-PERFORMEDSYSTEMATIC REVIEW, QUALITATIVEMETA-SYNTHESIS, AND CLINICAL PRACTICERECOMMENDATIONS

Abstract
Introduction: Cardiac arrest care systems are being designed and implemented to address patients’, family members’, and survivors’ care needs. We conducted a systematic review and a meta-synthesis to understand family experiences and care needs during cardiac arrest care to create treatment recommendations. Methods: We searched eight electronic databases to identify articles. Study findings were extracted, coded, and synthesized. Confidence in the quality, coherence, relevance, and adequacy of data underpinning the resulting findings was assessed using GRADE-CERQual methods.Results: In total 4181 studies were screened, and 39 met our inclusion criteria; these studies enrolled 215 survivors and 418 family participants—which includes both co-survivors and bereaved family members. From these studies findings and participant data we identified 5 major analytical themes: (1) When the crisis begins we must respond; (2) Anguish from uncertainty, we need to understand; (3) Partnering in care, we have much to offer; (4) The crisis surrounding the victim, ignore us, the family, no longer; (5) Our family’s emergency is not over, now is when we need help the most. Confidence in the evidence statements are provided along with our review findings.

Discussion: The family experience of cardiac arrest care is often chaotic, distressing, complex and the aftereffects are long-lasting. Patient and family experiences could be improved for many people. High certainty family care needs identified in this review include rapid recognition and response, improved informationsharing, more effective communication, supported presence and participation, or supported absence, and psychological aftercare.

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