Families’ Stressors and Needs at Time of Cardio-Pulmonary Resuscitation: A Jordanian Perspective

Abstract

Background:During cardio-pulmonary resuscitation, family members, in some hospitals, are usually pushed to stay out of the resuscitation room. However, growing literature implies that family presence during resuscitation could be beneficial. Previous literature shows controversial belief whether or not a family member should be present during resuscitation of their relative. Some worldwide association such as the American Heart Association supports family-witnessed resuscitation and urge hospitals to develop policies to ease this process. The opinions on family-witnessed resuscitation vary widely among various cultures, and some hospitals are not applying such polices yet. This study explores family members’ needs during resuscitation in adult critical care settings.Methods:This is a part of larger study. The study was conducted in six hospitals in two major Jordanian cities. A purposive sample of seven family members, who had experience of having a resuscitated relative, was recruited over a period of six months. Semi-structured interview was utilised as the main data collection method in the study.Findings: The study findings revealed three main categories: families’ need for reassurance; families’ need for proximity; and families’ need for support. The need for information about patient’s condition was the most important need. Updating family members about patient’s condition would reduce their tension and improve their acceptance for the end result of resuscitation. All interviewed family members wanted the option to stay beside their loved one at end stage of their life. Distinctively, most of family members want this option for some religious and cultural reasons such as praying and supplicating to support their loved one.Conclusions:This study emphasizes the importance of considering the cultural and religious dimensions in any family-witnessed resuscitation programs. The study recommends that family members of resuscitated patients should be treated properly by professional communication and involving them in the treatment process. The implications concentrate on producing specific guidelines for allowing family-witnessed resuscitation in the Jordanian context. Finally, attaining these needs will in turn decrease stress of those witnessing resuscitation of their relative.

Presence of the Family During Emergency Care: Patient and Family Living

“…This was described by relatives as a propeller of feelings such as calmness and security, for they were aware of the events that involved caring for their loved one. 12 The fact that relatives report doubts about emergency care seems to be a central issue in the studies. That is because, Chilean family members also pointed out that, when they attended the service, they perceived how little communication between the professional and the family, forcing them to interpret the language that the team used to capture more information.…”

“…11 It is understood that the care in the ER should not be focused exclusively on the aggravations that triggered the search for the service and, also, dissociated from the care to the family of the patient. Scientific evidence suggests that professionals need to provide family members with the possibility of witnessing care because, thus, it is possible better understand the severity of the event, 8,12 suffer less with anxiety and post-traumatic stress disorder 13 and to elaborate more easily the process of mourning, when unavoidable. 6,14 For the patients, the presence of the family during emergency care promotes a greater sense of security, comfort and support.…”

Meanings attributed by family and patients to family presence in emergency rooms

“…Specifically in relation to family presence during care at ER, professionals should consider that, commonly, relatives seek these services through unexpected events, grave, almost always surrounded by fanciful thoughts and that can definitively modify their lives (11) . In this sense, relatives of patients in critical and emergency situations, when investigated, demonstrate a need for information, support, comfort and closeness to see and even touch their loved one, to say a final good-bye and to make sure that all possible is being done (9,12) . In addition, relatives and patients express not only a desire, but the perception that they have the right to experience emergency care with family presence (8,11,13) .…”

Family Presence During Resuscitation Benefits-Risks Scale (FPDR-BRS): Instrument Development and Psychometric Validation

“…1 Remarkably, approximately 70% of relatives prefer to be present during health-related procedures including resuscitation, 2 and studies have presented various implications of familywitnessed resuscitation. 3,4 Family-centered care is a universally recognized standard that aims to improve patient safety, satisfaction, and outcomes.…”

“…(2) What are the core dimensions of family perception of FPDR? and (3) What is the parsimonious item pool that accurately and reliably represents these identified dimensions?…”