When resuscitation fails-Nurses' emotions and coping mechanisms after unsuccessful cardiopulmonary resuscitation: An integrative review.

Cardiopulmonary Resuscitation (CPR) is a life-saving procedure that performed when patient’s heart stops beating. Unsuccessful resuscitation that causes death inflicted a strong emotions and feelings, also potentially developed into emotional stress for nurses. Indealingwithstress,each individual has different abilities dependon physical, psychological, behavioral or cognitive sources which called coping mechanisms. This study aimed to describe the coping mechanism and the stress level of nurses after the unsuccessful CPR, along with the relationship between those two variables. The research design used in this study was descriptive correlational with a total sample of 50 Emergency Department and Intensive Care Unit nurses taken by convenient sampling technique from one public hospital in Cimahi. To answer the research question, critical care coping mechanisms questionnaire adapted from Mulyani & Litia were used to measured nurses coping mechanisms. Meanwhile, the stress level of nurses was measured using Perceived Stress Scale (PSS). The data obtained described using frequency and percentages, while the relationship between nurses coping mechanism and the level of stress measured using Pearson’s correlation. The results showed that most 28 (56%) nurses had moderate stress levels, and most 29 (58%) nurses had adaptive coping mechanisms after unsuccessful CPR. Finally, there was a significant relationship between coping mechanism and the level of stress of emergencyandICUnursesafterunsuccessfulCPR(r=-0.348,P=0.013).Hospitals take holder expected to facilitate training and counseling regarding stress management and the use of adaptive coping mechanisms when nurses performedan unsuccessful CPR.

Comparison of computed tomography and autopsy in detection of injuries after unsuccessful cardiopulmonary resuscitation

Perceived stress and coping strategies after unsuccessful cardiopulmonary resuscitation among pre-hospital emergency technicians: A multicenter cross-sectional study

To assess the construct validity and reliability of the Brazilian Portuguese versions of the 29- and 13-item scales of the Antonovsky's Sense of Coherence Scale (SOC-29 and SOC-13). Antonovsky's Sense of Coherence Questionnaire was developed to measure the main construct of the salutogenic theory, the sense of coherence. The use of the sense of coherence by health professionals might help identifying specific coping strategies used by person with chronic illness. Cross-sectional study. The SOC-29 has been culturally adapted to Brazilian Portuguese language. In this study, we assessed its psychometric properties (construct validity and internal reliability) tested on 203 cardiac patients. The SOC-13 was tested on another 100 cardiac patients hospitalised in the same hospital. The construct validity of both versions was investigated through Pearson correlation between the measures of sense of coherence and of correlated constructs (self-esteem, depression and age), analysis of the principal components and comparison of distinct groups (male vs. female). The internal reliability for both versions was evaluated by Cronbach's alpha. For both versions, the construct validity assessments showed strong positive correlations between sense of coherence and self-esteem and strong negative correlations between sense of coherence and depression (convergent validity), and weak correlation between sense of coherence and age (divergent validity). Principal component analysis supported in part the presence of a single component (unidimensionality). Differences in sense of coherence were found by sex with SOC-29, but not with SOC-13. Cronbach's alpha coefficients showed satisfactory internal consistency in both versions. The Brazilian Portuguese versions of SOC-29 and SOC-13 can be considered valid and reliable for the populations studied. More studies need to be performed to assess these proprieties in other Brazilian populations. This scale can be used in research and clinical practice in Brazil to assess nursing interventions aimed at decreasing stress during cardiac rehabilitation.

We have previously concluded that the use of the Antonovsky sense of coherence (SOC) scale was unable to document a predicted strong association between SOC and physical health. By way of statistical methods, numerous studies have investigated the validity, reliability and applicability of the SOC scale with positive results. However, this paper analyses whether the questions in the SOC scale actually represent the universe of factors necessary to describe the phenomenon of SOC, which we believe is an important supplement to the statistically means of investigating validity and reliability. In this paper we explore the idea, the concepts, the theory and the operationalisation behind the SOC Scale. The conclusions are: 1) it seems that Antonovsky's basic idea of coherence, for which he coined the term sense of coherence, as the basis for the highly popular salutogenic orientation is outstandingly good, in spite of the lack of statistical evidence; 2) the chosen key explanatory concepts of comprehensibility, manageability, and meaning, seems to be a fair, although mental, conceptualisation of this idea; 3) Antonovsky's theory was unfortunately much less clear, as Antonovsky assumed predictability to be very important for the sense of coherence, especially for comprehensibility and manageability. This notion of predictability leaves its footprints in his operationalization of SOC into the SOC Scale. Our analysis convinced us that the SOC scale is unlikely to be a fair materialization of the idea of coherence and thus unlikely to measure SOC correctly.

The main aim of the study was to investigate whether the three hypothesized subscales of Antonovsky's sense of coherence (SOC) scale: comprehensibility, meaningfulness and manageability, can be found when measuring SOC in a sample of patients with schizophrenia living in the community. A further aim was to study the relationship between SOC and psychopathology. The concept of SOC has been proposed to explain successful coping with life stressors. A total of 120 patients completed the SOC scale and the Brief Psychiatric Rating Scale (BPRS) was used to assess the psychopathology of the patients. The SOC scale was analysed by means of a factor analysis with a varimax rotation and the Spearman rank correlation test was used to test for associations between subscales, factors and psychiatric symptoms. A four-factor model presented the best solution and explained 48% of the total variation in SOC. The first factor, which included 12-items of the SOC scale, turned out to be the most salient factor explaining 29% of the total variation. All factors displayed some overlapping between items. Affective symptoms were negatively related to all the three subscales and the four factors of SOC, while positive symptoms were similarly related to two of the subscales and two of the factors while negative symptoms were not associated with any of the factors or subscales. The findings in this study corroborate those in studies with other patient groups and indicate that the theoretical framework of SOC should not be adopted uncritically. Furthermore, the use of the three subscales in the SOC scale in studies of patients with a severe mental illness is questioned and a further investigation of the relationship between SOC and psychopathology is proposed.

The present study aimed to clarify how the stress coping strategy of upper-grade elementary school children differ based on Sense of Coherence (SOC) level and sex.A cross-sectional and observational survey was conducted using an anonymous, self-administered questionnaire on all 4-6th grade pupils (n=402) at B Elementary School in A City, Kanagawa Prefecture, in urban area. The questionnaire categorized items related to SOC, 12 items of stress coping strategy, 12 symptoms of physical and mental status, grade and sex. Of the 391 questionnaires collected (collection rate, 97.3%), the 318 questionnaires with complete responses (valid response rate, 79.1%) were analyzed. Analysis was conducted by sex. At first, pupils were divided into low-SOC group and high-SOC group (boys, 68 in low group and 77 in high group ; girls, 91 and 82), and the proportion of pupils adopting each stress coping strategy was compared between the high and low SOC groups. Multiple logistic regression analysis was then conducted with each stress coping strategy as the dependent variable, SOC level as the independent variable and physical and mental symptoms and grade as control variables.Among boys, a significant correlation was observed between SOC and the coping strategy of“ask someone what to do” (odds ratio[OR], 2.48 ; 95% confidence interval[CI], 1.03-5.96 ; p=0.043), clarifying that this coping strategy was easier to adopt for the high-SOC group compared to the low-SOC group. Conversely, among girls, a significant correlation was observed between SOC and“spend time alone” (OR, 0.40 ; 95% CI, 0.19-0.83 ; p=0.014), clarifying that the high-SOC group was less likely to adopt this coping strategy than the low-SOC group.The present findings indicate that the relationship between SOC and stress coping strategy among upper-grade elementary school children differs between boys and girls. Boys with high SOC easily adopt the coping strategy of asking for help from those around them, while girls with high SOC find it harder to adopt the coping strategy of spending time alone.

CPR-related rib and sternum fractures after unsuccessful resuscitation by means of manual or mechanical chest compressions with the LUCAS™ device

The COVID‐19 lockdown experience is a unique and unexpected stressful life situation. In our research project, we explored gender differences in the mean level of stress appraisal (SAQ), the frequency of stress coping strategies (COPE), and the sense of coherence (SOC), as well as gender differences in the strength of the relationships between SAQ, COPE, and SOC during the COVID‐19 lockdown. Finally, we tested if stressor appraisal (as a threat, harm/loss, or challenge) mediates the relationship between SOC and COPE in women and men respectively. Data were collected during the first wave of the COVID‐19 lockdown in Poland in 2020. An online survey was conducted among 326 adults aged between 18 and 72. We observed gender differences in the level of SAQ, COPE, and SOC and gender differences in the significance and strength of the correlations between these variables. SOC had a twofold effect on COPE in men: direct and indirect through SOC‐threat and SOC‐harm/loss. In women, SOC did not directly predict COPE frequency but affected COPE in an indirect way through SAQ. SAQ is an important factor that modifies the strength of the SOC effect on COPE in women and men during the lockdown.

To test the hypothesis that Antonovsky's concept of sense of coherence (SOC) predicts stressful events, coping strategies, health status, and quality of life (QoL) in a cohort of postmenopausal women (n = 131) with newly diagnosed primary or recurrent breast cancer. Regression analyses of longitudinal data at baseline through 6 months following breast cancer diagnosis examined the relationships between SOC (13-item version), daily assessment of coping with stressful events, health status, and QoL (EORTC QLQ-30). The findings support Antonovsky's concept of SOC. Women with strong SOC reported fewer stressful events and more days without stressful events. They used more coping strategies and more frequently used distraction, situation redefinition, direct action, and relaxation, but seldom religion, to cope with stressful events, and reported better health status and QoL. Women with weak SOC experienced more distress and used fewer coping strategies, and they more frequently used coping strategies such as catharsis and seeking social and spiritual support, but seldom acceptance of the situation. They reported worse health status and QoL, regardless of disease stage or treatment. The relationships between SOC and health status and QoL were linear. Sense of coherence significantly predicts distress, number and type of coping strategies such as direct action and relaxation, health status, and QoL in women with breast cancer. Our data suggest that the SOC scale may be a useful screening tool to identify individuals particularly vulnerable to distress and unable to cope adequately. Assessing SOC strength may assist health care providers to provide individualized patient interventions.

To assess the relationship between mothers' Sense of Coherence (SOC) and oral health related quality of life (OHRQoL) of 3-5 year old preschool children in Udupi Taluk. 388 mothers aged 24-48 years old and their preschool children. A cross sectional study of mother-child pairs, randomly selected from 8 preschools. Information was obtained about mothers' sociodemographic factors along with the short version (SOC 13) of Antonovsky's sense of coherence scale and children's OHRQoL using the early childhood oral health impact scale (ECOHIS). Chi-square tests and multivariate logistic regression were used for analysis. Mothers' SOC and children's OHRQoL. Mothers' SOC and fathers' education were significantly associated with children's OHRQoL in multivariate analysis. Children of mothers with high SOC were 12.9 times as likely to have high OHRQoL as mothers with low SOC (p < 0.01). Children of fathers with college/university education were twice as likely to have high OHRQoL as those with primary education (p < 0.05). Our results suggest that mother's SOC could be a psychosocial determinant of the OHRQoL of their preschool children. Family environment should be considered when designing interventions to promote or improve the oral health as well as OHRQoL of preschool children.

To determine the epidemiology of death in PICUs at 5 geographically diverse teaching hospitals across the United States. Prospective case series. Five U.S. teaching hospitals. We concurrently identified 192 consecutive patients who died prior to discharge from the PICU. Each site enrolled between 24 and 50 patients. Each PICU had similar organizational and staffing structures. None. The overall mortality rate was 2.39% (range, 1.85-3.38%). One hundred thirty-three patients (70%) died following the withholding or withdrawal of life-sustaining treatments, 30 (16%) were diagnosed as brain dead, and 26 (14%) died following an unsuccessful resuscitation attempt. Fifty-seven percent of all deaths occurred within the first week of admission; these patients, who were more likely to have new onset illnesses or injuries, included the majority of those who died following unsuccessful cardiopulmonary resuscitation attempts or brain death diagnoses. Patients who died beyond 1-week length of stay in the PICU were more likely to have preexisting diagnoses, to be technology dependent prior to admission, and to have died following the withdrawal of life-sustaining treatment. Only 64% of the patients who died following the withholding or withdrawing of life support had a formal do-not-resuscitate order in place at the time of their death. The mode of death in the PICU is proportionally similar to that reported over the past two decades, while the mortality rate has nearly halved. Death is largely characterized by two fairly distinct profiles that are associated with whether death occurs within or beyond 1-week length of stay. Decisions not to resuscitate are often made in the absence of a formal do-not-resuscitate order. These data have implications for future quality improvement initiatives, especially around palliative care, end-of-life decision making, and organ donation.

In Antonovsky's salutogenic theory, the major concept sense of coherence (SOC) is constituted of three core components called comprehensibility, manageability, and meaningfulness. Several scales that are intended to measure SOC are available and used by researchers in health and caring sciences all over the world. When using a scale, evidence of its quality in different study groups is needed in order to get reliable and valid data. The aim of this study was to test reliability and construct validity of the Swedish version of Antonovsky's original 29-item sense of coherence (SOC) scale in a group of physically active older people. The scale was tested with a convenience sample of 140 physically active older individuals, who took part in different fitness-training groups in eastern Sweden. Reliability was assessed as item to total correlations and with the Cronbach's alpha coefficient. Construct validity was assessed with the known groups technique, confirmatory factor analysis, and with logistic regression analysis. The results showed that in the studied group of older individuals, the instrument was a very reliable tool with a Cronbach's alpha coefficient of 0.92. Construct validity of the scale was supported by the fact that the global concept sense of coherence was found to be hierarchically organized in a model that consisted of the three core components of comprehensibility, manageability, and meaningfulness. Furthermore, perceived health could be explained to some degree by sense of coherence, but even more by comprehensibility, in both cases independently of chronological age. The results clearly corroborated Antonovsky's theory.

No specific drug therapy has been shown to improve long-term survival after cardiac arrest, and only few drugs have a proven benefit for short-term survival. This study reviews recent studies on drugs during cardiopulmonary resuscitation. Epinephrine is the first-line vasopressor during cardiopulmonary resuscitation. Arginine vasopressin may be more effective than epinephrine in patients presenting with asystole or as a second vasopressor in refractory cardiac arrest. Sodium bicarbonate should not be 'blindly' administered during cardiopulmonary resuscitation unless an arterial blood gas analysis can be obtained or after prolonged unsuccessful cardiopulmonary resuscitation. Amiodarone may improve short-term survival. Thrombolytic therapy during cardiopulmonary resuscitation may be beneficial if a pulmonary embolism or acute myocardial infarction is suggested to be the cause of cardiac arrest. Epinephrine is the vasopressor of first choice for routine use during cardiopulmonary resuscitation. Arginine vasopressin may be considered in patients presenting with asystole or who are unresponsive to initial treatment with epinephrine. Amiodarone should be used in shock-refractory ventricular fibrillation. Although not recommended for routine use, thrombolytic therapy during cardiopulmonary resuscitation may be considered in patients with suspected pulmonary embolism or after unsuccessful conventional cardiopulmonary resuscitation in patients with a presumably thrombotic cause of cardiac arrest.

Objectives: The present study investigated the relationship between Antonovsky's sense of coherence (SOC) and well-being in a sample of Flemish elderly. In addition, the mediating role of Erikson's developmental task of integrity versus despair was examined in the relationship between SOC, depression, and life satisfaction. Method: Data on sociodemographic variables, SOC, depressive symptoms, life satisfaction, ego-integrity, and despair were collected. In total, 100 older persons with a mean age of 76.5 years participated. Mplus was used to test the mediating role of integrity and despair in the relationship between SOC and both life satisfaction and depression. Results: A positive relationship between SOC and well-being was found. More precisely, elderly individuals with a strong SOC experienced less depressive symptoms and higher levels of satisfaction with their life. In addition, mediation analysis indicated that the relationship between SOC and depressive symptoms was partially mediated by the positive resolution of the integrity–despair crisis, whereas the relationship between SOC and life satisfaction was fully mediated by integrity and despair. Conclusion: Our findings indicate that SOC might be a resource for greater well-being in the elderly. Furthermore, our study offers a partial explanation for the relations found and points to the importance of finding integrity and resolving despair in this stage of life.