Family Members Of High-risk Patients Research Articles

The effectiveness of different educational interventions in reducing the prehospital delay of patients with coronary artery disease: a systematic review

Abstract Funding Acknowledgements Type of funding sources: None. Background/Introduction Recognizing symptoms of coronary artery disease (CAD) is important and challenging for CAD patients. Failure in detecting the related symptoms may lead to prehospital delay and decelerate the golden time of ischemic reperfusion. Purpose The purpose of the systematic review aims to evaluate types of education programs (through randomized control trial) of their effectiveness on reducing prehospital delay regarding CAD. Method The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was adopted to proceed this review. We searched from Pubmed, Cochrane Library, Scopus, CINAHL and EMBASE using a combination of free text words and Medical Subject Headings guided by the PICO framework. The abstracts and full-text screening were peer-reviewed by two reviewers. Results A total of 722 records were identified through database searching of which 11 randomized controlled trials were finally included into this review (n = 38773). The Cochrane Risk of Bias assessment tool 2.0 was utilized to examine the methodological quality of the included studies. Eight out of 11 studies conducted one by one individualized-educational intervention program (n = 11007); two studies used mass media campaign for the general public education program (n = 24753), and one study used the community-based educational intervention model (n = 3031). Of the three types of education models, the one to one individualized-educational intervention was found to be the most effective model to have reduce prehospital delay time shorter ranged from 30-60 minutes in the experimental groups while comparing to the control groups. Conclusion Individualized-educational program is found to be the most effective intervention to reduce prehospital delay for CAD patients. Health care providers are encouraged to apply one to one educational program in term of reducing prehospital delay for CAD patients both in clinical and community setting. Moreover, family members of high-risk patients are suggested to be included in a step-by-step action plan that eliminates the wait and see approach to reach medical support.

Targeted cardiopulmonary resuscitation training focused on the family members of high-risk patients at a regional medical center: A comparison between family members of high-risk and no-risk patients.

We developed a hospital-based cardiopulmonary resuscitation (CPR) training model focused on the target population (family members of patients with potential risks for cardiac arrest) and compared the outcome of CPR training between target and non-target populations for validity. Family members of patients in training were divided into three groups on the basis of patients' diseases, as follows: 1) the cardio-specific (CS) risk group, including family members of patients with cardiac disease at risk of cardiac arrest; 2) the cardiovascular (CV) risk group, including family members of patients with risk factors for cardiovascular disease; and 3) the no-risk group. Pre- and posttraining surveys and skill tests as well as a post-training 3-month telephone survey were conducted. Educational outcomes were analyzed. A total of 203 family members were enrolled into 21 CPR training classes. The CS group (n=88) included elderly persons and housewives with a lower level of education compared with the CV (n=79) and no-risk groups (n=36). The CS group was motivated by healthcare professionals and participated in the training course. The CS, CV, and no-risk groups showed improvements in knowledge, willingness to perform CPR, and skills. Despite the older age and lower level of education in the CS group, the effects of education were similar to those in the other groups. A high rate of response and secondary propagation of CPR training were observed in the CS group. Family members of patients with heart disease could be an appropriate target population for CPR training, particularly in terms of recruitment and secondary propagation. Targeted intervention may be an effective training strategy to improve bystander CPR rates.

A systematic review of basic life support training targeting family members of high-risk patients

A systematic review of basic life support training targeting family members of high-risk patients

Evaluation of knowledge and skills training of cardiopulmonary resuscitation in families of high-risk patients with sudden cardiac death

Objective To find an optimal mode for cardiopulmonary resuscitation (CPR) skills training to family members of high-risk patients with sudden cardiac death (SCD).Methods Totals of 132 family members of high risk patients of SCD were recruited with convenient sampling method.After an upgraded training procedure was applied to them,their CPR knowledge was tested immediately.Results Among 132 family members,76.5％ of the trainees passed the test in terms of CPR knowledge with a mean knowledge score (11.46 ± 1.84),items with lower correct rates on airway opening (75.8％),activating of EMS (76.5％),chest compression frequency (79.6％),and mouth-to-mouth resuscitation (84.1％).And 87.8％ of the trainees passed CPR skill test with a mean skill score (22.9 ± 1.24),items had lower correct rates on airway opening(87.1％),breathing (88.6％) and blowing effect (81.8％).Conclusions The upgraded procedure can raise the pass ratio of CPR training,and the relevance training on the artificial respiration is the difficulty key. Key words: Sudden cardiac death ; Cardiopulmonary resuscitation ; Training; Effect

Abstract 19508: Remote Supervised Reinforcement of Cardiopulmonary Resuscitation Skills by Telephone Improves One-Year Retention: A Randomized-Controlled Trial

Objective: Bystander CPR is an effective way of improving the outcome of out of hospital cardiac arrest (OHCA). However, the survival rate of OHCA remains < 10% due to rapid skill deterioration following CPR training. We explored the effect of two remote supervised review models (audio-visual [AV] and audio-visual-practice [AVP]) on CPR skill retention. Method: Family members of patients at high risk of sudden cardiac arrest (SCA) were recruited from communities in Beijing, China. All subjects received a 90-min CPR course, and a CPR instruction booklet for review at home as needed. At the end of the course, if the subjects passed the skill test, they were randomized into one of the 3 groups (AV, AVP, and control) using sealed envelopes. The AV group was provided with a CPR instruction video (CPR-V) and asked to watch it every 3 months. The AVP group was provided with a practice dummy (designed for the project) as well as a CPR-V, and asked to practice their skills on the dummy while watching the CPR-V every 3 months. Both groups were given telephone follow up every 3 months to encourage compliance. The controls were given a placebo video without follow up. CPR skills were re-assessed after 12 months using Resusci Anne recording manikins. The subjects, the instructors, and the evaluators were blinded to the group assignment. Results: Of the 262 family members who finished the study, the retention rates of overall, and key elements of CPR skills were significantly higher in the AVP and AV groups, compared to the control group. Skill retention was higher in the AVP group compared to the AV group. Conclusion: Both review models improved long-term CPR skill retention for family members of high-risk patients with SCA. The AVP model was more effective than the AV model especially for skills related to performing high quality chest compression.

Psychologic effects of automated external defibrillator training: A randomized trial

Objective The objective of this study was to test whether an automated external defibrillator (AED) training program would positively affect the mental health of family members of high-risk patients. Methods A total of 305 patients with ischemic heart disease and their family members were randomized to 1 of 4 AED training programs: 2 video-based training programs and 2 face-to-face training programs that emphasized self-efficacy and perceived control. Patients and family members were surveyed at baseline and 3 and 9 months postischemic event on demographic characteristics, measures of quality of life (Short Form-36), self-efficacy, and perceived control. For this study, family members were the focus rather than the patients. Results Regression analyses showed that family members in the face-to-face training programs did not score better on any of the mental health status variables than family members who participated in the other training programs except for an increase in self-efficacy beliefs at 3 months after training. Conclusion The findings suggest that a specifically designed AED training program emphasizing self-efficacy and perceived control beliefs is not likely to enhance family member mental health.

From concept to standard-of-care? Review of the clinical experience with automated external defibrillators.

There is now both national and international acceptance of the "principle of early defibrillation," which contends that whoever arrives first at the scene of a cardiac arrest should have a defibrillator. The almost revolutionary technological event that permits widespread implementation of this principle has been the development of automated external defibrillators (AEDs). The simplicity, accuracy, and safety of these devices markedly expands the range of people who can deliver early defibrillation, which includes minimally trained emergency personnel, lay and community responders, and family members of high-risk patients. Even though AEDs now approach the status of "standard of care," the AED, as an example of a new technology, has not followed the classic technology paradigm: conceptualization, experimentation, dissemination, and standard of care. Instead, like many other technical innovations in emergency medicine, the development of AEDs proceeded simultaneously on many fronts, and implementation often occurred before confirmation of important subissues. AEDs may experience the life cycle of many new ideas: initial enthusiasm and widespread adoption, followed by disillusionment and rejection, and finally a mature, proper perspective. Careful implementation and continued evaluation may help emergency personnel avoid periods of disillusionment with AEDs and move steadily and uneventfully to a proper perspective.