METHODS: A seven-step meta-ethnography and synthesis of qualitative evidence was undertaken, informed by the Meta-Ethnography Reporting Guidelines (eMERGe). Four major databases were searched (Medline, EMBASE, CINAHL, PsycINFO; January 1995-January 2022, updated July 2023) for qualitative studies exploring survivors\' and/or key supporters\' experiences of cardiac arrest survival. The Critical Appraisal Skills Programme checklist and Grading of Recommendations Assessment, Development and Evaluation - Confidence in Evidence from Reviews of Qualitative Research (GRADE-CERQual) were applied to evaluate the overall confidence in research findings. Constructs were identified from each paper, informing theme and sub-theme development.
RESULTS: From 15,917 unique titles/abstracts and 196 full-text articles, 32 met the inclusion criteria. Three themes captured the survivors\' experiences: 1) Making sense of my cardiac arrest; 2) Learning to trust my body and mind; and 3) Re-evaluating my life. A further three themes reflected key supporters\' experiences: 1) Emotional turmoil; 2) Becoming a carer: same person but different me; and 3) Engaging with a new and unknown world. However, limited data and some methodological weaknesses in included studies reduced confidence in several themes. The findings were conceived within the overarching concept of \'negotiating a new normal\'.
CONCLUSIONS: The enduring psychosocial and physical sequelae of cardiac arrest survival substantially impacts the lives of survivors and their key supporters, requiring negotiation of their \'new normality\'. The need for sense-making, physical and psychological recovery, and the new roles for key supporters should be strong considerations in the development of future interventions.
方法:进行了七步人种学和定性证据综合,由荟萃人种学报告指南(eMERGe)通知。搜索了四个主要数据库(Medline,EMBASE,CINAHL,PsycINFO;1995年1月至2022年1月,2023年7月更新)用于定性研究,探索幸存者和/或主要支持者的心脏骤停生存经验。关键评估技能计划清单和建议评估分级,开发和评估-定性研究评论(GRADE-CERQual)对证据的信心用于评估对研究结果的总体信心。从每篇论文中确定了构造,告知主题和子主题的发展。
结果:从15,917个独特的标题/摘要和196个全文文章中,32符合纳入标准。三个主题捕捉到了幸存者的经历:1)了解我的心脏骤停;2)学会信任我的身心;3)重新评估我的生活。另外三个主题反映了主要支持者的经历:1)情绪动荡;2)成为照顾者:同一个人,但我不同;3)参与一个新的未知世界。然而,有限的数据和纳入研究中的一些方法学缺陷降低了对几个主题的信心。这些发现是在“谈判新常态”的总体概念内构思的。
结论:心脏骤停生存的持久心理和生理后遗症极大地影响了幸存者及其主要支持者的生命,需要谈判他们的“新常态”。理智的需要,身体和心理的恢复,关键支持者的新角色应该是未来干预措施发展的重要考虑因素。