Family witnessed resuscitation : is it beneficial to the relatives?

Abstract

This dissertation aims to explore, whether the option of family witnessed resuscitation (F.W.R) would enhance the relatives' acceptance of the outcome of a resuscitation effort. This practice ignited considerable controversy worldwide, as in reality it is stressful both to the relatives and the health carers who are to provide their support. Since relatives and patients are all individuals with their own attitudes and beliefs, it is difficult to establish a protocol that suits everybody. These important issues led the author to investigate this phenomenon by using the PICO framework, and to the clear question: In adult critically ill patients, would having relatives present during resuscitation, rather than keeping them outside, result in better acceptance of the outcome? A literature search regarding the subject was carried out. Various opinion reports were found and 2 RCTs and 5 descriptive design studies were chosen. It was evident that surveys were mostly used to investigate such practice. Due to the nature of the subject, the qualitative studies used convenience samples with a limited number of participants. Various approvals and ethical considerations were taken by the researchers especially when investigating relatives of patients who had died. The CASP tool for qualitative studies and RCTs were used as guidelines for appraising the relevant studies. The findings suggest that F.W.R is beneficial because it enhances family connectedness and the needed reassurance to the patient. Moreover it ascertains that everything possible was done for the patient. However, there are certain factors that need to be considered prior to implementing this practice. It is suggested that relatives are to be given the option whether to stay. Ideally their opinion is sought prior to the patient's admittance to the resuscitation room. The relatives should be accompanied by a trained professional person who leads and escorts them at all times. The staff also needs to be given the necessary training so as to feel confident to work within such a stressful witnessed environment. Key words in relation with the research question are: resuscitation, stress, attitudes, believes, reassurance, connectedness and psychological influences.