Surviving Cardiac Arrest: Patients' Experiences of the In-Hospital Phase of Recovery

Abstract

In the UK, cardiac arrest affects approximately 30,000 people in the community annually and the incidence of cardiac arrest in hospitals is currently reported as being 1.6 events per 1000 hospital admissions. Whilst survival to hospital discharge is variable, it is likely to be no more than 10% for out-of-hospital cardiac arrest and 19% for in-hospital cardiac arrest. The survivorship literature has suggested that patients experience a range of cognitive, functional and behavioural impairments, however, contemporary outcome data from the UK has indicated that the numbers of severely brain-injured patients surviving cardiac arrest is actually low. Furthermore a review of the literature revealed that little is known about the recovery experiences of those cardiac arrest survivors who were not apparently brain-injured.

This research inquiry intended to develop an informed understanding of the patients’ experiences of recovery from cardiac arrest. This included their medical and nursing care, their response and adaptation to the extra-ordinary circumstances of their survival, their worries, fears and anxieties and any other matters that that they chose to illuminate. Accordingly, an in-depth, unstructured, qualitative approach was used to interview sixteen patients during their recovery from cardiac arrest whilst they were still in-hospital patients.

Grounded analysis revealed that patients experienced a three-phase recovery process that commenced with (a brief) existentialist phase followed by a calmer, more rational period. During this second phase of recovery patients appeared to develop a coping strategy that followed the salutogenic model (Antonovsky, 1996) that included phase three, the development of recovery milestones which helped them to move away from a position of illness, towards a position of health. The narrative accounts of the patients suggested that the care provision of the medical gaze during the recovery process was variable and inattentive, being that it was principally constructed around its own operational workings, rather than being centred upon the patient.